Medicare Enrollment Quiz

Understanding Medicare enrollment is essential to getting the best cost and coverage options from a Medicare plan. Reviewing and comparing Medicare coverage every year during the various Medicare open enrollment periods can save you money while getting the best coverage for your health care needs.

Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

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  • Edited By
    Savannah Hanson
    Savannah Hanson, financial editor for RetireGuide

    Savannah Hanson

    Senior Financial Editor

    Savannah Hanson is a professional writer and content editor with over 16 years of professional experience across multiple industries. She has ghostwritten for entrepreneurs and industry leaders and been published in mediums such as The Huffington Post, Southern Living and Interior Appeal Magazine.

    Read More
  • Published: September 2, 2022
  • Updated: March 1, 2023
  • 15 min read time
  • This page features 9 Cited Research Articles
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APA Turner, T. (2023, March 1). Medicare Enrollment Quiz. Retrieved June 9, 2023, from

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How Well Do You Understand Medicare Enrollment?

When you enroll in Medicare — or when you have the chance to change Medicare plans — can have lasting effects on how much you have to pay and the quality of coverage you receive.

Most people who switch Medicare plans are beneficiaries who are now using more health care and looking for plans that can provide them even more coverage, according to multiple studies from Deft Research, a market research firm that specializes in older adult consumers.

But finding the best Medicare plan can be complicated. There are a dizzying number of plans and options to choose from beyond Original Medicare. You have to do your homework to make sure you’re getting the best care for your money.


Medicare Enrollment Quiz

The first thing you need to understand are some basic facts about Medicare enrollment. Take this quiz to test your Medicare knowledge.

Enrollment is not automatic in most cases. However, if you are getting Social Security benefits or benefits from the Railroad Retirement Board, you will automatically be enrolled in Original Medicare on the first day of the month you turn 65. If you are not receiving these benefits at that time, you need to enroll on your own during your initial enrollment period.

You can enroll in Medicare without work history, but it may be more expensive. Depending on your circumstances, you will likely need to pay for Medicare Part A premiums if you haven’t worked. However, you will pay the same as others with your income for Medicare Part B premiums even if you have never worked.

There are late enrollment penalties for different parts of Medicare. If you don’t sign up for Medicare Part B when you’re first eligible, for example, you may have to pay a penalty for as long as you have it when you do enroll. If you don’t have creditable prescription drug coverage when you’re first eligible, you may have to pay a penalty when you later enroll in a Medicare Part D drug plan.

The annual open enrollment period allows you to switch between all Medicare plans Oct. 15 through Dec. 7 each year. The Medicare Advantage open enrollment period Jan. 1 through March 31 each year allows you to switch between Advantage plans if you already have one.

You can change your Medicare Advantage or Medicare Part D prescription drug plan during special enrollment periods. These happen due to special circumstances in your life such as a change in where you live, losing your plan’s coverage and other qualifying situations.

False, the findings are even higher. A Kaiser Family Foundation study found that seven out of every 10 Medicare beneficiaries — 71% — failed to compare costs and coverage of different plans during open enrollment in 2019. Prices and coverage change yearly and people with Medicare should comparison shop each year for the best coverage and cost.

No, you cannot have Medigap and Medicare Advantage at the same time. Medigap will only work with Original Medicare.

You can enroll in Medicare Part D during your initial enrollment period — the seven-month period beginning three months before the month you turn 65. After that, you must wait until the next annual open enrollment period or eligible special enrollment period.

As long as you have employer-provided health insurance through your job or your spouse’s job, you don’t have to enroll in Medicare while still working — until you leave your job or lose your insurance.

People who have received Social Security disability benefits for 24 months may be eligible for Medicare before they turn 65. People with ALS or End-Stage Renal Disease also qualify for Medicare before they turn 65.

Keep reading to boost your Medicare enrollment knowledge.

Note: The above quiz is intended for informational purposes only and does not constitute retirement planning advice. By submitting your answers, you agree to anonymously share your feedback with RetireGuide and your responses may be included in future data.

10 Things To Consider During Medicare Enrollment

Medicare can be complicated, but these 10 simple steps can walk you through the most complex parts of Medicare enrollment.

Your Medicare plan’s costs and coverage change yearly. Comparing your current coverage with other Medicare plans each year during open enrollment may get you better coverage at lower cost.

Don't Leave Your Health to Chance
Find a local Medicare plan that fits your needs by connecting with a licensed insurance agent.

#1: Your Medicare Enrollment Period

Medicare has an initial enrollment period — when you first sign up for Medicare — then open enrollment periods when you can change coverage.

Your initial enrollment period is the seven-month period that begins three months before the month you turn 65 when you can sign up for Original Medicare (Medicare Part A and Part B).

If you miss your initial enrollment period, you can sign up during the general enrollment period running Jan.1 through March 31 each year specifically for people who missed initial enrollment. You can sign up for Medicare Part A and Part B, but you may have to pay a late-enrollment fee. Coverage will start July 1.

Medicare open enrollment periods themselves can be confusing because there are three different open enrollment periods, and two of them give you the chance to change your Medicare coverage.

Each one works differently. Here’s how each one affects you.

Medicare’s Open Enrollment Periods
Annual Open Enrollment Period
This is your chance every year to switch Medicare coverage to a plan that’s better for you. The annual open enrollment period is from Oct. 15 to Dec. 7 and allows you to join, drop or switch Medicare plans.
Medicare Advantage Open Enrollment Period
This is a chance to switch between Medicare Advantage plans. It runs from Jan. 1 through Mar. 31 each year. The Medicare Advantage open enrollment period also allows you to switch from Medicare Advantage to Original Medicare and add a Medicare Part D drug plan — though you can only make this switch once.
Medigap Open Enrollment Period
Medigap — or Medicare Supplement insurance — helps cover your out-of-pocket costs with Original Medicare. The Medigap open enrollment period is a six-month period that begins the first month you have Medicare Part B medical insurance and are 65 or older. This is the best time to enroll in Medigap because, outside of that open enrollment period, you may not be able to buy a policy or may have to pay more for one because of any health conditions.

#2: Situations That Allow Medicare Changes Anytime (Special Enrollment Periods)

If you move or there are changes in your coverage, you may be eligible for a special enrollment period or SEP.

Moving is a common circumstance that qualifies beneficiaries for a special enrollment period. Because private insurers sell Medicare Advantage and Medicare Part D drug plans, they rely on networks of health care providers and may only have limited doctors, hospitals and pharmacies available in a given area.

Examples of Special Circumstances Creating a Special Enrollment Period
  • Left Medicare coverage for employer or union coverage (including COBRA coverage)
  • Lost drug coverage
  • Moving back to the U.S. after living abroad
  • Moving into a long-term care facility or other institution
  • Moving out of your plan’s service area
  • Moving within the service area, but new options are available
  • No longer eligible for Medicaid
  • Plan’s contract with Medicare changes or ends

Rules for each special circumstance vary. It’s important to talk with your plan provider or with Medicare to find out what the rules for your particular SEP are.

You can call Medicare toll-free at 1-800-633-4227 (TTY at 1-877-486-2048).

How Medicare Taxes Pay for Coverage

Medicare taxes are federal payroll taxes deducted from your paycheck. They pay for the Medicare Part A hospital insurance component. You and your employer each pay 1.45% of your income in Medicare tax. If you are self-employed, you pay the full 2.9% of the tax yourself.

Medicare taxes are sometimes bundled with your Social Security payroll taxes. They may show up together as FICA taxes on your pay stub.

Medicare Spending
Medicare is projected to spend $733 billion on health coverage for 80 million Americans over 65 or with disabilities in 2022.

The money you pay as Medicare tax goes into one of two Medicare trust funds. The Hospital Insurance Trust Fund pays for hospital, hospice and skilled nursing facility costs of people currently on Medicare.

A second trust fund — the Supplementary Medical Insurance Trust Fund — receives money from Congress and interest on the fund’s investments. It pays for Medicare Part B costs.

#4: Late Enrollment Penalties Raise Your Premium

It’s important to sign up for Medicare plans when you are first eligible for them to avoid late enrollment penalties.

These penalties can raise your premiums and can have other financial consequences depending on the Medicare plan you choose.

Late Enrollment Penalties and Consequences
Medicare Part A (Hospital Insurance) Late Enrollment
Deadline: Before the end of your initial enrollment period. Most people won’t have to pay a late enrollment penalty for Medicare Part A if they miss the deadline. But if you don’t qualify for premium-free Part A — meaning you haven’t paid Medicare taxes for at least 10 years — you’ll have to pay an extra 10% on top of your premium.
Medicare Part B (Medical Insurance) Late Enrollment
Deadline: Before the end of your initial enrollment period. If you miss the deadline, you’ll have to pay an additional 10% on top of your premium for every 12-month period that goes by. For example, if you wait five years, you’ll pay an additional 50% every month on your premiums.
Medicare Part D Drug Plan Late Enrollment
Deadline: After 63 days in a row without creditable drug coverage. Part D is voluntary, but if you wait past this 63-day window and later enroll, you’ll have to pay a monthly Medicare Part D penalty for as long as you do have coverage.
Medigap Late Enrollment
There is no formal penalty for Medigap late enrollment. But if you wait beyond the Medigap open enrollment period when you’re first eligible for Medigap, you may not be able to enroll later on. Medigap insurers have to sell you a policy at the same price as anyone else during open enrollment. Outside that time, they can require medical underwriting. Depending on your health, they may refuse to sell you a policy or charge you a higher premium.

#5: Knowing When To Switch Medicare Plans

Open enrollment periods are your opportunity each year to get the best bargain for Medicare coverage. You should review your options each year during open enrollment and look for the best plan for your needs and budget.

But more than seven in 10 Medicare beneficiaries never even compared plans during a recent open enrollment, according to a 2021 study by the Kaiser Family Foundation.

The study looked at beneficiaries during the 2018 Open Enrollment Period for 2019 coverage. Overall, 71% of beneficiaries did not compare plans. And the average was even higher for certain demographic groups.

Percentages of Demographic Groups Who Did Not Compare Medicare Plans
  • Black beneficiaries — 74%
  • Hispanic beneficiaries — 79%
  • Beneficiaries 85 and older — 84%
  • Beneficiaries with low incomes — 85%
  • Beneficiaries enrolled in both Medicare and Medicaid — 87%

#6: Why It’s Important to Review Medicare Plans

It’s important to compare Medicare plans during open enrollment periods to make sure you’re getting the best coverage at the best price available.

A 2022 study published in the Journal of the American Medical Association Network found ‌that vulnerable populations tended to be subjected to high-cost or poor-quality coverage choices more often because of a lack of health care literacy help.

Further, they found that “annual review and comparison of coverage choices [were] associated with higher Medicare Advantage enrollment and choice of a particular Medicare Advantage plan.”

#7: Choosing Between Medicare Advantage and Medigap

You have to choose between a Medigap and Medicare Advantage plan — you can’t have both at the same time.

Medicare Advantage plans are private plans that effectively replace Original Medicare. Advantage plans cover everything Medicare Part A and Part B cover — but they also offer other benefits. These commonly include built-in Part D prescription drug coverage and hearing, vision and dental benefits.

Medicare Advantage plans may limit your choice of doctors and hospitals. But more than 90% of doctors — other than pediatricians — accept Original Medicare.

Medicare Advantage plans also have maximum limits on your out-of-pocket costs. Original Medicare does not, but a Medigap plan can reduce them if you have Original Medicare.

Medigap are private plans that only work with Original Medicare by helping you cover out-of-pocket costs associated with Medicare Part A and Part B. Medigap plans won’t pay for things that Original Medicare does not cover, so they won’t pay for prescription drugs, vision, dental and hearing services.

It’s important to look past monthly premiums and consider your total out-of-pocket costs with different plans before deciding which plan is best for you.

#8: How To Get Prescription Drug Coverage

While most Medicare Advantage plans include prescription drug coverage, you will have to enroll in a Medicare Part D plan if you want prescription drug coverage with Original Medicare.

You can add a Part D plan to Original Medicare during the initial enrollment period, the annual open enrollment period or a special enrollment period.

It’s important to compare your Part D plan each year during open enrollment to make sure the costs and coverage are the best you can find.

Also evaluate changes to your drug coverage if you have a Medicare Advantage plan. Medicare Part D and Medicare Advantage plans update their drug coverage each year and they may change the drugs they cover or the pharmacies that are in their network.

#9: How Medicare Works if You’re Still Working After 65

In many cases, you don’t need to enroll in Medicare while still working past 65 and have insurance through your employer or your spouse’s employer. You do, however, have to meet certain requirements to avoid late enrollment fees later on.

Insurance Factors To Check When Working After 65
If You’re Self-Employed or Have Health Insurance Not Available to Everyone at Your Company
You should check with the insurance provider to see if your insurance is considered an employer group health plan as defined by the IRS. If not, you should sign up for Medicare when you turn 65 to avoid a Medicare Part B late enrollment fee.
If Your Employer Has Fewer Than 20 Employees
In some cases, you may need to sign up for Medicare when you turn 65 to avoid gaps in employer-based health care, which could lead to late enrollment fees later on. You should check with the employer to see if you’re affected.
If You Have COBRA Coverage
If you have COBRA coverage, you should sign up for Medicare when you turn 65. Otherwise, you could face a Medicare Part B late enrollment fee when you later enroll. Your COBRA coverage will probably end when you sign up for Medicare.

If you have Medicare and other health insurance — through an employer, a union, veterans’ benefits or other sources — Medicare will work with your other insurance to cover your health care costs.

Exactly how it works depends on the combination of plans and a process called the coordination of benefits which spells out which plan pays first. This order can affect your out-of-pocket costs.

#10: Circumstances That Allow for Early Enrollment

There are three circumstances that allow people to receive Medicare before they turn 65. These include having a disability, End-Stage Renal Disease or ALS (Lou Gehrig’s disease).

Medicare Eligibility for People Under 65
If you qualify for Social Security Disability Insurance (SSDI), you will be automatically enrolled in Medicare after receiving 24 monthly SSDI checks. Medicare coverage begins upon receipt of your 25th check.
End-Stage Renal Disease (ESRD)
If you are diagnosed with ESRD, you qualify for Medicare on the first day of your fourth month of dialysis (or immediately if you are receiving home dialysis). You can also qualify for Medicare when you are first hospitalized for a kidney transplant. Starting in 2023, Medicare will cover the costs of immunosuppressants for the lifetime of transplant patients. Medicare only covered 36 months of the drugs in the past.
Amyotrophic Lateral Sclerosis (ALS)
If you are diagnosed with ALS and approved for SSDI benefits, you will immediately qualify for Medicare. There is no SSDI 24-month waiting period for ALS patients, but it may take up to five months for Medicare to approve your enrollment and issue your Medicare card.

Social Security, not Medicare, determines when people are eligible for SSDI coverage.

Those insured through the Railroad Retirement Board should also contact Social Security rather than Medicare to find out if they are eligible.

Last Modified: March 1, 2023

9 Cited Research Articles

  1. Park, S., et al. (2022, February 3). Association of Health Insurance Literacy With Enrollment in Traditional Medicare, Medicare Advantage, and Plan Characteristics Within Medicare Advantage. Retrieved from
  2. U.S. Centers for Medicare & Medicaid Services. (2021, December 1). Medicare Open Enrollment Period. Retrieved from
  3. U.S. Centers for Medicare & Medicaid Services. (2021, November). Understanding Medicare Advantage & Medicare Drug Plan Enrollment Periods. Retrieved from
  4. Koma, W., et al. (2021, October 13). Seven in Ten Medicare Beneficiaries Did Not Compare Plans During Past Open Enrollment Period. Retrieved from
  5. Kaiser Family Foundation. (2020, October 22). How Many Physicians Have Opted Out of the Medicare Program? Retrieved from
  6. U.S. Centers for Medicare & Medicaid Services. (2018, January). Enrolling in Medicare Part A & Part B. Retrieved from
  7. U.S. Centers for Medicare & Medicaid Services. (2017). How is Medicare Funded? Retrieved from
  8. U.S. Centers for Medicare & Medicaid Services. (n.d.). Sign Up/Change Plans. Retrieved from
  9. U.S. Centers for Medicare & Medicaid Services. (n.d.). When Does Medicare Coverage Start? Retrieved from