New to Medicare
Getting Started With Medicare in Las Vegas and Nevada
New to Medicare
New to Medicare? You are not alone. Medicare has several parts, enrollment rules, cost considerations, and
coverage choices. The best way to approach Medicare is step by step. Start by learning what Medicare covers,confirm when you are eligible, understand what you may pay, apply for the right parts at the right time, and then compare the plan options available in your ZIP code.
Medicare in Las Vegas helps Medicare-eligible Nevadans understand these choices in plain language.
Whether you are turning 65, already have Part A, leaving employer coverage, or helping a family member prepare for
Medicare, this section can help you get organized before choosing a plan.
Getting started with Medicare is easier when the process is organized. Use this page as a roadmap. Begin with the
basics, review costs and eligibility, learn how to apply, understand enrollment periods, and then compare the two main ways people receive Medicare coverage: Original Medicare with additional coverage or a Medicare Advantage plan.
Getting Started With Medicare in Las Vegas and Nevada
New to Medicare
New to Medicare? You are not alone. Medicare has several parts, enrollment rules, cost considerations, and
coverage choices. The best way to approach Medicare is step by step. Start by learning what Medicare covers,confirm when you are eligible, understand what you may pay, apply for the right parts at the right time, and then compare the plan options available in your ZIP code.
Medicare in Las Vegas helps Medicare-eligible Nevadans understand these choices in plain language.
Whether you are turning 65, already have Part A, leaving employer coverage, or helping a family member prepare for
Medicare, this section can help you get organized before choosing a plan.
Getting started with Medicare is easier when the process is organized. Use this page as a roadmap. Begin with the
basics, review costs and eligibility, learn how to apply, understand enrollment periods, and then compare the two main ways people receive Medicare coverage: Original Medicare with additional coverage or a Medicare Advantage plan.
Quick roadmap: The correct order to get started:
1 Learn the basics first. Understand Original Medicare, Part A, Part B, Part C, and Part D before comparing
plans.
2 Confirm your Medicare eligibility and timing. Most people first become eligible around age 65, but some qualify
earlier due to disability, End-Stage Renal Disease, or ALS.
3 Review your current coverage. Determine whether you have active employer group coverage, retiree
coverage, COBRA, VA benefits, Medicaid, or no other coverage. This matters for Part B timing and penalties.
4 Know your enrollment window. Your Initial Enrollment Period usually lasts 7 months: 3 months before the
month you turn 65, the month you turn 65, and 3 months after.
5 Apply for Medicare if you are not automatically enrolled. Some people are enrolled automatically because they
are already receiving Social Security or Railroad Retirement Board benefits. Others must actively sign up
through Social Security.
6 If you already have Part A and need Part B because employer coverage is ending, complete the right Part B
process. In many cases, this involves CMS-40B and CMS-L564, or the online Part B application process
through Social Security.
7 Verify your Medicare card. Your red, white, and blue card should show whether you have Part A, Part B, or
both, and the coverage start dates.
8 Compare your coverage paths. Decide whether to use Original Medicare with additional coverage such as
Medicare Supplement and Part D, or a Medicare Advantage plan if available in your area.
9 Review prescription drug coverage. Part D choices can affect premiums, deductibles, copays, pharmacy
access, and whether your medications are covered.
10 Review your coverage each year. Plans, premiums, networks, drug formularies, pharmacies, and costs can
change from year to year.
What is Medicare?
1. What is Medicare?
Medicare is federal health insurance for people age 65 or older and for some younger people with certain
disabilities, End-Stage Renal Disease, or ALS. It is important to understand that Medicare is not one single plan. It
is made up of different parts that cover different types of care.
Original Medicare includes Part A and Part B. Many people then add other coverage to help with prescription drugs
and out-of-pocket costs, or they choose a Medicare Advantage plan offered by a private insurance company
approved by Medicare.
1 Learn the basics first. Understand Original Medicare, Part A, Part B, Part C, and Part D before comparing
plans.
2 Confirm your Medicare eligibility and timing. Most people first become eligible around age 65, but some qualify
earlier due to disability, End-Stage Renal Disease, or ALS.
3 Review your current coverage. Determine whether you have active employer group coverage, retiree
coverage, COBRA, VA benefits, Medicaid, or no other coverage. This matters for Part B timing and penalties.
4 Know your enrollment window. Your Initial Enrollment Period usually lasts 7 months: 3 months before the
month you turn 65, the month you turn 65, and 3 months after.
5 Apply for Medicare if you are not automatically enrolled. Some people are enrolled automatically because they
are already receiving Social Security or Railroad Retirement Board benefits. Others must actively sign up
through Social Security.
6 If you already have Part A and need Part B because employer coverage is ending, complete the right Part B
process. In many cases, this involves CMS-40B and CMS-L564, or the online Part B application process
through Social Security.
7 Verify your Medicare card. Your red, white, and blue card should show whether you have Part A, Part B, or
both, and the coverage start dates.
8 Compare your coverage paths. Decide whether to use Original Medicare with additional coverage such as
Medicare Supplement and Part D, or a Medicare Advantage plan if available in your area.
9 Review prescription drug coverage. Part D choices can affect premiums, deductibles, copays, pharmacy
access, and whether your medications are covered.
10 Review your coverage each year. Plans, premiums, networks, drug formularies, pharmacies, and costs can
change from year to year.
What is Medicare?
1. What is Medicare?
Medicare is federal health insurance for people age 65 or older and for some younger people with certain
disabilities, End-Stage Renal Disease, or ALS. It is important to understand that Medicare is not one single plan. It
is made up of different parts that cover different types of care.
Original Medicare includes Part A and Part B. Many people then add other coverage to help with prescription drugs
and out-of-pocket costs, or they choose a Medicare Advantage plan offered by a private insurance company
approved by Medicare.
2. Medicare Costs
Medicare can include monthly premiums, deductibles, copayments, and coinsurance. Your costs depend on which
parts of Medicare you have, whether you add drug coverage, whether you buy a Medicare Supplement policy, or
whether you enroll in a Medicare Advantage plan.
For 2026, the standard Medicare Part B monthly premium is $202.90, although some people pay more based on
income. The Part B deductible is $283 in 2026. Medicare drug plan deductibles vary by plan, but Medicare states
that no Medicare drug plan may have a deductible higher than $615 in 2026.
Because costs can change each year, people should review current premiums, deductibles, drug coverage, and
plan options before enrolling or making changes.
Medicare can include monthly premiums, deductibles, copayments, and coinsurance. Your costs depend on which
parts of Medicare you have, whether you add drug coverage, whether you buy a Medicare Supplement policy, or
whether you enroll in a Medicare Advantage plan.
For 2026, the standard Medicare Part B monthly premium is $202.90, although some people pay more based on
income. The Part B deductible is $283 in 2026. Medicare drug plan deductibles vary by plan, but Medicare states
that no Medicare drug plan may have a deductible higher than $615 in 2026.
Because costs can change each year, people should review current premiums, deductibles, drug coverage, and
plan options before enrolling or making changes.
3. How to Apply
Some people get Medicare automatically. Others need to sign up through Social Security. If you are already
receiving Social Security benefits before Medicare eligibility, you may be automatically enrolled in Part A and Part
B. If you are not receiving Social Security benefits, you usually need to apply yourself.
You can apply for Medicare through Social Security online, by phone, or through a local Social Security office. If
you already have Part A and need to add Part B because job-based coverage is ending, Social Security and
Medicare provide a specific Part B process. That process may involve the Part B application form CMS-40B and the employer coverage verification form CMS-L564.
When completing the Part B process after employer coverage, pay careful attention to the month you want Part B
to begin. Timing matters because you want to avoid a coverage gap between employer coverage and Medicare
Some people get Medicare automatically. Others need to sign up through Social Security. If you are already
receiving Social Security benefits before Medicare eligibility, you may be automatically enrolled in Part A and Part
B. If you are not receiving Social Security benefits, you usually need to apply yourself.
You can apply for Medicare through Social Security online, by phone, or through a local Social Security office. If
you already have Part A and need to add Part B because job-based coverage is ending, Social Security and
Medicare provide a specific Part B process. That process may involve the Part B application form CMS-40B and the employer coverage verification form CMS-L564.
When completing the Part B process after employer coverage, pay careful attention to the month you want Part B
to begin. Timing matters because you want to avoid a coverage gap between employer coverage and Medicare
4. Eligibility
Most people become eligible for Medicare when they turn 65. Some people qualify before 65 because of a
qualifying disability, End-Stage Renal Disease, or ALS. Eligibility does not always mean every part of Medicare
starts automatically. Your specific situation determines whether you need to sign up, when coverage begins, and
whether you may delay Part B because you have qualifying current employer group coverage.
People with Medicaid, TRICARE, employer coverage, retiree coverage, COBRA, Marketplace coverage, VA
benefits, or other coverage should review how that coverage works with Medicare before delaying any part of
Medicare
Most people become eligible for Medicare when they turn 65. Some people qualify before 65 because of a
qualifying disability, End-Stage Renal Disease, or ALS. Eligibility does not always mean every part of Medicare
starts automatically. Your specific situation determines whether you need to sign up, when coverage begins, and
whether you may delay Part B because you have qualifying current employer group coverage.
People with Medicaid, TRICARE, employer coverage, retiree coverage, COBRA, Marketplace coverage, VA
benefits, or other coverage should review how that coverage works with Medicare before delaying any part of
Medicare
5. Enrollment Periods
Your first Medicare enrollment window is usually your Initial Enrollment Period. It lasts 7 months: the 3 months
before the month you turn 65, the month you turn 65, and the 3 months after the month you turn 65. Signing up
during the right window can help avoid late enrollment penalties and coverage gaps.
If you are working past 65 and have health coverage based on current employment through your job or a spouse’s
job, you may be able to delay Part B and use a Special Enrollment Period later. However, COBRA and retiree
coverage are not the same as coverage based on current employment for Part B Special Enrollment Period
purposes. Do not wait until COBRA ends to ask about Part B timing.
If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you may have to use
the General Enrollment Period. Penalties may apply, and coverage may not start when you expected.
Your first Medicare enrollment window is usually your Initial Enrollment Period. It lasts 7 months: the 3 months
before the month you turn 65, the month you turn 65, and the 3 months after the month you turn 65. Signing up
during the right window can help avoid late enrollment penalties and coverage gaps.
If you are working past 65 and have health coverage based on current employment through your job or a spouse’s
job, you may be able to delay Part B and use a Special Enrollment Period later. However, COBRA and retiree
coverage are not the same as coverage based on current employment for Part B Special Enrollment Period
purposes. Do not wait until COBRA ends to ask about Part B timing.
If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you may have to use
the General Enrollment Period. Penalties may apply, and coverage may not start when you expected.
6. Choosing a Plan
Once you have Medicare Part A and Part B, the next decision is how you want to receive your coverage. Many
people compare two main paths:
● Original Medicare path: Use Original Medicare as the foundation and consider adding a Medicare Supplement
policy and a stand-alone Medicare Part D prescription drug plan.
● Medicare Advantage path: Enroll in a Medicare Advantage plan, also called Part C, if one is available in your
area and fits your doctors, prescriptions, budget, and network preferences.
There is no one-size-fits-all answer. The right direction depends on your doctors, prescriptions, pharmacies,
preferred hospitals, travel patterns, monthly budget, and comfort with networks and referrals.
Once you have Medicare Part A and Part B, the next decision is how you want to receive your coverage. Many
people compare two main paths:
● Original Medicare path: Use Original Medicare as the foundation and consider adding a Medicare Supplement
policy and a stand-alone Medicare Part D prescription drug plan.
● Medicare Advantage path: Enroll in a Medicare Advantage plan, also called Part C, if one is available in your
area and fits your doctors, prescriptions, budget, and network preferences.
There is no one-size-fits-all answer. The right direction depends on your doctors, prescriptions, pharmacies,
preferred hospitals, travel patterns, monthly budget, and comfort with networks and referrals.
Parts of Medicare Section
Part A - Hospital Insurance
Medicare Part A is hospital insurance. It helps cover inpatient hospital care, skilled nursing facility care, hospice
care, and some home health care. Many people qualify for premium-free Part A based on their work history or a
spouse’s work history.
Part B - Medical Insurance
Medicare Part B is medical insurance. It helps cover doctor services, outpatient care, durable medical equipment,
many preventive services, and other medically necessary services. Most people pay a monthly premium for Part B.
Part C - Medicare Advantage
Medicare Part C is Medicare Advantage. These plans are offered by private insurance companies approved by
Medicare. Medicare Advantage plans provide Part A and Part B benefits, and many include prescription drug
coverage and additional benefits. Plan availability, networks, costs, and benefits vary by ZIP code and county.
Part D - Prescription Drug Coverage
Medicare Part D is prescription drug coverage. It can be offered as a stand-alone Medicare drug plan or included in
many Medicare Advantage plans. Each plan has its own formulary, pharmacies, premiums, deductibles, copays,
and rules, so an annual prescription review is important
Part A - Hospital Insurance
Medicare Part A is hospital insurance. It helps cover inpatient hospital care, skilled nursing facility care, hospice
care, and some home health care. Many people qualify for premium-free Part A based on their work history or a
spouse’s work history.
Part B - Medical Insurance
Medicare Part B is medical insurance. It helps cover doctor services, outpatient care, durable medical equipment,
many preventive services, and other medically necessary services. Most people pay a monthly premium for Part B.
Part C - Medicare Advantage
Medicare Part C is Medicare Advantage. These plans are offered by private insurance companies approved by
Medicare. Medicare Advantage plans provide Part A and Part B benefits, and many include prescription drug
coverage and additional benefits. Plan availability, networks, costs, and benefits vary by ZIP code and county.
Part D - Prescription Drug Coverage
Medicare Part D is prescription drug coverage. It can be offered as a stand-alone Medicare drug plan or included in
many Medicare Advantage plans. Each plan has its own formulary, pharmacies, premiums, deductibles, copays,
and rules, so an annual prescription review is important
Special Section: New to Medicare With or Without Employer Coverage
If you are turning 65 and not working with employer coverage
If you are turning 65 and do not have active employer group coverage through your work or a spouse’s work, you
generally should review your Initial Enrollment Period carefully. Delaying Part B without qualifying coverage may
create a late enrollment penalty and a coverage gap.
If you are still working and covered by active employer insurance
If you or your spouse are still working and you have active employer group health coverage, you may have options
for when to enroll in Part B. This is one of the most important timing questions for people who work past 65. The
size of the employer, whether the coverage is based on current employment, and how your employer plan
coordinates with Medicare can all matter.
Before delaying Part B, ask your employer benefits department how the group plan coordinates with Medicare,
whether the prescription coverage is creditable, and what documents you may need when you eventually enroll in
Part B.
If you already have Part A and need Part B
Many people enroll in premium-free Part A at 65 but delay Part B because they keep working and stay covered
under active employer group coverage. When that employer coverage is ending, you may need to enroll in Part B
so Medicare can become your primary coverage. In many cases, this process includes completing the Part B
application and providing proof of employer group coverage through CMS-L564. The employer typically completes
the employer section, and the forms are submitted to Social Security.
A useful planning goal is to begin the Part B process before employer coverage ends so your Medicare Part B start
date lines up with the month you need coverage.
If you have COBRA or retiree coverage
COBRA and retiree coverage can be helpful, but they are not the same as active employer coverage for Medicare
Part B timing. Do not assume COBRA or retiree coverage allows you to delay Part B without risk. Review your
situation before relying on COBRA or retiree coverage after Medicare eligibility.
Common New to Medicare Questions
When should I start learning about Medicare?
A good time to start is several months before you become eligible, especially if you are turning 65 or planning to
leave employer coverage. This gives you time to understand costs, enrollment windows, and plan choices before
you need coverage to begin.
Will Medicare automatically send me a card?
Some people are automatically enrolled and receive a Medicare card. Others must sign up through Social Security.
Your card should show whether you have Part A, Part B, or both, and the coverage start dates.
Do I need Part B if I am still working?
It depends on whether your coverage is based on current employment, how the employer plan coordinates with
Medicare, and other factors. People working past 65 should confirm this before delaying Part B.
What if I already have Part A and now need Part B?
You may need to complete the Part B enrollment process through Social Security. If you delayed Part B because
of active employer group coverage, you may also need employer coverage verification, commonly handled through
CMS-L564.
What is the difference between Medicare Advantage and Medicare Supplement?
Medicare Advantage is another way to receive Medicare benefits through a private plan approved by Medicare.
Medicare Supplement insurance works with Original Medicare to help pay some out-of-pocket costs. The best fit
depends on your doctors, prescriptions, travel, budget, and plan availability.
Do I need Medicare Part D?
Many people need prescription drug coverage to avoid uncovered medication costs and possible late enrollment
penalties. Part D can be a stand-alone drug plan or included in many Medicare Advantage plans.
Why should I review my Medicare coverage every year?
Plans can change. Premiums, deductibles, copays, formularies, pharmacies, provider networks, and extra benefits
can change each year. An annual review helps make sure your coverage still fits your current needs.
If you are turning 65 and not working with employer coverage
If you are turning 65 and do not have active employer group coverage through your work or a spouse’s work, you
generally should review your Initial Enrollment Period carefully. Delaying Part B without qualifying coverage may
create a late enrollment penalty and a coverage gap.
If you are still working and covered by active employer insurance
If you or your spouse are still working and you have active employer group health coverage, you may have options
for when to enroll in Part B. This is one of the most important timing questions for people who work past 65. The
size of the employer, whether the coverage is based on current employment, and how your employer plan
coordinates with Medicare can all matter.
Before delaying Part B, ask your employer benefits department how the group plan coordinates with Medicare,
whether the prescription coverage is creditable, and what documents you may need when you eventually enroll in
Part B.
If you already have Part A and need Part B
Many people enroll in premium-free Part A at 65 but delay Part B because they keep working and stay covered
under active employer group coverage. When that employer coverage is ending, you may need to enroll in Part B
so Medicare can become your primary coverage. In many cases, this process includes completing the Part B
application and providing proof of employer group coverage through CMS-L564. The employer typically completes
the employer section, and the forms are submitted to Social Security.
A useful planning goal is to begin the Part B process before employer coverage ends so your Medicare Part B start
date lines up with the month you need coverage.
If you have COBRA or retiree coverage
COBRA and retiree coverage can be helpful, but they are not the same as active employer coverage for Medicare
Part B timing. Do not assume COBRA or retiree coverage allows you to delay Part B without risk. Review your
situation before relying on COBRA or retiree coverage after Medicare eligibility.
Common New to Medicare Questions
When should I start learning about Medicare?
A good time to start is several months before you become eligible, especially if you are turning 65 or planning to
leave employer coverage. This gives you time to understand costs, enrollment windows, and plan choices before
you need coverage to begin.
Will Medicare automatically send me a card?
Some people are automatically enrolled and receive a Medicare card. Others must sign up through Social Security.
Your card should show whether you have Part A, Part B, or both, and the coverage start dates.
Do I need Part B if I am still working?
It depends on whether your coverage is based on current employment, how the employer plan coordinates with
Medicare, and other factors. People working past 65 should confirm this before delaying Part B.
What if I already have Part A and now need Part B?
You may need to complete the Part B enrollment process through Social Security. If you delayed Part B because
of active employer group coverage, you may also need employer coverage verification, commonly handled through
CMS-L564.
What is the difference between Medicare Advantage and Medicare Supplement?
Medicare Advantage is another way to receive Medicare benefits through a private plan approved by Medicare.
Medicare Supplement insurance works with Original Medicare to help pay some out-of-pocket costs. The best fit
depends on your doctors, prescriptions, travel, budget, and plan availability.
Do I need Medicare Part D?
Many people need prescription drug coverage to avoid uncovered medication costs and possible late enrollment
penalties. Part D can be a stand-alone drug plan or included in many Medicare Advantage plans.
Why should I review my Medicare coverage every year?
Plans can change. Premiums, deductibles, copays, formularies, pharmacies, provider networks, and extra benefits
can change each year. An annual review helps make sure your coverage still fits your current needs.
Need help understanding your Medicare starting point?
Call David Karel, Nevada Licensed Insurance Agent #210603
702.403.6348 (TTY: 711)
Need help understanding your Medicare starting point?
Call David Karel, Nevada Licensed Insurance Agent #210603
702.403.6348 (TTY: 711)