Medicare 2026

Your "Get Ready for Medicare" Package: How to Keep or Turn Down Part B

If you're already receiving Social Security or Railroad Retirement Board (RRB) benefits when you become eligible for Medicare, you don't have to sign up — you're enrolled automatically. About three months before your coverage begins, you'll get a "Welcome to Medicare" packet in the mail (officially CMS Product 11095). Inside is a letter, a booklet, and your red, white, and blue Medicare card showing the start dates for Part A (hospital insurance) and Part B (medical insurance). That package asks you to make one important decision: keep Part B or turn it down.

Here's how to think it through.

What's in the package

The letter explains what to do; the booklet walks through your choices; and the card itself shows your Medicare Number and the dates your Part A and Part B coverage begin. Keep the card somewhere safe — you'll show it to providers to prove you have Medicare.

Keeping Part B: just pay the premium

If you want to keep Part B, you don't need to do anything. Keep the card and start using it on the date printed on the front.

For 2026, the standard Part B premium is $202.90 per month. If you receive Social Security or RRB benefits, Medicare takes the premium directly from your monthly check. If your benefit isn't large enough to cover the full premium, you'll get a bill every three months. People with higher incomes pay more through an income-related adjustment (IRMAA); the 2027 Part B premium, deductible, and IRMAA income brackets haven't been announced yet — CMS typically releases those figures in the fall.

Turning down Part B: follow the form exactly

If you decide not to take Part B, the package gives specific instructions:

1. Leave the Medicare card attached to the form — don't tear it off. 2. On the back of the form, check the box that says "I DON'T want Part B (Medical Insurance)." 3. Sign the form. 4. Mail the entire form (with the card attached) in the enclosed envelope before the Part B coverage start date printed on the front of the card.

Before you send the card back, write down your Medicare Number from the front. You'll still have Part A, and if you need hospital care before your new "Part A only" card arrives (usually within a few weeks), you'll want that number handy.

Who should think hard before turning down Part B

The package notes that most people keep Part B. It suggests you consider keeping it if you:

• Are retired with former-employer coverage or are on COBRA,
• Have VA coverage,
• Have individual Marketplace or other private non-employer coverage,
• Have Medicaid, or
• Have no other insurance at all.

If you have CHAMPVA or TRICARE retiree coverage, you must keep Part B to keep that coverage.

Still working? The rules depend on employer size

If you (or your spouse) are still working and covered by a job-based health plan:

• If the employer has fewer than 20 employees, Medicare generally pays first.
• If the employer has 20 or more employees, the employer plan generally pays first.

People with active employer coverage who delay Part B can usually sign up later through a Special Enrollment Period without a penalty. Importantly, COBRA, VA coverage, and retiree plans do not count as coverage based on current employment for this purpose. If you're relying on one of those and skip Part B, you may not qualify for a penalty-free special sign-up window later.

The cost of delaying Part B

If you turn down Part B and don't qualify for a Special Enrollment Period, you can only sign up during the General Enrollment Period (January 1 – March 31 each year). You'll also likely owe a late-enrollment penalty: 10% added to your premium for each full 12 months you could have had Part B but didn't — usually for as long as you have Part B. In the example in the 2026 package, a 24-month delay turns the $202.90 standard premium into $243.50 a month.

A quick word on your Part D and broader choices

Separate from the keep-or-decline-Part B decision, you'll eventually choose how to get your coverage: Original Medicare (often paired with a stand-alone Part D drug plan and sometimes a Medigap supplement) or a Medicare Advantage plan that bundles everything together. Each path has trade-offs around provider access, cost-sharing, extra benefits, and paperwork. Neither is "better" — it depends on your doctors, medications, budget, and preferences.

A few national 2027 Part D figures to know: the out-of-pocket cap is $2,400 (up from $2,100 in 2026), the maximum allowable plan deductible is $700, and the national base beneficiary premium (used to calculate the Part D late-enrollment penalty) is $41.33. Annual Enrollment runs October 15 – December 7, 2026, for coverage starting January 1, 2027. Social Security has announced a 3.6% cost-of-living adjustment for benefits beginning January 2027.

If you have Medicaid or qualify for Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan (or to switch stand-alone plans). Full-benefit dual-eligible individuals can also enroll in an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

Where can you get help with Medicare questions?

For personalized answers, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week. The official "Medicare & You" handbook and the Medicare enrollment pages at Medicare.gov are the best starting points when you're ready to dig deeper.