A plain-English guide for people turning 65 in Missouri and Illinois. Written by Marc Mantia, independent Medicare agent in Ellisville — 15 years, and not a 1-800 number.

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For anyone turning 65 or retiring soon — Missouri & Illinois

Turning 65? Here is how Medicare actually works

Medicare is confusing, and that is why I am here. When to sign up, how to do it, and why the choice at 65 is harder to undo than it looks.

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The short version

If you read nothing else, read this. Five facts drive everything else.

It starts at 65 for most people. Medicare is based on your age, not on retiring. You can be working full time and still make this decision.
It begins with two parts. Part A covers hospital stays. Part B covers doctor visits, outpatient care, labs and preventive care.
Part A is usually free. Part B is not. Part B is $202.90 a month in 2026 for most people, normally taken straight out of Social Security.
Parts A and B put no cap on your costs. There is no yearly limit on your share of the bills. That is why almost everyone adds coverage on top.
You get one seven-month window, opening three months before your birthday month. Miss it without other coverage, and you can pay a penalty for life.

That is the framework. The rest of this page is the detail — and matching it to your doctors, your prescriptions and your budget is where I come in.

When you sign up: your seven-month window

Your Initial Enrollment Period is seven months wide, not one deadline. When you file inside it changes when coverage starts.

3 months before

Your window opens. The sweet spot — file here and coverage starts the first day of your birthday month, with no gap.

Your birthday month

You can still file, but coverage often starts the first day of the next month, so you may go a few weeks uncovered.

3 months after

You can enroll, but your start date can be delayed. The late penalties start here.

Still working at 65? With 20 or more employees, you can usually keep that coverage as your main plan and delay Part B with no penalty. Under 20, Medicare pays first, so enroll on time.

Retiree coverage or COBRA? Those are not active employment, so they do not give you extra time. Enroll inside your window.

Contributing to a health savings account at work? Once you are on Medicare you cannot add to it, and Part A can be backdated up to six months. Tell me about your HSA before you file.

How you actually sign up

Enrolling happens through Social Security, not an insurance company. There is no fee, and you do not need an agent to file.

Apply yourself. Online at ssa.gov/medicare/sign-up, by phone at 1-800-772-1213, or at a Social Security office. Have your employer details handy.
Watch the mail. Your card arrives a few weeks after you apply — or about three months before your birthday if you already collect Social Security, since you are enrolled automatically.
Decide what fills the gaps. Parts A and B have deductibles and copays and no yearly cap. What you add on top affects your checkbook the most.
Line it up before your start date. Your new coverage should begin with Parts A and B, so there is no month where you pay for two plans, or have neither.

⚠ Two things that surprise people

If you draw Social Security, you are already enrolled. Parts A and B start automatically and the premium comes out of your check. You can still decline Part B if you have employer coverage.
Your Medicare card is free. Anyone who offers to get you one for a fee is not legitimate.

What you put on top of Parts A and B

There is no single best answer, only the one that fits your doctors, your prescriptions and how you feel about risk. There are two paths.

Path one

Original Medicare + a Supplement + a drug plan

Your copays and deductibles get picked up, so costs become predictable.
Any doctor in the country who takes Medicare. No networks, no referrals.
A monthly Supplement premium, plus a small Part D premium — both on top of Part B.

Good fit if you want the fewest surprise bills, you travel, or you want to keep your doctors.

Path two

Medicare Advantage (Part C)

One plan delivers Parts A and B, usually with drug coverage and extras like dental or vision.
Plan premiums are often very low, sometimes zero, on top of Part B. You pay copays as you use care, up to a yearly cap.
In exchange you stay in the plan’s network, and some care needs the plan’s approval first.

Good fit if your doctors are in a strong local network and the lowest monthly cost matters most.

Both paths include Parts A and B — and the Part B premium. You pay it either way: $202.90 a month in 2026, usually out of your Social Security. A Medicare Advantage plan does not replace that premium. It comes on top of it.

The part I ask people to slow down on: the choice at 65 is easier to live with than to undo.

Your best window to buy a Supplement is the six months starting the month your Part B begins. In those six months, any carrier must sell you one — no health questions. Step outside it and a carrier can say no, or charge you more because of your health.

Medicare Advantage is the opposite — you can switch plans every fall with no health questions. So one path is easy to revisit, and the other has a door that usually opens once.

One more cost worth knowing about: IRMAA

IRMAA is the extra amount added to your Part B and Part D premiums when your income is above a certain level. It is not a penalty, and it is not permanent.

For 2026, the standard Part B premium is $202.90 a month. IRMAA starts above $109,000 in income for a single filer and $218,000 for a married couple, and steps up in tiers from there.

It looks back two years. What you pay this year comes from the tax return you filed two years ago.
It is a cliff, not a ramp. One dollar over a threshold moves you into the next tier for the whole year.

If your income dropped — retirement, divorce, losing a spouse or business income — you can ask Social Security to use your current income instead. That request is Form SSA-44, one page.

Where I come in: people are often told “you make too much to get help with Medicare” and stop there. IRMAA can be reviewed, and often corrected.

The mail and phone calls you are about to get

Turning 65 puts your name on lists. Most of the Medicare mail you receive is marketing dressed up to look official.

⚠ How to tell what is real

Medicare and Social Security never call you to sell or change a plan. Anyone who opens with “this is Medicare calling” is not Medicare.
Your card is free, and it comes from Social Security. Anyone charging a fee is not legitimate.
Not sure whether something is real? Do not guess and do not click. Call me first at (314) 724-6590.

And I will never call you out of the blue to pressure you into a plan. If we talk about coverage, it is because you and I set the appointment.

Why people call me instead of a 1-800 number

Independent

I compare plans across the carriers I represent, not one company’s lineup.
I work for you. No quota decides your recommendation.

Local, and Medicare only

My office is on Manchester Road in Ellisville. Licensed in Missouri and Illinois.
Medicare is all I do — 15 years.

Free, and proven

Consultations and help after you enroll cost you nothing. Your premium is the same either way.
BBB accredited, 4.9 stars from 62 Google reviews.

Questions I hear most from people turning 65

Does this cost me anything?

No. The conversation, the comparisons and help after you enroll are free. Carriers pay me a standard commission, and your premium is identical whether you use me or call them yourself.

I am still working and covered by my employer. Do I have to sign up?

It depends on the size of the employer. At 20 or more employees you can usually delay Part B with no penalty. Under 20, Medicare generally pays first. Either way it is worth a short conversation now.

I am on a Marketplace plan I like. What happens at 65?

Your premium tax credit ends when Medicare begins. End the Marketplace plan the month before, rather than letting it auto-renew.

What if I already missed my window?

You can still enroll — the question is the cost and when coverage starts. Losing employer coverage can open a Special Enrollment Period that avoids penalties. Call me and we will sort it out.

Let’s get your Medicare decision right the first time

Pick a time that works for you. Once you book, I will send you a short, secure form so I can look at your doctors and prescriptions before we talk. Twenty minutes, no cost, no pressure.

Book My Free Medicare Conversation

Prefer to talk first? Call me directly at (314) 724-6590.

To clarity without the confusion,

Marc Mantia
Independent Agent | Review Medicare Benefits, LLC
Office: (636) 203-5840 | Mobile: (314) 724-6590
marc@reviewmedicarebenefits.com
16024 Manchester Rd, Ste 200, Ellisville, MO 63011

P.S. Getting expert help with Medicare doesn’t cost you anything extra. Going without it might.