Why are you forced to go on Medicare?

Medicare isn't strictly mandatory for everyone, but it's effectively required for most people at age 65 to avoid significant lifetime penalties and gaps in coverage, especially if you're on Social Security; automatic enrollment happens if you receive Social Security, while delaying Part B (medical) without other "creditable" coverage (like employer insurance) results in late enrollment fees and higher premiums. For certain government employees, Medicare coverage is mandatory by law unless they belong to a specific retirement system.

What if I don't want Medicare at 65?

If you don't want Medicare at 65, you can delay enrolling in Part B (Medical Insurance) without penalty only if you have credible group health coverage from an employer (your own or spouse's) with 20+ employees; otherwise, you face permanent late enrollment penalties for Part B and Part D, and if you're on Social Security, you must take Part A or lose benefits. It's crucial to compare your employer plan's costs and coverage to Medicare's to see if delaying makes financial sense, as penalties can be significant. 

Can you be forced into Medicare?

Strictly speaking, Medicare is not mandatory. But very few people will have no Medicare coverage at all – ever. You may have good reasons to want to delay signing up, though.

What happens if you never enroll in Medicare?

If you don't sign up for Medicare when first eligible (usually at 65) and don't have a Special Enrollment Period (SEP) due to other creditable coverage (like from a job), you risk paying permanent late enrollment penalties for Part B and Part D, increasing your monthly premiums for as long as you have coverage. You might also have gaps in coverage and have to wait for the General Enrollment Period (GEP) to sign up, delaying benefits and incurring penalties. 

Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

Medicare: Why you need to sign up when you're 65, even if you're still working

Do you legally have to have Medicare?

While Part D isn't technically mandatory, you may still be subject to a penalty for signing up late. If you don't join a Medicare drug plan when you are first eligible or go 63 days without creditable drug coverage, you'll pay an extra 1% for each month you went without prescription drug coverage.

Why would someone opt out of Medicare?

The ONLY reason to opt out of Medicare is if you want to 1) see a Medicare patient, 2) under private contract, 3) for covered services. All three of these must be true, or it is not worth your trouble to opt out.

How much does Medicare cost per month?

Medicare costs vary, but for 2026, the standard Part B (Medical Insurance) premium is $202.90/month, with higher amounts for higher incomes, while most people pay $0 for Part A (Hospital Insurance) if they paid Medicare taxes for 40+ quarters, or a premium of $311 or $565 if they didn't. Prescription drug plans (Part D) average around $34.50/month, and Medicare Advantage (Part C) plans have varied costs, some with $0 premiums. 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

What is the penalty for not getting Medicare at 65?

Part A late enrollment penalty

If you have to buy Part A, and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay the penalty for twice the number of years you didn't sign up.

Can I collect social security and not have Medicare?

Yes, you can get Social Security without Medicare, especially if you're under 65 or have other creditable coverage like an employer plan, but if you're over 65 and already receiving Social Security retirement benefits, you'll usually be automatically enrolled in Medicare Part A (hospital) and can delay Part B (medical) if you have other insurance. You can also apply for Social Security benefits (like retirement) before 65 and not get Medicare until later, but if you're on disability (SSDI), Medicare usually kicks in after 24 months. 

What is the new Medicare rule for 2025 over 65?

Starting in 2025, there is an annual limit on what you pay out-of-pocket for prescription medications through Medicare and Medicare Advantage prescription drug plans. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.

What happens if I decline Medicare?

If you decline Medicare, you risk significant financial penalties if you sign up later and could face gaps in coverage, paying 100% of costs for services Medicare covers, but you can delay enrollment without penalty if you have other "creditable" coverage like a good employer plan, but you must enroll during a Special Enrollment Period when that coverage ends. Declining Part B (Medical Insurance) leads to a 10% premium increase for each year you were eligible but didn't sign up, and delaying Part D (Drugs) can also trigger a lifelong penalty.
 

Why would you not want Medicare?

Less freedom in choosing health care providers.

In some areas, it can be difficult to find a local doctor or hospital that works with Medicare Advantage. And if you visit a doctor or a hospital that isn't “in-network,” you will pay higher out-of-pocket costs.

Does everyone have to pay $170 for Medicare?

Medicare Part A (pays for hospital stays) is usually free, but almost everyone has to pay $202.90 per month for Medicare Part B (pays for medical care). If you have a Part D, Medicare Advantage or Medicare Supplement plan, you'll have an extra monthly cost on top of paying for Part B.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:

• Eye exams (for prescription eyeglasses)
• Long-term care.
• Cosmetic surgery.
• Massage therapy.
• Routine physical exams.
• Hearing aids and exams for fitting them.

How much is taken out of your social security check for Medicare?

The amount taken from your Social Security check for Medicare depends on your income and plan, but the standard is the Medicare Part B premium, which is $202.90 monthly for most people in 2026, automatically deducted from benefits if you receive them. Higher earners pay more (Income-Related Monthly Adjustment Amount or IRMAA) for Part B and Part D, while some with low income or qualifying for Medicaid may pay less or have premiums covered, with amounts adjusted annually. 

Can you say no to Medicare?

Yes, you can opt out of Medicare, but it's usually for healthcare providers (like doctors) who want to treat Medicare patients privately, not for beneficiaries to avoid enrolling, as it's generally mandatory if you receive Social Security, but opting out has strict rules, requiring written contracts and affidavits every two years for providers, while beneficiaries must follow specific steps to decline coverage if eligible, often incurring penalties later. 

What does Dave Ramsey say about Medicare?

Dave Ramsey's Medicare advice centers on planning ahead, understanding enrollment periods to avoid penalties, using Health Savings Accounts (HSAs) if possible, and supplementing Original Medicare with Medigap or Medicare Advantage (Part C) to cover gaps like dental, vision, and long-term care, stressing that mistakes can be costly and recommending expert advice for personalized choices. 

Why are doctors dropping Medicare patients?

Physician Medicare reimbursement dropped 33% since 2000, when adjusted for inflation, according to the AMA. As a result, Ferguson said, many practices—particularly small, independent ones—can no longer afford to absorb the losses. "It's gotten to a point where you can't absorb it.

What happens if you don't join Medicare?

If you don't sign up for Medicare when first eligible (usually at 65) and don't have a Special Enrollment Period (SEP) due to other creditable coverage (like from a job), you risk paying permanent late enrollment penalties for Part B and Part D, increasing your monthly premiums for as long as you have coverage. You might also have gaps in coverage and have to wait for the General Enrollment Period (GEP) to sign up, delaying benefits and incurring penalties. 

Is it illegal to not accept Medicare?

Since January 1, 1998, physicians have been permitted to opt out of Medicare and enter into private contracts with Medicare beneficiaries that allow them to set their own fees. If you don't officially opt out, it is illegal to have Medicare patients pay for your services outside of Medicare.

Who is exempt from Medicare?

Certain groups are exempt from paying this tax, such as some religious groups and foreign workers who are not considered residents for tax purposes. Additionally, specific types of employment may be exempt from Medicare tax under certain conditions.