Your Wisconsin Medicare, step by step

No-cost tools and plain-English guides from a licensed local agent. No account needed.

When does MY Medicare start?

Enter your date of birth to get your personalized Medicare timeline.

Date of Birth

Please enter your complete date of birth.

Step 2

Disability Benefits

Do you currently receive Social Security Disability (SSDI) or Railroad Retirement disability benefits?

Step 3

When did benefits start?

What month and year did your SSDI (or Railroad Retirement disability) payments begin? This is the date on your first disability payment, not when you applied.

Month

Year

Not sure? Check your Social Security award letter or bank statement.

Please enter the month and year your benefits started.

Step 3

Do you have a qualifying condition?

Some conditions allow Medicare before age 65. Do any of the following apply to you?

Step 4

Will you still be working at 65?

Do you expect to have health insurance through your own active employment or your spouse's active employment when you turn 65? Retiree coverage and COBRA don't count here — only coverage from an employer where someone is actively working.

Step 4

When did dialysis start?

What month and year did you begin regular dialysis (or have a kidney transplant)?

Month

Year

Please enter the month and year dialysis began.

Step 2

Are you enrolled in Medicare?

Are you currently enrolled in Medicare Part A and/or Part B?

Step 3

Do you have employer coverage?

Do you have health insurance through your own active employment or your spouse's active employment? (Retiree coverage or COBRA does not count here.)

Your Medicare Timeline

Good to know

If you enroll in Part B during the first 3 months of your IEP, your coverage starts the month you turn 65. Enrolling later in the IEP delays your start date. Enroll early to avoid gaps.

You Can Delay Medicare

Because you'll have health coverage through active employment at 65, you have the right to delay Medicare enrollment without penalty. You don't need to sign up during your Initial Enrollment Period.

No late enrollment penalty while covered through active employment

As long as you or your spouse is actively employed and the coverage comes from that employer, your IEP deadline doesn't apply.

You get an 8-month Special Enrollment Period when that coverage ends

When employment ends — whether you retire, get laid off, or your spouse leaves their job — you have 8 months to enroll in Medicare without a penalty. Don't miss this window.

COBRA does not extend your Special Enrollment Period

Your 8-month window starts when active employment ends — not when COBRA ends. Enroll in Medicare before or when COBRA starts, not after it runs out.

Consider enrolling in Part A at 65 anyway

Part A (hospital coverage) has no premium for most people. Enrolling at 65 costs nothing and adds a safety net — it just can't be used as primary coverage while you have employer insurance.

Your Medicare Timeline

Because you receive Social Security Disability benefits, you'll be automatically enrolled in Medicare after 24 months of receiving those benefits.

Important

About 3 months before your Medicare start date, you'll receive a red, white, and blue Medicare card in the mail. You'll be enrolled in Original Medicare (Parts A & B) automatically. You'll still need to choose a Part D drug plan and decide whether to add a Medicare Advantage plan or Medicare Supplement.

Your Medicare Timeline

Because you have ALS (Lou Gehrig's disease), you qualify for a special rule: the 24-month SSDI waiting period is waived.

Medicare begins the same month your SSDI benefits start

No waiting period — Medicare Part A and Part B begin immediately when you start receiving SSDI disability benefits.

Next steps

If you haven't applied for SSDI yet, that's the first step — Medicare follows automatically. Once approved, you'll receive your Medicare card and will want to choose a drug plan and decide on Medicare Advantage vs. Original Medicare + Supplement.

We can help you navigate this

An ALS diagnosis brings a lot of decisions. Let us walk you through your coverage options at no cost.

Your Medicare Timeline

Because you have End-Stage Renal Disease (ESRD), you can qualify for Medicare before age 65.

You must apply

Unlike SSDI-based Medicare, ESRD Medicare enrollment is not automatic. You need to contact Social Security to apply. Call 1-800-772-1213 or visit your local Social Security office.

Let us help with your ESRD coverage options

There are specific rules around which Medicare Advantage plans cover ESRD. We can help you compare your Wisconsin options at no cost.

Get Help

You're enrolled in Medicare

Great — you've already taken the first step. Now the question is making sure you have the right type of coverage for your situation.

Medicare Advantage (Part C)

All-in-one plans with extra benefits — dental, vision, hearing

Part D – Drug Coverage

Add prescription drug coverage to Original Medicare

Not sure if your current plan is the best fit?

Every year during the Annual Enrollment Period (Oct 15 – Dec 7), you can switch plans. We can review your current coverage at no cost.

Review My Coverage

You Can Delay Medicare

Because you have health coverage through active employment, you have the right to delay Medicare enrollment without penalty — for now.

No late enrollment penalty while covered by employer insurance

As long as you or your spouse is actively employed and the coverage comes from that employer, you're protected.

You get an 8-month Special Enrollment Period (SEP)

When your employer coverage ends — whether you retire, get laid off, or your spouse leaves their job — you have 8 months to enroll in Medicare without penalty. Miss this window and penalties apply.

COBRA and retiree coverage do NOT extend your SEP

Your 8-month window starts when active employment ends — not when COBRA ends. Don't rely on COBRA to protect you from the Medicare penalty.

Planning for retirement?

We can help you plan the transition from employer coverage to Medicare so there are no gaps and no penalties.

Plan My Transition

Late Enrollment — Act Soon

You're past your Initial Enrollment Period and don't have qualifying employer coverage. Here's what that means and what to do next.

Part B late enrollment penalty

Your Part B premium increases by 10% for each 12-month period you were eligible but didn't enroll. This penalty is permanent and added to your monthly premium for as long as you have Part B.

General Enrollment Period (GEP)

You can enroll in Medicare Part A and Part B during the General Enrollment Period: January 1 – March 31 each year. Coverage starts July 1.

Don't wait — the penalty grows over time

There may be options to reduce or avoid the penalty depending on your situation. Talk to us — we can help you figure out the fastest path to coverage.

Get Help Now

How do you receive your Medicare coverage?

How do you get your prescription drug coverage?

What is your tax filing status?

Used to determine your IRMAA income brackets for 2026.

What was your household income two years ago?

Medicare uses your 2024 MAGI (from your 2024 tax return) to determine 2026 IRMAA surcharges.

Do you pay a Part A premium?

Most people get Part A at no cost. A premium applies only if you — or your spouse — haven't accumulated enough work credits.

What are your plan costs?

You can edit these numbers in the results if you want to compare scenarios.

Plan monthly premium

$ / month

Part B giveback (if your plan offers one)

Some MAPD plans pay back part of your $202.90 Part B premium each month. Check your plan's Summary of Benefits — it may be listed as "Part B premium reduction." Enter 0 if unsure.

$ / month

Part D (PDP) monthly premium

Standalone Part D premiums vary by plan and county. Check Medicare Plan Finder for your options.

$ / month

You don't have a plan premium to enter. Your fixed Medicare cost is your Part B premium plus any IRMAA surcharge — click Calculate to see your estimate.

My Medicare Budget Estimate

Dairy State Guide to Medicare — dairystatehealth.com — Based on 2026 Medicare costs

Your Estimated Medicare Budget

Based on 2026 Medicare costs — updated annually. Edit the plan premiums in the table to adjust your estimates.

WI SeniorCare note: Your drug coverage is through Wisconsin SeniorCare, not Part D — so no Part D IRMAA surcharge applies. SeniorCare costs $30/year ($2.50/month) in enrollment fees, not included above.

Talk to an Agent About Your Options

Marit Ulness, licensed Wisconsin agent in Appleton. Independent, so we compare plans from many carriers. Our help costs you nothing.

(920) 735-2852

Where are you starting from?

Pick the one that sounds like you. Each guide walks through your next steps.

I'm Turning 65 When to sign up, what's automatic, and what to decide first
I'm Retiring From Work Leaving employer coverage without late penalties
I Want to Review My Plan Check your coverage and learn when you can switch
I'm on a Limited Income Programs that help with premiums, deductibles and drugs
I Can't Afford My Prescriptions Extra Help, SeniorCare and other ways to lower drug costs
See All Situations Moving here, retiring early, snowbirds and more

Independent Medicare Help from Ulness Health

Dairy State Guide to Medicare is published by Ulness Health, a family-run, Wisconsin-based independent insurance agency. We're not tied to any single carrier, so we compare plans across the market to find what fits your situation. Always at no cost to you.

Talk to an Agent About Ulness Health

The ABCDs of Medicare

Medicare has four main parts. Here's what each one covers.

A Part A: Hospital Inpatient stays, skilled nursing, hospice B Part B: Doctors & Outpatient Office visits, preventive care, equipment C Part C: Medicare Advantage Private plans that bundle A, B and usually D D Part D: Prescription Drugs Drug coverage alone or inside an Advantage plan

Guides & Resources

Medicare Advantage vs. Medicare Supplement
Costs, networks and who each fits best
Why Wisconsin Is Different
Our own Medigap rules and SeniorCare
IRMAA Income Surcharges
The 2026 brackets and how to appeal
MSA Plans
High-deductible Advantage with a savings account
Avoiding Medicare Scams
Red flags and how to report them
Medicare Knowledge Quiz
10 questions to test what you know

View all guides →