There’s a lot to know about enrolling in Medicare, especially if you’re helping someone else sign up. Deadlines and plan types can be confusing, and not having all the details can lead to penalties or spending more on premiums and out-of-pocket costs. If you’re taking on this task for a loved one turning 65, these tips can help you understand the system and avoid financial surprises for them down the road.

Medicare penalties for late enrollment

Your loved one is eligible to enroll in Medicare when they turn 65. Most people sign up during what’s known as the initial enrollment period. This lasts for seven months – three months before their birthday, their birthday month, and three months after.

If your loved one misses the initial enrollment, they can enroll during the general enrollment period, which lasts from January 1 through March 31. If they do this, however, they might end up paying late penalties.

• The Part B (physician coverage) penalty is 10% of their premium for every 12 months they delay enrollment. The basic monthly premium in 2026 is $202.90. So, if they enroll a year late, they will pay an extra $20.29 monthly the whole time they are on Medicare.
• If someone goes 63 days or more without creditable drug coverage, they’ll pay the Part D (prescription coverage) penalty, which is 1% of their premium for each month they don’t have coverage. The base monthly premium in 2026 is $38.99. If they enroll a year late, they’ll pay an extra $3.89 a month the entire time they are on Medicare.

Avoiding penalties when working

If your loved one is 65 and still working, they may be able to delay signing up for Medicare without paying penalties. This also applies to Medicare coverage for spouses. Here’s what to know:

• Your loved one must be working (or get insurance through their working spouse).
• Their employee health plan must be considered creditable coverage, which often means there are at least 20 people in the workplace.
• Their employer must inform employees annually if their health plan is creditable.
• Your loved one can sign up for Part A (hospital insurance) only.
• Part A is typically free if someone has worked for 10 years and paid Medicare taxes.
• Some people choose this coverage to fill gaps in their employer coverage.

When someone loses their employer coverage after age 65, they need to enroll in Part B (Part A if they haven’t already) and Part D coverage. They can do this during the special enrollment period. This is an eight-month time frame that begins when their life change (like losing employer coverage) happens. They need to sign up during this period, even if they get COBRA insurance coverage, or they will incur late enrollment penalties.

How to avoid Medicare IRMAA

The standard monthly premium for Part B in 2026 is $202.90. People with higher incomes, however, will be subject to increased premiums known as the Income-Related Monthly Adjustment Amount, or IRMAA.

• Part B premiums start at $284.10 for individuals who make more than $108,000 and couples who make more than $218,000. The premiums increase from there as income rises.
• Part D premiums have the same income thresholds. Higher premiums include your individual Part D premium plus $14.50 a month and go up from there.

The Social Security Administration looks at your loved one’s past two years of adjusted gross income to determine their IRMAA amount.

To avoid overpaying the IRMAA, it’s important to remember that your loved one can appeal their premium for qualified life-changing events. They may be able to save a lot of money if they appeal when they (or a spouse):

• Retire or reduce the number of hours they work.
• Get divorced or a spouse dies.
• Lose or sell property that produced income.
• Lose or have a reduction in some types of pension income.

Compare plan types

Another way to help your loved one manage their spending when they sign up for Medicare is to understand the different types of plans. Along with Original Medicare, there are two other kinds of plans your loved one can choose – Medicare Advantage and Medigap (supplement). Both plans help cover out-of-pocket costs that Original Medicare doesn’t pay. They’re very different types of coverage, though, and knowing which will work best for your loved one can save them a lot of money.

Medigap policies are private insurance policies that supplement coverage for a person on Original Medicare. Medicare Advantage policies are an alternative to Original Medicare and are all-in-one plans. They cover Part A, Part B, and, typically, Part D, into one bundled plan.

One of the major differences between the two types of coverage is that a supplemental plan has more upfront costs – the monthly premiums can be relatively high, but the plans cover a lot of out-of-pocket costs down the road. Medicare Advantage plans have much lower monthly premiums, but your loved one may spend more on copays and coinsurance when they need healthcare treatments and services.

The following is a breakdown of other differences between the two types of policies:

Legally helping your loved one

Before it’s time to get your loved one enrolled in Medicare, you’ll need to get legal access. Otherwise, Medicare or an insurance broker can’t give you policy information, nor can you sign your loved one up for a plan through them. If you want to act on behalf of a family member, you need a Medicare Authorization Form. This form lets someone opt to share all, or part of their information – like plan enrollment – with you.

If your loved one can’t sign the form for medical reasons, a legal representative can sign for them. But you must include paperwork showing this person is their power of attorney when you turn in the authorization form. Even if you’re someone’s healthcare power of attorney and can legally make medical decisions on their behalf, you still need to fill out the authorization form to receive their Medicare information.

There are many areas where costly errors can happen when it comes to enrolling in Medicare. If you are taking on this big responsibility for someone else, don’t guess at the numbers. Talk with a SmartConnect representative who can run a personalized cost comparison for your loved one.