What Is Medicare?
Medicare is the federal health insurance program for:
- Individuals 65 or older
- Certain people under 65 with qualifying disabilities
- People with End-Stage Renal Disease (ESRD)
Some individuals who continue working past age 65 and have creditable employer coverage may be able to delay enrollment without penalty.
Medicare Enrollment Rockwall Texas - Benefit Writers Can Help
Whether you’re new to Medicare, getting ready to turn 65, or preparing to retire, you’ll need to make several important decisions about your health coverage. If you wait to enroll, you may have to pay a penalty, and you may have a gap in coverage. Use these steps to gather information so you can make informed decisions about your Medicare:
Step 1: Understanding the Parts of Medicare
The different parts of Medicare help cover specific services.
Medicare Part A – Hospital Insurance
Covers:
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- Inpatient hospital care
- Skilled nursing facility care
- Hospice services
- Limited home health care
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Most beneficiaries qualify for premium-free Part A.
Medicare Part B – Medical Insurance
Covers:
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- Doctor visits
- Outpatient care
- Preventive services
- Durable medical equipment
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Part B requires a monthly premium, which is income-based.
Medicare Part C – Medicare Advantage
Medicare Advantage Plans are offered by private insurance companies approved by Medicare and provide:
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- All Part A and Part B benefits
- Often include prescription drug coverage
- Plans such as HMO, PPO, and Special Needs Plans
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Medicare Part D – Prescription Drug Coverage
Medicare Part D helps cover the cost of prescription medications and can be added to:
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- Original Medicare (Part A & B)
- Certain Medicare Advantage Plans
- Some Medicare Cost or MSA Plans
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Step 2: Understand When You Can Enroll
What Are The Ages I Can Qualify?
There are specific times when you can enroll in Medicare. Depending on the situation, some people may get Medicare automatically, and others need to apply for Medicare.
Your first opportunity is your Initial Enrollment Period (IEP), which lasts 7 months:
- Begins 3 months before the month you turn 65
- Includes the month you turn 65
- Ends 3 months after the month you turn 65
If you don’t enroll when first eligible:
- You may pay a late enrollment penalty (especially for Part B)
- You may experience a gap in coverage
Step 3: Decide if you want Part A and Part B
Most people should enroll in Part A when they turn 65, even if they have health insurance from an employer. This is because most people paid Medicare taxes while they worked so they don't pay a monthly premium for Part A. Certain people may choose to delay Part B. In most cases, it depends on the type of health coverage you may have. Everyone pays a monthly premium for Part B. The premium varies depending on your income and when you enroll in Part B. Most people will pay the standard premium amount of $206.50 in 2026.
Learn more about whether you should take Part A and Part B.
Step 4: Choose your coverage
If you decide you want Part A and Part B, there are 2 main ways to get your Medicare coverage — Original Medicare or a Medicare Advantage Plan (like an HMO or PPO). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Most people who are still working and have employer coverage don’t need additional coverage. Learn about these coverage choices.
Step 5: Sign up for Medicare (Unless you’ll get it automatically)
Some people automatically get Part A and Part B. Find out if you’ll get Part A and B automatically.
If you're automatically enrolled, you'll get your red, white, and blue Medicare card in the mail
- 3 months before your 65th birthday, or
- In your 25th month of disability benefits
If you don't get Medicare automatically, you’ll need to apply for Medicare online.
Step 6: Learn the Key Tasks for Your First Year on Medicare
Your first year may include:
- Choosing or changing a health plan
- Selecting prescription drug coverage
- Understanding costs and benefits
- Reviewing annual notices and coverage changes
Learn about 4 tasks for your first year.
Not sure what kind of coverage you have?
- Check your red, white, and blue Medicare card
- Check all other insurance cards that you use
- Call the phone number listed on the insurance cards to get more information about the coverage
- Check your Medicare health or drug plan enrollment
Prescription Drug Coverage Options
How to get drug coverage
You can get drug coverage in one of two ways:
- Enroll in a Medicare Part D plan
- Choose a Medicare Advantage Plan that includes drug coverage (like an HMO or PPO)
What drug plans cover
Learn what Medicare drug plans cover, including information about a drug formulary and tiers.
Costs for drug coverage
Learn about the types of costs you’ll pay in a Medicare drug plan.
Joining a health or drug plan
Find out when you can sign up for or change your coverage. This includes your Medicare Advantage Plan (Part C) or Medicare Prescription Drug Coverage (Part D).
How Part D works with other insurance
Learn about how Medicare Part D (prescription drug coverage) works with other coverage, like employer or union health coverage.
Click To Find health & drug plans
Find and compare drug plans, health plans, and Medicare Supplement Insurance (Medigap) policies.
Related Resources
Helpful Medicare Resources
- Medicare & You - The Official US government Medicare Handbook
- Parts of Medicare
- Medigap & Medicare drug coverage (Part D)
Still Have Questions about Medicare?
Let Diane Eller Help You Feel More Comfortable
Call Now: 214-771-3011
Important Compliance Notice
Note: For 2025, CMS has proposed to reinstate the 48-hour Scope of
Appointment (SOA) time frame, prohibiting personal marketing
appointments from taking place until 48 hours after a potential
enrollee completes an SOA. Under the new rule, SOAs will need to
be obtained at least 48 hours in advance and will remain valid for six
months from the beneficiary's signature date.