Your Medicare Enrollment Guide
Getting Started With Medicare
Essential information about Medicare enrollment, costs, and coverage options for PFT retirees.
Medicare & You 2026 Handbook
The official U.S. government Medicare handbook for 2026.
PDF • 4.9 MB
When Does Medicare Start?
Understanding enrollment periods
Coverage Coordination
Initial Enrollment Period
When first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.
Special Enrollment Period (Still Working)
If you (or your spouse) are working with employer/union group health coverage based on current employment, you can delay enrollment without penalty.
8-Month Window
COBRA & Retiree Plans
Not Current Employment Coverage
- COBRA and retiree health plans are NOT considered current employment coverage
- You're NOT eligible for Special Enrollment when these plans end
- If eligible for Medicare when you retire or during COBRA, enroll in Part B to avoid penalties
Medicare Open Enrollment
October 15 – December 7 annually
- •Review health and prescription drug coverage
- •Check changes in costs, coverage, and benefits for next year
- •Make changes if needed; no action required if satisfied with current plan
What Will I Pay for Medicare?
Understanding premiums and penalties
Part A (Hospital Insurance)
Usually $0 monthly premium if you or your spouse paid Medicare taxes while working ("premium-free Part A").
Learn what Part A covers →Part B (Medical Insurance)
Standard premium: $134.00/month (2018 rate)
- •Automatically deducted from Social Security if you receive benefits
- •Billed directly if you don't receive Social Security
Income-Related Adjustment (IRMAA)
Part D (Prescription Drug Coverage)
Monthly premiums vary by plan. Private insurers, employers, and unions offer Part D plans.
Higher Income = Higher Premiums
Late Enrollment Penalty
Avoid Penalties
Creditable Prescription Drug Coverage
Coverage from a current/former employer or union that pays, on average, at least as much as Medicare's required drug coverage.
- •H&W Retiree Plan (Under 65): Considered creditable coverage
- •H&W Plan (65+ or Medicare eligible): Medicare Part D drug plan
Do I Need a Medical Plan with Medicare?
Yes — choose the right plan for you
Even with Medicare Parts A & B, you need additional coverage. Choose between a Medicare Supplement Plan (Medigap) or a Medicare Advantage Plan.
Medicare Supplement (Medigap)
Supplements Original Medicare by covering costs like copayments, coinsurance, and deductibles.
Learn about Medigap plans →Compare Medigap plans side-by-side →Medicare Advantage Plan
Bundled alternative to Original Medicare, offered by private companies. Often includes prescription drug coverage.
Learn about Medicare Advantage →Health Options Program (HOP)
We encourage you to check out the Health Options Program, which operates for the sole benefit of PSERS participants, dependents, and survivors.
Visit www.hopbenefits.com →Quick Reference
Key Enrollment Periods
| Period | Timeline |
|---|---|
| Initial Enrollment | 7 months (around 65th birthday) |
| Special Enrollment | 8 months after employment/coverage ends |
| Open Enrollment | October 15 – December 7 annually |