Medicare’s… Enrollment Check-List!!

Hello Toni:

My husband, David, has been laid off because of what is happening to oil companies in the Houston area.  He is 68 and has never enrolled in Medicare, but I am turning 65 in November. We both are covered under his employer’s health plan and it is ending on October 31st.

We have been told that he will get a penalty because he is over 65 and never enrolled in Part B.  I assume that I am ok since I turn 65 in November.  Please explain what our options are since we are different ages.  Thanks, Peggy from Bellaire, TX.


Great Question, Peggy:

There are 2 different rules regarding enrolling in Medicare Parts A and B in your household.

David needs to apply for a SEP (Special Enrollment Period) by downloading the form OMB #0938 (request for employers information) from or email and we can email you a form.

Have David’s HR department sign off on the form in October and take the form in person to your local Social Security department to apply for Medicare Parts A and B. Advise the Social Security representative that he is losing his company benefits and need his Medicare Parts A and B to begin November 1st.

For you, Peggy, enrolling in Medicare is simple and very different from David’s because you are turning 65 in November. You need to go online at only 90 days prior to turning 65 and apply online for a November 1st effective date.

Below is a check-list for those enrolling in Medicare the correct way:

  1. Learn that Original Medicare: Part A covers your in-patient hospital stay, skilled nursing/rehab stay, blood transfusions, home health and hospice. Original Medicare: Part B covers your primary care or specialist whether in the office or performing surgery, outpatient surgery, durable medical equipment, x-rays, CAT scans, MRIs, chemotherapy, etc.  Discuss with your doctor about what they accept such as Original/Traditional Medicare or a Medicare Part C (Medicare Advantage plan).
  2. Explore your Medicare Advantage plan options such as HMO, PPO or PFFS.
  3. Go to the specific Medicare Advantage plan’s hospital/provider online directory to be sure your physicians and hospitals are available for you. Remember online directories are more accurate than printed copies, since many providers may have already opted out of accepting that specific plan.
  4. Shop for a Medicare Supplement/Medigap policy. Start seeking a Medicare Supplement by talking with your doctor
  5. Seek Medicare Prescription Drug planning every year to see if your standalone Prescription Drug or Medicare Advantage Plan with prescriptions formulary covers all of your brand name or generic prescription drugs.
  6. Seek “Extra Help” with prescription drugs if you meet low-income qualifications.
  7. Consider a Long Term Care option such as standalone LTC policies, hybrid annuities or life insurance with LTC riders, VA aid and attendant benefits or applying for financial help from your specific states Medicaid for LTC.
  8. Make sure your legal documents are in order such as power of attorney, medical power of attorney and living will.

Toni King, author of the new Medicare Survival Guide®, which is a simple guide that puts Medicare in “people” terms, is on sale at  Medicare consultations are available at the Toni Says office or email questions to or call 832/519-TONI (8664).





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