Congratulations, you made it. With birthday candles coming 24 candles to a pack, you and I both now need 3 packs of candles. Lucky you, you’re now also part of the Medicare Club. And, as a member of the club myself, “Welcome.”
The question that so many of our clients begin with is a basic one: “How do I get my Medicare card?” Some people also ask and another question when it comes to their Medicare card, “Should I get my Medicare card now or wait until I retire?” We will address this second question later in this presentation.
People usually become eligible to apply for their Medicare card at the beginning of the month that is three months before the month in which they turn 65. So, if your birthday is November 19, then, working backwards, you can apply for your Medicare card as soon as August 1. The latest date to apply is 3 months past your birth month. In our example counting forward three months, your Medicare enrollment period would end February 28th. Your Medicare sign-up period adds up to 7 months in total, three months before your birth month, your actual birth month and then three months after your birth month.
If, in our November 19th birthday example, you apply for your card at any time prior to November 1 then your Medicare will start on the first day of November. It doesn’t matter what your actual birth date in the month is, everyone starts on the 1st.
With a strange exception. If your birthday is on the first of a month such as November 1 then your Medicare will start not on November 1 but on October 1, and your sign-up period will also begin a month earlier on July 1. The government, of course, has a very good reason why they set up this strange first-of-the-month birthday rule. But nobody knows what it is.
Generally, you need to be 65 years old or older to have Medicare. An exception is that people who have been disabled for at least 24 months can join Medicare at any adult age.
There are two Parts to Medicare. Part A which is mainly hospital coverage and Part B which is doctors and most everything else. Part A has no cost as long as you or your spouse have worked at least 10 years. Part B has a cost of $202.90 a month, in 2026, for most people who are not above the high-income threshold where you pay an extra amount called IRMAA.
The usual way to sign up for Medicare is through the Social Security website, SSA.gov or at your MySocialSecurity.gov page. You can also sign up on the phone at 800-772-1213. Expect a long, long hold. You can also sign up by making an appointment at a Social Security office. If you have any complicating circumstances, such as that you are a naturalized citizen, an appointment would be highly recommended.
If you intend to continue working and plan to keep your Group Health Insurance, then you can still sign up for just Part A, which has no cost, and because you get some benefits, you should probably should do so. It provides secondary coverage to your Group Health Insurance and could help to pay part of your hospital deductible with your Group Health plan. The exception is that people paying into an HSA, Health Savings Account, should not sign up for Part A as doing so will likely trigger tax penalties. If you don’t know what an HSA is, you most likely aren’t paying into one.
If you are not in a Group Health Plan you will want to sign up for both Parts A and Part B. You will need both Parts A and B for Medicare to be your primary coverage. Medicare also has another confusing rule impacting those in Group Health plans with less than 20 employees. If there are less than 20 employees where you work then Medicare becomes the primary provider, not your Group Health plan, meaning you will probably need to have Part B. Consult your HR department, or us, if this is the case.
If you are turning 65 and continuing to work, you should compare the cost and benefits of Group Health with the cost and benefits of a Medicare plan. Medicare often presents the better value. If you are IRMAA high income, or have a spouse under age 65 requiring you to keep with your Group plan, then you will likely however want to delay enrolling into Medicare.
