Medicare at 65, without the expensive surprises.
Whether to sign up while you’re still working. What Part B will really cost you. Whether the income surcharge applies. Plain rules with the numbers attached, free calculators, and a no-cost conversation when you want one.
- Figures verified for 2026
- We don’t sell insurance
- Statewide by phone or video
Tell us which describes you and we’ll set up a no-cost review
Three situations, three different answers
Most people turning 65 fit one of these. Pick yours and the rules, the dates, and the costs are on one page.
Do I have to sign up?
Twenty or more employees and you can wait. Fewer, and Medicare is already your primary insurance.
Read the guide →
How do I cover the gap?
Three years of coverage to bridge, priced after the 2026 marketplace change.
Read the guide →
When exactly do I enroll?
Seven months, eight months, and the penalty that never expires if you miss them.
Read the guide →Your coverage at 65: what changes depending on where it comes from
The single most important fact is who pays first. That decides whether you can wait on Part B, and whether waiting costs you.
| Question | ●Employer plan, 20+ employees | ●Employer plan, under 20 | ●COBRA or retiree plan | ●Marketplace (ACA) |
|---|---|---|---|---|
| Can you delay Part B without penalty?Only current employment coverage stops the clock. | Yes | No | No | No |
| Who pays first once you are 65?If Medicare is primary and you skipped it, you hold the bill. | Employer plan | Medicare | Medicare | Medicare |
| Special Enrollment Period later?8 months from the end of the job or the coverage. | Yes | From the job only | No | No |
| Keeps your subsidy or employer contribution?Marketplace subsidies end at Part A eligibility. | Yes | Yes | You pay it all | No |
| Can you keep contributing to an HSA?Any Medicare enrollment ends it; Part A backdates 6 months. | If you delay Part A too | No | No | No |
TRICARE For Life requires Part B at 65. VA care does not count as creditable for Part B. Details in the still-working guide.
Calculators that show their work
Each one states the rule it applies and shows worked examples you can check by hand. Nothing you type leaves your browser, and no result is hidden behind a form.
Open the tools- 1Open →
Income surcharge (IRMAA) calculator
Your tier from your 2024 return, and what a Roth conversion would add two years later.
- 2Open →
Enrollment window calculator
Initial Enrollment Period, start date, Medigap window, and the still-working window from your birthday.
- 3Open →
Part B penalty calculator
Two years late is $40.58 a month at 2026 rates, about $9,739 over twenty years.
- 4Open →
Part D penalty calculator
1% of $38.99 per uncovered month, rounded to the dime, for life.
- 5Open →
Still-working checker
Four questions, matched to the rules for your coverage.
Six decisions, one page each
- Read →
Still working at 65
The 20-employee rule, who pays first, and the 8-month window that starts when you stop.
- Read →
Windows and penalties
Seven months, eight months, and the 10%-a-year penalty that never expires.
- Read →
The income surcharge
Two-year lookback, six tiers, and the appeal form for the year you retire.
- Read →
Retiring before 65
COBRA, the marketplace after the 2026 subsidy change, and gap-year income.
- Read →
Medigap vs. Advantage
Which door you want to be able to walk back through.
- Read →
Medicare and your HSA
The six-month lookback and the exact month to stop.
Built for the way Utah retires
Hill Air Force Base retirees moving from TRICARE to TRICARE For Life, which requires Part B. State, school-district, and university employees deciding between PEHP retiree coverage and Medicare. Intermountain and University of Utah Health staff working past 65 on large-employer plans. Early retirees in St. George pricing three years of marketplace coverage. The rules are federal; the situations are local.
Free local help that is not a sales call
Three places to get answers without being sold anything. We are independent and not affiliated with any of them.
- Utah SHIP
- Senior Health Insurance Information Program counselors: 1-800-541-7735
- Social Security
- Enrollment: ssa.gov/medicare or 1-800-772-1213
- Medicare
- 1-800-MEDICARE and the plan finder at medicare.gov
Three steps, no sales pitch
Run the numbers
Use the calculators with your birth date, your work situation, and your 2024 return. Five minutes.
Read the one guide that is yours
Most people need exactly one: still working, before 65, or the surcharge. Each has the rule, the cost, and the sources.
Talk it through if you want to
A no-cost consultation with an independent advisory firm covers timing, income sequencing, and the surcharge appeal. We do not sell plans.
Questions people ask before they call
Is it mandatory to sign up for Medicare at age 65?
No, but the penalties make it feel that way. Without coverage from current employment at a 20+ employer, the Part B late penalty (10% per year, for life) starts when your 7-month Initial Enrollment Period ends. With that coverage, you can delay and get an 8-month window when the job ends.
How much do I have to pay for Medicare when I turn 65?
Part A is premium-free for most people. Part B is $202.90 a month in 2026 ($283 annual deductible), more if your 2024 income was above $109,000 single or $218,000 joint. Part D and Medigap or Advantage premiums are on top.
What are the biggest mistakes people make with Medicare?
Staying on COBRA or a retiree plan past 65 and missing the Part B window; forgetting that Part A backdates six months into HSA contributions; choosing an Advantage plan without knowing the Medigap window closes; and a big income year at 63 that becomes a surcharge at 65.
What happens if you don’t sign up for Medicare at 65?
If you have qualifying employer coverage: nothing until it ends. If you don’t: the Part B penalty accrues, marketplace subsidies stop, a Part D penalty may start after 63 days, and you may wait until the next January–March General Enrollment Period for coverage.
Do I need Medicare if I have insurance through work?
Part B, no, if the employer has 20 or more employees and the coverage is from current employment. Part A, usually yes, unless you contribute to an HSA. Under 20 employees, enroll in both at 65.
Does this site sell Medicare plans?
No. We do not sell insurance and are not affiliated with Medicare. The guides and calculators are free; if you request a consultation, we refer you to an independent advisory firm for retirement-income and surcharge planning, and we are paid for that referral. Plan questions go to a licensed agent or Utah’s SHIP counselors.
Talk it through before you decide
Bring your birth date, your work situation, and last year’s tax return. Leave knowing your enrollment window, what Medicare will cost you, and whether the income surcharge applies.
- No-cost, no-obligation consultation
- Statewide by phone or video
- Education first — no plans sold here
Request your no-cost consultation
Tell us how to reach you — we follow up within one business day.