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MedicareFAQ
Turning 65 Medicare Checklist
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Navigating Medicare at 65? Use our step-by-step checklist to avoid penalties, choose the right plan, and ensure comprehensive coverage.
Hey, thanks for joining us on the podcast with Elite Insurance Partners. Imagine um getting a bill for an extra $240 every single year for the rest of your life, all because you missed a deadline by like three weeks.
SPEAKER_01Oh, yeah. It happens way more often than you'd think.
SPEAKER_00Right. Well, the mission of this duck dive today is to help you conquer that daunting turning 65 Medicare checklists so you can avoid those lifelong premium penalties and, you know, completely bypass coverage gaps in 2026.
SPEAKER_01Aaron Ross Powell Exactly. Because people spend, I mean, months researching a new car or a TV, but they let their Medicare enrollment just slip. And missing this deadline isn't a slap on the wrist. It literally alters your retirement budget forever.
SPEAKER_00Yeah, that's a scary thought. So I like to think of your initial enrollment period, the IEP, as a ticking countdown. You get the strict seven-month window to act before the alarms go out.
SPEAKER_01The very strict window, yeah.
SPEAKER_00It's uh three months before your birthday month, your actual birthday month, and then three months after.
SPEAKER_01Precisely. And if you let that clock run out, the penalty trap just snaps shut. So let's look at Medicare Part B. The government hits you with a permanent 10% penalty for every 12 months you go without coverage.
SPEAKER_00Wait, permanent, like forever.
SPEAKER_01Forever. In 2026, the standard Part B premium is $202.90 a month. So a one-year delay adds about $20 a month to your bill for the rest of your life.
SPEAKER_00Man, okay, but let me push back on this a little. If I'm turning 65 and I feel, you know, perfectly healthy and my old job offers Cobra. I mean, why not just delay Medicare? I already have coverage.
SPEAKER_01See, that right there is the exact trap that catches so many retirees. It all comes down to how the government classifies your insurance. To delay Medicare without a penalty, you have to have creditable coverage from active employment.
SPEAKER_00Oh, active. So Cobra doesn't count.
SPEAKER_01Right, because Cobra, by definition, is based on past employment. Because of that little technicality, Medicare automatically becomes your primary insurance at 65.
SPEAKER_00Wow. Okay.
SPEAKER_01Yeah. So if you haven't enrolled, your Cobra plan might just uh refuse to pay your medical bills entirely. And on top of that, because you delayed, you'll still get that permanent penalty for Medicare.
SPEAKER_00That is wild. So Cobra is basically a mirage, but once you avoid that trap and you actually open your enrollment window, you hit this huge crossroads. Right. Which coverage path to take?
SPEAKER_01That's the biggest choice you'll make.
SPEAKER_00Right. So to me, it seems like original Medicare is sort of like ordering a lockhart, and Medicare Advantage Part C is like a combo meal with Advantage. Private insurers bundle your care and cap your out-of-pocket costs at what is it, $9,250 for 2026?
SPEAKER_01Yep, that's the cap. But the catch is they decide which doctors, or you know, keeping with your analogy, which restaurants you're actually allowed to visit. Right. You're trading freedom for a structured safety net. Original Medicare, the a la carte option, gives you nationwide access to almost any doctor, but it does not cover everything.
SPEAKER_00Aaron Powell Which brings up the massive side dish you absolutely need for that a la carte menu Medigap Plan G.
SPEAKER_01You absolutely need it. And here is why. Original Medicare's Part Egg, a hospital coverage has a $1,736 deductible. But the sneaky mechanism here is that it's per benefit period.
SPEAKER_00Not per year.
SPEAKER_01Not per year. A benefit period resets after you've been out of the hospital for 60 days. So if you have a really bad year and go into the hospital three separate times, you pay that $1,700 deductible three times.
SPEAKER_00That would bankrupt people.
SPEAKER_01Exactly. But Medigap Plan G covers that resetting deductible and almost everything else original Medicare misses except the $283 Part B deductible.
SPEAKER_00Okay, that's huge.
SPEAKER_01It is. But you only get a strict six-month guaranteed issue window to buy it without insurers digging into your health history.
SPEAKER_00Man, if looking at these menus and strict deadlines is stressing you out, um we at Elite Insurance Partners can help you select a Medicare plan. Just fill out the form on this page or call us at 877-324-1512, and we'll answer any questions you have. It really is, especially because your past income might actually be secretly inflating your current costs.
SPEAKER_01Oh, yes. The IRMAA surcharge.
SPEAKER_00IRMAA.
SPEAKER_01Yeah, the income-related monthly adjustment amount. See, Medicare calculates your premiums based on your tax return from two years ago.
SPEAKER_00Oh, I saw.
SPEAKER_01So for 2026, they're looking at 2024. If your individual income back then exceeded $109,000, your Part B premium isn't that standard $202. It scales up and it can actually skyrocket to $689.90 a month.
SPEAKER_00Wait, wait, that is incredibly frustrating. What if you say retired in 2025 and your income completely panked? You're basically being taxed on ghost money.
SPEAKER_01You are, yeah. Unless you fight it. You can appeal this if you just retired and your income dropped. Really? How? You use IRS form SSA 44. If you've had a life-changing event like retirement, the government allows you to bypass that two-year look back. They'll recalculate your premium based on your current lower income.
SPEAKER_00Oh, thank goodness. And honestly, navigating government forms like the SSA 44 is exactly why you can lean on us.
SPEAKER_01Navigating forms like the SSA 44 is exactly why you can lean on us. Just call 877-324-1512.
SPEAKER_00Yeah, we deal with this stuff every day, but getting your premiums fixed today doesn't mean you're set for life, right?
SPEAKER_01Not at all. Medicare isn't a set it and forget it choice. Your health changes, and so do these plans. A network that fits you perfectly at 65 might drop your favorite specialist by the time you're 75.
SPEAKER_00That makes total sense.
SPEAKER_01You really must use the annual enrollment period, which runs from October 15th to December 7th, to reassess your evolving needs.
SPEAKER_00Absolutely. So whatever you do, don't let the clock run out on your coverage. Fill out the form on this page or call 877-324-152A and let elite insurance partners help you navigate this whole journey.
SPEAKER_01We'd love to help.
SPEAKER_00Because, you know, it really makes you think we spend decades obsessing over how to save money for retirement, but we rarely realize how easily the healthcare system can just drain those exact savings if we aren't paying attention. What other autopilot decisions in your financial plan might be hiding a lifelong penalty?