Yes, losing employer insurance triggers an 8-month Special Enrollment Period (SEP) that lets you enroll in Medicare without penalties. Your SEP starts the month after your employer coverage or employment ends, whichever comes first. During this window you can enroll in Part A (free for most people with 40+ quarters of work history), Part B ($202.90/month in 2026, $283 annual deductible), and add a Medicare Advantage plan (2026 out-of-pocket maximum $9,350) or Medigap policy. If you miss this 8-month window, the Part B penalty is 10% of the monthly premium for every 12 months you delayed — and it lasts for life. For your specific situation in Wake County, call Rob Simm at (828) 761-3326 — free, no obligation.

What Wake County families ask

What happens if I don’t enroll in Medicare after losing my employer plan?

These are the four questions I hear most from Wake County residents who just lost employer coverage.

Does COBRA count as creditable coverage for Medicare?

COBRA does not extend your 8-month SEP. Your enrollment clock started when your employer coverage ended — not when COBRA expires. Waiting for COBRA to run out can cost you permanently.

How much is the penalty if I miss my window?

The Part B penalty is 10% of the $202.90 monthly premium for every full 12 months you delay. That’s $20.29/month per year of delay — added to every premium payment for life.

Can I enroll in Medicare Advantage right away?

Yes. Once you have Part A and Part B, you can enroll in a Medicare Advantage plan during your SEP. Wake County has 30+ plans available in 2026 with a $9,350 out-of-pocket cap.

What if my employer had fewer than 20 employees?

If your employer has fewer than 20 employees, Medicare is primary even while you’re working. You may already owe a penalty if you didn’t enroll at 65. Call to check your situation.

⚠️ The Part B penalty is permanent and has no cap

Unlike most insurance penalties, the Medicare Part B late-enrollment penalty never goes away. Every 12 months you delay costs you an extra 10% of the standard premium — $20.29/month in 2026 dollars — added to your bill for as long as you have Medicare. Delay 3 years and you pay an extra $60.87 every month for life. There is no forgiveness, no appeals process, and no cap.

The difference

Why does it matter who helps you enroll after losing employer coverage?

What do you need to know?	Medicare.gov	Rob Simm — NC #10447418
SEP eligibility	Generic rules — written for all 50 states, every employer type	I verify your exact coverage end date, employer size, and SEP timeline before we do anything
COBRA interaction	Says COBRA exists — doesn’t explain how it affects your Medicare clock	I map your COBRA timeline against your 8-month SEP so you don’t accidentally miss the window
Penalty calculation	Shows the formula — doesn’t run it with your specific delay period	I calculate your exact penalty exposure and show you the lifetime cost of waiting
Plan selection	Lists every plan nationally — can’t tell you which ones your Wake County doctors accept	I check your doctors against the 30+ plans available in Wake County right now
Employer size rules	Mentions the 20-employee threshold — doesn’t check your employer	I verify your employer size to determine whether Medicare or your employer plan was primary
Ongoing support	800 number, hold times, different agent every call	I answer my phone next year when your plan changes — same broker, same number

2026 Medicare numbers

What will Medicare cost me in Wake County in 2026?

$202.90

Part B premium per month

2026 standard rate. Higher with IRMAA surcharge based on income above $106,000.

$283

Part B annual deductible

You pay this before Medicare covers 80% of outpatient care.

$9,350

MA in-network out-of-pocket max

2026 cap on in-network Medicare Advantage spending.

$2,100

Part D out-of-pocket cap

No catastrophic Rx costs in 2026. Insulin capped at $35/month.

💡 Broker Tip — Wake County

Many Wake County residents with employer coverage through Duke Health, WakeMed, or state government assume COBRA will protect them while they figure out Medicare. It won’t extend your SEP. Your 8-month clock started the day your employer coverage ended — not when COBRA runs out. Before you do anything else, verify your exact SEP deadline. I can check it in under 5 minutes on the phone.

— Rob Simm, Licensed Medicare Broker, NC #10447418

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Rob Simm · Licensed NC Medicare Broker · NPN #10447418

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Real scenario · Wake County

What does a 2-year delay in Medicare enrollment actually cost?

Delayed 2 years — no broker

+$40.58/mo

You waited on COBRA for 18 months, then took 6 more months to “figure it out.” Now you owe a permanent 20% Part B penalty — $40.58 extra every month on top of your $202.90 premium, for life. Over 20 years that’s $9,739 in avoidable penalties.

Enrolled during SEP — with Rob

$0 penalty

You called the week your employer coverage ended. Rob verified your SEP eligibility, checked your Wake County doctors against 30+ plans, and enrolled you within the 8-month window. No penalty. No gap. No stress.

It pays to talk to the right broker

Does it cost more to use a Medicare broker in Wake County?

It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.

Common questions

Frequently asked questions

How long do I have to enroll in Medicare after my employer insurance ends in Wake County?

You have an 8-month Special Enrollment Period that starts the month after your employer coverage or employment ends, whichever comes first. This applies whether you quit, retired, were laid off, or your employer dropped coverage. Enroll during this window and you avoid late-enrollment penalties entirely.

Can I use COBRA instead of Medicare after losing employer coverage?

You can elect COBRA, but it does not extend your 8-month Medicare SEP. If you delay Medicare enrollment while on COBRA and your SEP expires, you will face a permanent 10% Part B penalty for every 12 months of delay. In most cases, enrolling in Medicare first and using COBRA as secondary coverage is the safer strategy.

What are the penalties if I miss my Medicare enrollment window after losing employer coverage?

The Part B late-enrollment penalty is 10% of the standard premium ($202.90 in 2026) for every full 12 months you could have had Part B but did not. That adds $20.29 per month for each year of delay — and the penalty is permanent. You will also face a Part D penalty of 1% of the national base premium ($37.20 in 2026) per uncovered month if you go 63+ days without creditable drug coverage.

Does my employer size affect my Medicare enrollment rights in Wake County?

Yes. If your employer has 20 or more employees, your employer plan is primary and Medicare is secondary — meaning you can safely delay Part B without penalty while actively employed. If your employer has fewer than 20 employees, Medicare is primary, and delaying Part B can result in penalties and coverage gaps even while you are still working.

Is there a licensed Medicare broker in Wake County who can help me enroll?

Yes. Rob Simm is a licensed independent Medicare broker serving Wake County. He can verify your SEP eligibility, check your employer size rules, confirm your doctors are in-network, and enroll you at no cost. Call (828) 761-3326 for a free 10-minute consultation.

Related Medicare guides

Medicare Enrollment in NC – 2026 Guide Working Past 65 – Medicare Enrollment Special Enrollment Periods in NC Medicare Premium Penalties in NC Compare Medicare Advantage Plans in NC Medicare Costs in NC 2026 Free Medicare Quotes Online Medicare Help in Wake County

Get help in nearby NC counties

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Robert Simm

Licensed Independent Medicare Broker

Helping NC families navigate Medicare since 2014. Independent — I work with all carriers and get paid the same regardless of which plan you choose. I verify provider networks with Duke Health directly and answer my own phone the next year when something changes.

📞 (828) 761-3326 📋 NC #10447418 🏥 AHIP Certified ⭐ 5.0 · 20+ reviews 📍 2731 Meridian Pkwy, Durham NC 27713 🕐 Mon–Fri 9am–7pm ET

Last Updated: 2026-05-03 | Reviewed By: Robert Simm, Licensed Medicare Broker, NC #10447418 | Next Review: October 2026

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