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Operated by HealthBenefitsCompass LLC, a subsidiary of HealthcareGPS Inc.Medicare education · Not a government websiteReviewed by Lauri Middleton, RN, MSN (licensed Medicare agent) and Karen OrillaHow we prepare our guidance →Meet our reviewers →

Reviewed for accuracy by Lauri Middleton, RN, MSN, licensed Medicare agentReviewed for clarity by Karen OrillaMeet our reviewers →

The rules

The rules we use

Every date on this site traces to one of these federal or California rules. Each card names its source and when it was last checked. Cards marked "verify" still await a rule-by-rule sign-off; confirm them with the source before you act on them.

Federal rules

Federal rules

01 / 16

The first enrollment window is seven months long

It starts three months before the month you turn 65, includes that month, and ends three months after it. If your birthday is on the 1st, the whole window moves one month earlier.

Source: Medicare.gov — When does Medicare coverage start? · In effect since 2023-01-01 · Last checked 2026-09-06

02 / 16

When coverage starts depends on when you sign up

Sign up in the three months before your birthday month and Part B starts on the first day of that month. Sign up in your birthday month or the three months after, and it starts on the first day of the month after you sign up. The older two-to-three-month delays ended in 2023.

Source: Medicare.gov — When does Medicare coverage start? · In effect since 2023-01-01 · Last checked 2026-09-06

03 / 16

Drug coverage has the same first window

After your first enrollment period, a gap of 63 consecutive days or more without Part D or other creditable drug coverage can lead to a late penalty. People who get Extra Help do not pay this penalty.

Source: Medicare.gov — Part D costs and the late enrollment penalty · In effect since 2006-01-01 · Last checked 2026-09-06

04 / 16

Medigap has one six-month window with no health questions

It starts the first month you are 65 or older and enrolled in Part B. During those six months a company must sell you any Medigap policy it offers, at the same price as someone in good health. Outside it, rights vary by state.

Source: Medicare.gov — Ready to buy Medigap · In effect since 1992-01-01 · Last checked 2026-09-06

05 / 16

Leaving job coverage opens an eight-month window

If you or your spouse are still working and you have health coverage from that job, you can sign up for Part B later without a penalty. The window is eight months, starting the month after the job or the coverage ends — whichever comes first. COBRA and retiree coverage do not count as coverage from a current job.

Source: Medicare.gov — Working past 65 · In effect since 2023-01-01 · Last checked 2026-09-06

06 / 16

Drug coverage: two months after job coverage ends

The Part D window after losing job-based drug coverage is shorter than the Part B one: two months after the coverage ends. Ask the benefits office for a letter saying whether the drug coverage was creditable.

Source: Medicare.gov — Special Enrollment Periods · In effect since 2006-01-01 · Last checked 2026-09-06

07 / 16

Employer size decides who pays first

With 20 or more employees, the job plan pays first and Medicare second, so delaying Part B is usually safe while that coverage lasts. With fewer than 20, Medicare pays first — and if you have not signed up, the job plan may pay very little.

Source: Medicare.gov — Working past 65 · In effect since 1986-01-01 · Last checked 2026-09-06

08 / 16

HSA contributions must stop before Part A

Part A can be backdated up to six months when you sign up after 65. Contributions made for any month you have Part A are not allowed, so the safe stop is six months before the month you plan to apply — but never earlier than your eligibility month.

Source: Medicare.gov — Working past 65 · IRS Publication 969 · In effect since 2004-01-01 · Last checked 2026-09-06

09 / 16

The General Enrollment Period runs January through March

If the first window closed and no special window applies, you can sign up for Part B between January 1 and March 31 each year. Coverage starts the first day of the month after you sign up.

Source: Medicare.gov — When does Medicare coverage start? · In effect since 2023-01-01 · Last checked 2026-09-06

10 / 16

Part B late enrollment: 10 % for each full year late

For every full 12-month period you could have had Part B but did not — and were not covered by a current job — the monthly premium goes up by 10 %. It stays that way for as long as you have Part B.

Source: Medicare.gov — Avoid late enrollment penalties · In effect since 1966-01-01 · Last checked 2026-09-06

11 / 16

Part D late enrollment: 1 % of the base premium per month

When a Part D penalty applies, Medicare counts full uncovered months at 1% of the national base premium and rounds the penalty to the nearest 10 cents. It generally lasts while you have Part D; Extra Help is an exception.

Source: Medicare.gov — Part D costs and the late enrollment penalty · In effect since 2006-01-01 · Last checked 2026-09-06

12 / 16

Every year: Open Enrollment, October 15 to December 7

After the first year, this is when anyone with Medicare can join, switch or drop a Medicare Advantage or Part D plan for the following January.

Source: Medicare.gov — Joining a plan · In effect since 2011-01-01 · Last checked 2026-09-06

13 / 16

Medicare Advantage members get one more change, January to March

Someone already in a Medicare Advantage plan can switch to another one, or go back to Original Medicare (and add a Part D plan), between January 1 and March 31. Only one change in that window.

Source: Medicare.gov — Joining a plan · In effect since 2019-01-01 · Last checked 2026-09-06

14 / 16

Help with costs exists; an agency decides who gets it

Extra Help lowers Part D costs and is applied for through Social Security. Medicare Savings Programs help with Part B premiums and sometimes more, and are applied for through the state Medicaid office (Medi-Cal in California). Both look at income and resources; this site does not screen for them.

Source: SSA — Extra Help · Medicare.gov — Medicare Savings Programs · In effect since 2006-01-01 · Last checked 2026-09-06

15 / 16

A higher premium from old income can be appealed after a life change

Part B and Part D premiums are set from the tax return two years back. If income dropped because of retirement, a death, divorce or a lost pension, Social Security can use the current year instead — form SSA-44.

Source: SSA — Medicare premiums: rules for higher-income beneficiaries · In effect since 2007-01-01 · Last checked 2026-09-06

16 / 16

A denied claim or service can be appealed, with a deadline

Original Medicare gives 120 days from the notice to ask for a redetermination; Medicare Advantage and Part D plans have their own timelines, printed on the denial. Free HICAP counselors help with appeals.

Source: Medicare.gov — Appeals · In effect since 2005-01-01 · Last checked 2026-09-06

California rules

California rules

01 / 4

California's Medigap birthday rule

Each year, starting on your birthday, you have 60 days to switch to another Medigap policy with equal or lesser benefits, from any company, without health questions.

Source: California Department of Insurance — Medicare Supplement · In effect since 2020-01-01 · Last checked 2026-09-06

02 / 4

Under 65 with Medicare: California guarantees a Medigap window

People with Medicare because of a disability get a six-month Medigap open enrollment in California when Part B starts, and a second one at 65. Premiums for people under 65 can be higher, and some plans are not offered; HICAP explains the current options.

Source: California Department of Insurance — Medicare Supplement · In effect since 2000-01-01 · Last checked 2026-09-06

03 / 4

HICAP is California's free Medicare counseling program

The Health Insurance Counseling and Advocacy Program gives free, confidential, one-on-one help in every county. Counselors do not sell insurance. The statewide line is 1-800-434-0222.

Source: California Department of Aging — HICAP · In effect since 1990-01-01 · Last checked 2026-09-06

04 / 4

Medi-Cal runs the Medicare Savings Programs in California

Applications for help with the Part B premium go through the county Medi-Cal office. Since 2024 California no longer counts assets for Medi-Cal, but income limits still apply and the county decides.

Source: DHCS — Medicare Savings Programs · In effect since 2024-01-01 · Last checked 2026-09-06