Do I enroll in Medicare at 65 or keep working?

Published 12:00 am Saturday, August 7, 2021

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Hi Toni!
I will turn 65 in October and am worried that my employer will be having a lay off due to struggles in the oil industry. I do not know what to do regarding Medicare because I have great benefits covering my husband and myself. Should I enroll in Medicare now since I’m turning 65 or wait until I am either laid off or decide to retire. Thanks, Karen from Sugar Land area



You have a few different Medicare enrollment options available to you that are not explained in the Medicare & You handbook.

Enrolling in Medicare Parts A and B when turning 65 is called the “Initial Enrollment Period.” The Medicare enrollment time is called theMedicare effective date schedule.” It is a very important window of time for those who are “only” turning 65, not those past 65 and 90 days, retiring or laid off from their current employment with benefits.

The “Medicare effective date schedule” is the seven-month period which occurs three months before turning 65, the month you turn 65, and three months after turning 65, when your Medicare begins.

Below is a simple explanation of the Medicare effective date schedule with the delays:

  • Enrolling three months before turning 65, your Medicare begins the first day of the month you turn 65. Karen’s would begin Oct. 1.
  • Enroll the month you turn 65, then Medicare will begin one month after you sign up.

Karen, if you enroll in October, then your Medicare begins Nov. 1.

  • Enroll one month after you turn 65, and your Medicare will begin two months after you sign up.

Karen, if you enroll in November; your Medicare begins Feb. 1.

  • Enroll two months after you turn 65, your Medicare will begin three months after you sign up.

Karen, if you enroll in December; your Medicare begins April 1.

  • Enroll three months after you turn 65, your Medicare will begin three monthsafter you sign up. Karen, if you enroll in January; your Medicare will begin May 1.

During a Toni Says® Medicare consultation with someone who wishes to apply for Medicare as you are discussing, we help that person with a personalized Medicare plan to meet their specific needs. Medicare is not “cookie cutter…one size does not fit all!”

Let’s say you wait until February to retire, which is the first month past your “Medicare effective date schedule”; we would advise you to apply at your local Social Security office for a Medicare SEP (Special Enrollment Period) with form #CMS L-564 “Request for Employment Information” which is signed by your company HR and CMS-40B “Application for Part B”. Your Medicare could begin Feb. 1, not March 1 or April 1 as if you had applied during your Medicare effective date schedule.

Karen, when you enroll in Medicare Part A and B whether working full-time or not, your Medicare premiums start the month that your Medicare Part B begins.  Your Medicare Part B and D premiums will be based on your MAGI amount reported to the IRS from two years ago. Medicare premiums for 2021 are based on 2019 MAGI amount reported to the IRS.  SSA-44 form can appeal your income has lowered and you wish to appeal the higher Medicare premium.


For Medicare enrollment questions call the Toni Says Medicare hotline at 1-888-TONI-SAY (888-866-4729) and talk with the Toni Says® Medicare team or email for help. Toni King, Medicare author/advocate is giving a $5 discount to the Toni Says® readers on the new 2021Medicare Survival Guide® Advanced book at