Enrollment Guide
Medicare Enrollment — Dates, Deadlines & Rules
Missing an enrollment window can mean permanent penalties or gaps in coverage. Here's everything California seniors need to know about when and how to enroll.
Enrollment Periods Explained
Medicare has several enrollment windows. The one that applies to you depends on your age, employment status, and current coverage.
Your first chance to enroll in Medicare. It's a 7-month window centered on your 65th birthday month.
- Starts 3 months before the month you turn 65
- Includes the month you turn 65
- Ends 3 months after the month you turn 65
- Covers Part A, Part B, Part C (Medicare Advantage), and Part D
If you enroll after your birthday month, your Part B coverage may be delayed by up to 3 months. Enroll in the 3 months before your birthday for the smoothest start date.
Late Enrollment Penalties
These penalties are permanent — they're added to your monthly premium for as long as you have Medicare.
10% per year
For each 12-month period you were eligible for Part B but didn't enroll (and didn't have qualifying employer coverage), your monthly premium increases by 10% — permanently. The 2026 standard Part B premium is $185.00/month.
Example
If you delay 2 years without qualifying coverage, your Part B premium is 20% higher for life — about $222/month instead of $185.
1% per month
For each month you go without creditable drug coverage after your IEP ends, your Part D premium increases by 1% of the national base beneficiary premium — permanently.
Example
A 24-month gap means roughly a 24% higher Part D premium for life.
10% for 2x enrollment period
Most people get Part A free. If you have to buy Part A and don't enroll when first eligible, your premium is 10% higher — and you pay it for twice the number of years you delayed.
Example
Rare — only affects people who don't have 40 quarters of Medicare-covered work.
Your Enrollment Timeline at a Glance
Here's what to do and when — starting 6 months before you turn 65.
Review your current coverage
Take stock of your current health insurance — employer plan, spouse's plan, COBRA, or marketplace coverage. Determine whether you need to enroll in Part B now or can delay.
IEP opens — enroll in Part A and Part B
Your Initial Enrollment Period begins. If you're not covered by an active employer plan, enroll now. Enrolling in the 3 months before your birthday month ensures coverage starts on the 1st of your birthday month.
Compare Medicare Advantage vs. Original Medicare
Research plan options in your California county. Use Medicare's Plan Finder at medicare.gov or speak with a HICAP counselor for free, unbiased help comparing plans.
Enroll in Part D or Medicare Advantage
If you choose Original Medicare, enroll in a standalone Part D drug plan. If you choose Medicare Advantage, select a plan that includes drug coverage. Don't leave a gap in drug coverage — the penalty is permanent.
Notify your current insurer
If you're leaving an employer plan or marketplace coverage, notify your insurer of your Medicare start date to avoid overlapping premiums or coverage gaps.
Review your plan annually
Plans change their premiums, networks, and formularies each year. Review your Annual Notice of Change (ANOC) and use the Annual Enrollment Period (Oct 15 – Dec 7) to switch if a better plan is available.
California-Specific Resources & Protections
HICAP — Free Medicare Counseling
The Health Insurance Counseling and Advocacy Program (HICAP) provides free, unbiased Medicare counseling from trained volunteers across California. Call 1-800-434-0222 or visit aging.ca.gov/HICAP to find your local office.
Medi-Cal Dual Eligibility
If you qualify for both Medicare and Medi-Cal, you may be eligible for a Dual Eligible Special Needs Plan (D-SNP) that coordinates both programs. These plans often have $0 premiums and minimal cost-sharing.
Extra Help (Low Income Subsidy)
Federal Extra Help program reduces Part D drug costs for qualifying low-income beneficiaries. In 2026, individuals with income up to about $23,340 and limited assets may qualify. Apply through Social Security at ssa.gov.
California Birthday Rule
Each year during the 30 days after your birthday, you can switch to a Medigap plan with equal or lesser benefits without medical underwriting — regardless of your health status. This is unique to California and can save you thousands if your health changes.
Ready to Enroll? We Can Help.
Don't navigate Medicare enrollment alone. Get a free consultation to make sure you enroll on time and choose the right plan for your needs.