Medicare 2026

First Medicare steps for people in Lawrence, Kansas

# Aging into Medicare: the enrollment window you don't want to…

LAWRENCE, Kan. — If your 65th birthday is on the horizon, Medicare has a specific stretch of time reserved just for you. It's called the Initial Enrollment Period, and it lasts seven months. Miss it, and you could face lifelong late penalties and a wait to get covered. Hit it, and you set yourself up for a smoother transition into Medicare.

Here in Douglas County, thousands of residents cross the Medicare threshold each year. Whether you're still working at KU, easing into retirement, or already covered by a spouse's plan, the same federal rules apply — and the clock starts ticking the same way for everyone.

What the Initial Enrollment Period actually is

The Initial Enrollment Period, or IEP, is the seven-month window Medicare gives you around your 65th birthday. It includes:

• The three months before your birthday month
• Your birthday month
• The three months after your birthday month

For most people in Lawrence, this is the first and best chance to sign up for Medicare Part A (hospital coverage) and Part B (doctor and outpatient coverage). If you enroll during the three months before you turn 65, your coverage generally starts on the first day of your birthday month. Wait until after your birthday, and your start date gets pushed back.

Do you have to sign up at 65?

Not always — and this is where people trip up.

If you're already receiving Social Security benefits before you turn 65, you'll usually be enrolled in Parts A and B automatically. If you're not drawing Social Security yet, you have to sign up yourself through the Social Security Administration.

If you're still working at 65 and have solid job-based health coverage (through your employer or your spouse's employer with 20 or more employees), you may be able to delay Part B without a penalty. When that job coverage ends, a Special Enrollment Period opens up so you can join Medicare then. But retiree coverage, COBRA, and marketplace plans don't count as "active" employer coverage for this rule — a common and costly mix-up.

If you're unsure, ask before your birthday. Guessing wrong can be expensive.

The penalties for waiting

Medicare's late enrollment penalties are permanent, and they get bigger the longer you wait.

• Part B penalty: 10% added to your monthly premium for every full 12-month period you were eligible but didn't sign up.
• Part D penalty: A monthly surcharge based on how many months you went without creditable prescription drug coverage.

These penalties stay with you for as long as you have Medicare. That's why even people who don't take any prescriptions today are often advised to get some form of drug coverage in place at 65.

First steps for Lawrence residents

Here's a simple checklist as your window opens:

1. Mark your seven-month window on the calendar. Count back three months from your birthday month — that's your start date. 2. Check your current coverage. If you have employer insurance, ask your HR department for a "creditable coverage" letter, especially for prescription drugs. 3. Decide how you want to get your Medicare. You can stick with Original Medicare (Parts A and B) and add a stand-alone Part D drug plan, or you can choose a Medicare Advantage plan (Part C) that bundles them together. Douglas County residents have multiple plan options to compare. 4. Look at prescription drug coverage carefully. In 2026, Part D has a $2,100 annual out-of-pocket cap and a maximum deductible of $615. The old "donut hole" coverage gap is gone as of 2025, replaced by a simpler three-phase structure. There's also an optional Medicare Prescription Payment Plan that lets you spread your drug costs across the year in monthly installments. 5. Know the income rules. Higher earners may pay an IRMAA surcharge on Parts B and D. For 2026, that kicks in above $109,000 in income for single filers, based on your tax return from two years ago.

After your window closes

Once your IEP ends, you're not locked out forever — but your options narrow.

• The Annual Enrollment Period runs October 15 through December 7 each year. This is when you can join, switch, or drop a Medicare Advantage or Part D plan.
• The Medicare Advantage Open Enrollment Period runs January 1 through March 31, for people already in a Medicare Advantage plan who want to switch or drop it.
• Special Enrollment Periods open for specific life events, such as losing job-based coverage or moving out of your plan's service area.

Where to get local help

You don't have to figure this out alone, and you shouldn't lean on a sales pitch as your only source of information. Free, unbiased counseling is available through SHICK (Senior Health Insurance Counseling for Kansas), the state's SHIP program. Trained counselors can walk you through your choices without steering you toward any particular plan.

You can also:

• Visit medicare.gov to compare plans available in Douglas County using your ZIP code
• Call 1-800-MEDICARE (1-800-633-4227), available 24/7
• Contact the Social Security Administration at 1-800-772-1213 to enroll in Parts A and B