Whether you need to “do something” to get Medicare depends entirely on your Social Security status:
- If you already receive Social Security: Enrollment is automatic. About three months before you turn 65, the SSA will mail you a “Welcome to Medicare” package containing your Medicare card. Your coverage starts the first day of your birth month.
- If you are NOT yet receiving Social Security: You must actively sign up. You can do this online at ssa.gov during your Initial Enrollment Period (the 7-month window around your 65th birthday).
One of the most common surprises for new enrollees is that Medicare is not entirely free. While Part A (Hospital Insurance) is typically premium-free for those who have worked and paid Medicare taxes for at least 10 years, Medicare Part B (Medical Insurance) carries a monthly premium. The cost of Part B is set annually by the government and can be higher depending on your income level. If you are already receiving Social Security benefits, this premium is usually deducted automatically from your monthly check. If you have not yet started drawing Social Security, you will receive a bill from Medicare directly.
If your income from two years ago exceeds the government's set thresholds, you may be required to pay an Income-Related Monthly Adjustment Amount (IRMAA). This is a mandatory surcharge added to your Part B and Part D coverage, which is recalculated annually by Social Security. Because these costs are based on a two-year lookback, they may not reflect your current financial situation. If your income has decreased significantly since that time due to retirement or other major life events, you may be eligible to appeal for a premium reduction.
Download the 2026 Medicare Costs & Premiums sheet (PDF) — complete reference for Part A deductibles, Part B premiums, and IRMAA brackets.
- Review your Social Security COLA every January to understand changes to your monthly income.
- Monitor Part B Premium adjustments and check for annual updates to income-related surcharges.
- Evaluate Part D plan changes, specifically watching for shifts in out-of-pocket maximums and deductibles.
- Verify your formulary and pharmacy network annually to ensure your prescriptions are still covered at the best available price.
Unsure what your monthly benefits will be? The Social Security Benefit Calculators will give you an estimated monthly benefit at various retirement ages — a helpful tool for planning your transition. For more accurate information, log into your personal account at www.ssa.gov. Open the official SSA Benefit Calculators.