Why are you forced to have 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 happens if you don't want Medicare when you turn 65?

If you don't sign up for Medicare at 65 and don't have other creditable coverage (like employer insurance), you risk paying late enrollment penalties, delaying your coverage, and potentially facing gaps in healthcare, especially for Part B (medical) and Part D (drugs). Penalties increase your premiums (10% for Part B per year delayed) and last as long as you have the coverage, while late Part D enrollment leads to a 1% penalty of the national average premium per month without coverage. 

Are you forced to be on Medicare?

Strictly speaking, Medicare is not mandatory. But very few people will have no Medicare coverage at all – ever.

What happens if you don't want to use Medicare?

There are some risks to dropping coverage: Your costs for health care: You may have to pay all of the costs for services that Medicare covers, like hospital stays, doctors' services, medical supplies, and preventive services.

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.

Medicare Part A B C D Explained (and made simple!)

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). 

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. 

Does everyone have to pay $170 a month for Medicare?

If you don't get premium-free Part A, you pay up to $565 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($202.90 in 2026).

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 mandatory to go on Medicare when you are 65?

Is Medicare Mandatory At Age 65? Enrolling in Original Medicare is not mandatory, but you might have gaps in coverage or will have to pay late enrollment penalties if you don't enroll when your first eligible.

What is the 3 month rule for Medicare?

Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)

Do you have to pay for Medicare Part A when you turn 65?

No, Medicare Part A isn't strictly mandatory at 65, but it's highly recommended and often automatic if you receive Social Security, with penalties for delaying if you don't have other creditable job-based coverage. Part A is usually premium-free if you or your spouse worked 10 years, making it a great primary or secondary insurer, while delaying Part B (medical) is fine with employer coverage but triggers penalties later if you don't sign up when that job-based insurance ends. 

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. 

Can I collect Social Security but not 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. 

Who cannot opt out of Medicare?

The following physicians and practitioners are not eligible to opt out of Medicare:

• Anesthesiologist Assistants.
• Chiropractors.
• Independent, non-clinical Psychologists.
• Occupational Therapists in private practice.
• Physical Therapists in private practice.
• Speech Language Pathologists in private practice.

What are the 5 things Medicare doesn't cover?

Medicare generally doesn't cover long-term care, most dental care, routine vision services (like glasses), hearing aids/fittings, and cosmetic surgery, though it does provide strong coverage for hospital and doctor services; you can often get coverage for these gaps through Medicare Advantage (Part C) or supplemental plans. 

What Medicare is free for seniors?

Part A is free if you worked and paid Medicare taxes for at least 10 years. You may also be eligible because of your current or former spouse's work.

What happens if I can't afford to pay for Medicare?

If you can't afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer Medicare Savings Programs for people entitled to Medicare who have limited income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance.

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.

Is it better to have plain Medicare or Medicare Advantage?

Neither Original Medicare nor Medicare Advantage (MA) is universally "better"; the best choice depends on your healthcare needs, budget, and preference for provider choice, with Original Medicare offering nationwide provider freedom but requiring separate drug/supplement plans, while MA provides all-in-one coverage with networks and extra benefits like dental/vision but often requires referrals and has regional limits. 

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. 

Does Medicare cover 100% of hospital bills?

No, Original Medicare (Part A & B) does not cover 100% of hospital bills; beneficiaries pay deductibles, coinsurance, and copays, but you can get full coverage by adding Medicare Supplement (Medigap) plans or choosing a Medicare Advantage plan. Part A covers the first 60 days of a hospital stay (after a deductible), but after that, you pay daily coinsurance, and there's no limit on your total costs unless you have supplemental coverage.
 

What states have the worst Medicare Advantage plans?

States often cited for weaker Medicare Advantage performance include Louisiana, Mississippi, Kentucky, West Virginia, and Florida, due to challenges with care access, provider shortages, and quality issues like higher rates of avoidable hospitalizations and inappropriate medication prescriptions, though specific rankings vary by report and focus (e.g., satisfaction vs. overall system). Other states like New York, California, Texas, and Michigan appear on lists for low member satisfaction with specific plans, not necessarily the whole state's system. 

What is the best secondary insurance if you have Medicare?

Best Medicare Supplement Insurance Companies in 2026

• UnitedHealthcare / AARP – Best Plan Pairing: Plan G or Plan N.
• Cigna Healthcare – Best Plan Pairing: Plan G.
• Humana – Best Plan Pairing: Plan N.
• Aetna (CVS Health) – Best Plan Pairing: Plan N.