Of all the benefits programs, Medicare is the one that garners the most questions. Let us help you get started!

Medicare is a federal health insurance program for specific groups of people who might otherwise have limited or no access to healthcare. The primary group is individuals who are 65 and older.

When to apply for Medicare

• If you are not currently working during that period, most people have an initial enrollment period that lasts 7 months. Three months before your 65th birthday, the month of your 65th birthday, and 3 months after your birthday month. If you have signed up for early social security benefits, then you do not need to apply for Medicare; you will automatically be enrolled.
• If you are still working, you can delay signing up.
• If you are working but plan to retire, sign up 4-6 weeks before you actually retire.

How to apply for Medicare

Apply through the Social Security Administration (SSA) website or by making an appointment by calling SSA. You do not need to sign up for Social Security benefit at the same time unless you want to.

A penalty for signing up late

Not signing up for Medicare on time can lead to a permanent penalty. The penalty is 10% of the standard monthly premium for each 12-month period you were eligible but did not enroll.

Delaying Medicare coverage while employed

If you are still employed, you can delay your Medicare signup without penalty. Once you retire, you are eligible for an eight month special enrollment period without being subject to the penalty. Visit the SSA website for more information.

City of Austin Retirees ages 65 and older

You do not have to sign up for the City’s BC/BS Medicare Advantage Plan. However, the PPO and HMO plans that are offered to City employees are not available to you once you are 65. Your choice is to take the Medicare Advantage Plan – or not. If you choose this Medicare Advantage Plan, you do need to first enroll in Medicare Parts A&B. You have the option of being enrolled in Medicare, or supplementing Medicare with the City’s plan, or supplementing Medicare with a plan of your own choosing purchased elsewhere.

Medicare is not free

Most people do not pay a premium for Part A, but do pay a premium for Part B (see below). That premium varies based on income and other factors. The standard cost for Medicare Part B premium in 2026 is $202.90 per month, though it can be higher for high-income earners. This cost is generally subtracted from your Social Security benefits. Neither the City of Austin nor COAERS can make any changes to your Medicare costs. Part D (drug coverage) is also not free, though there are programs to help lower income Seniors. Part D is not needed for retirees who plan on signing up for the City’s Medicare plan.

Different Medicare Parts

Part A is generally hospital insurance (in patient stays)

Part B is generally medical insurance (doctors’ services, outpatient care, preventive services)

Part C is Medicare Advantage – a comprehensive plan incorporating parts A&B offered by private insurers but approved by Medicare. Part C often includes vision and dental care.

Part D is prescription drug coverage.

Actionable Steps or Tips

During Open Enrollment expect your mailbox, email, and phone messages to be full of people and companies trying to sell plans to you. We recommend starting with one of the trusted sources below before making any decisions.

Decisions

Whether you are still employed or retired, the months leading up to your 65th birthday require a decision. There is no right decision for everyone, and good advice can be elusive. Take an inventory of your budget, your health, and your employment status before making any commitments.

 

Trusted Sources

City of Austin Benefits Office 512-974-3284 www.austintexas.gov/department/benefits-division

Blue Cross Blue Shield Medicare Advantage PPO (Group PTX00025) 855-380-8542   www.bcbstx.com/retiree-medicare-coa

Medicare 1-800-MEDICARE or www.Medicare.Gov

Area Agency on Aging of the Capital Area 512-916-6178 or bcinfo@capcog.org

 

Disclaimer: 
This page provides information and links to not-for-profit external websites that we believe may be of interest to our membership and is made available as a public service. COAERS is not responsible for the content or the security of such sites nor any damage to those accessing these sites or damage caused by the use of the products and services provided by these resources.  Resources have been chosen according to our Social Media policy and for the purpose of providing useful, relevant, information avoiding for-profit entities, political organizations, organized labor organizations, and individuals or entities soliciting money or donations.