Preparing for Medicare: What You Need to Know Before You Turn 65

June 8, 2026

Most people spend decades saving, investing and planning for retirement. But one of the biggest financial decisions of your retirement years has little to do with your portfolio. Rather, it has to do with a government program, an important birthday and a deadline you really do not want to miss.

That program is Medicare, and you have a short window around your 65th birthday to sign up. Doing so will help you take full advantage of all that Medicare has to offer and give you more flexibility as you navigate healthcare spending in retirement.

Here, we will explain what you need to know about your Medicare benefits and how to prepare.

Signing Up for Medicare

Medicare was created in 1965 to ensure seniors have access to affordable healthcare in retirement. While it is not free, you have likely already paid for a big chunk of it through decades of payroll taxes, a compelling reason to start taking advantage of your benefits as soon as you are eligible.

The enrollment window opens three months before the month of your 65th birthday and closes three months after. If you do not enroll during your Initial Enrollment Period, you could face coverage delays and higher monthly premiums for the rest of your life. These penalties are designed to discourage people from waiting until they get sick to buy coverage. You can enroll and choose plans on the Social Security website.

Note that seniors who continue to receive private health insurance through an employer might be exempt from Medicare enrollment obligations and penalties. It depends on the company’s size and plan details.

Let’s take a closer look at each part of Medicare, and what you need to consider.

Part A: Hospital Coverage

Part A covers inpatient hospital stays, skilled nursing facility care, hospice services and some home healthcare. For most people, there is no monthly premium. That is because Part A is what you funded through payroll deductions, assuming you or your spouse contributed for at least 10 years. But you will be responsible for deductibles: $1,736 in 2026 for the first 60 days of a hospital stay, with substantial copayments beyond that.

Assuming you have paid into Medicare through your lifetime earnings, there is no financial penalty for delaying Part A enrollment, but also no reason not to enroll.

Part B: Outpatient Coverage

Part B covers outpatient services, including emergency room and doctor visits, preventive care, lab work and medical equipment. In 2026, standard monthly premiums for Part B are $202.90, and they can be higher, depending on your income and filing status. There is also an annual deductible of $283, plus a 20% copay for most doctor visits.

Missing your Initial Enrollment Period will add a permanent 10% surcharge to your Part B premium for every full 12-month period delayed.

Part C: Medicare Advantage

Part C, commonly known as Medicare Advantage, refers to optional plans offered by private insurers that combine Parts A and B and sometimes Part D. Part C plans offer lower out-of-pocket costs and have fixed copays for office visits (instead of 20% for Part B), with smaller or no annual deductibles. By law, they must include a maximum annual out-of-pocket cost, which varies depending on whether you see doctors in or outside the plan’s network. The plans may also include benefits like dental, vision and hearing.

When you sign up for Part C, you will still need to pay your Part B premium. While you might need to pay an additional premium on top of that, some Medicare Advantage plans charge no additional premium.

Part D: Prescription Drug Coverage

Part D covers prescription drugs, with plans offered through private insurance companies. In 2026, the average monthly Part D premium is $34.50, but it varies based on the plan details and where you live. You may also pay an annual deductible (in 2026, up to $615) and co-insurance on each prescription, which can vary depending on the drug’s “tier” or pricing scale. Note that most Medicare Advantage plans also include Part D coverage.

You will not have to pay for Part D if you have creditable drug coverage already (from a current employer, for instance) or qualify for extra help. Otherwise, you are required to have Part D, and delaying enrollment will add a permanent 1% surcharge to your premium for every month delayed.

Medigap: The Final Piece of the Puzzle

Medigap policies are supplemental private policies that help pay out-of-pocket costs for Parts A and B. They charge higher premiums, sometimes several hundred dollars more a month. However, they fill in the gaps of what is not covered by Parts A and B.

You cannot have both Medigap and Medicare Advantage. The Medigap enrollment period is six months beginning the first day you are 65 and have Part B coverage. Enroll in this period and you cannot be denied coverage based on preexisting conditions.

Medicare has a lot of moving parts, and we can help you unpack them. If you have any questions, reach out. After all, understanding Medicare, and when to sign up for what, is good for your health and wealth. With smart preparation, you will almost certainly pay less for healthcare in retirement, even as your medical needs grow.

This post was written and first distributed by The Writing Company.

DISCLAIMERS

This material is intended for general public use. By providing this material, we are not undertaking to provide investment advice for any specific individual or situation, or to otherwise act in a fiduciary capacity. Please contact one of our financial professionals for guidance and information specific to your individual situation. This is not an offer to buy or sell a security.

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