Turning 65
Turning 65? Here's What You Need to Know About Medicare
Your 65th birthday is a Medicare milestone. This guide walks you through what to do, when to do it, and the common mistakes that catch people off guard.
Step-by-Step Timeline
Here's a practical roadmap for the months around your 65th birthday.
Start Learning and Planning
- Research the difference between Original Medicare and Medicare Advantage
- List all your current doctors and medications
- Think about your health priorities and how often you use medical care
- Contact Ashley Watson for a free, no-pressure consultation
- Check if your employer coverage ends when you turn 65
Your Enrollment Window Opens
- Your Initial Enrollment Period (IEP) begins 3 months before your 65th birthday month
- You can now sign up for Medicare Part A and Part B through Social Security
- This is the best time to enroll to ensure your coverage starts on your birthday
- Begin comparing Medicare Advantage or Supplement plans with Ashley
Coverage Can Begin
- If you enrolled early, your Medicare coverage starts this month
- Confirm your Medicare card has arrived in the mail
- Finalize your Medicare Advantage or Supplement plan selection
- Enroll in a Part D drug plan if using Original Medicare
Settle In and Stay Informed
- Inform your doctors of your new Medicare plan
- Review your Explanation of Benefits (EOB) statements
- Mark your calendar for open enrollment each fall (Oct 15 – Dec 7)
- Call Ashley anytime with billing or claims questions
Turning 65 Medicare Checklist
Use this checklist to make sure you haven't missed anything important.
- Request your Social Security statement to confirm your work history
- Decide between Original Medicare vs. Medicare Advantage
- Compare Medicare Supplement plans if using Original Medicare
- Compare Part D drug plans based on your current medications
- Confirm your preferred doctors accept Medicare
- Set up a My Medicare account at Medicare.gov
- Review your current prescriptions with Ashley for drug plan comparison
- Understand the coordination of benefits if you have other insurance
- Schedule your free 'Welcome to Medicare' preventive visit after enrolling
Ashley can walk through this entire checklist with you in a single free consultation — usually less than an hour.
Common Medicare Mistakes to Avoid
These are the mistakes Ashley sees most often — and that are entirely avoidable with a little planning.
Missing your Initial Enrollment Period
If you don't sign up during your 7-month IEP and don't have qualifying coverage elsewhere, you may face lifetime premium penalties and gaps in coverage.
Assuming you have to take Medicare at 65
If you're still working and have employer health coverage, you may be able to delay Medicare without penalty. The rules depend on the size of your employer. Ashley can help you figure out your specific situation.
Choosing a plan based on premium alone
A low-premium plan can end up costing more in out-of-pocket expenses. It's important to look at the total picture — including deductibles, copays, and whether your doctors are in-network.
Not checking if your drugs are covered
Each drug plan has a formulary — a list of covered medications. If your prescriptions aren't on the list, you could pay far more than expected. Always check your medications before choosing a plan.
Forgetting about Medigap enrollment rules
You have a guaranteed right to buy a Medicare Supplement (Medigap) plan during your first 6 months on Part B. After that, insurers can deny you or charge more based on your health history. This window is critically important.
Thinking Medicare is free
While Part A is usually premium-free, Part B has a monthly premium. And even with Medicare, you'll have deductibles, copays, and coinsurance. Planning for these costs is essential.
Common Questions About Turning 65 and Medicare
When should I enroll in Medicare when turning 65?
Your Initial Enrollment Period (IEP) opens 3 months before your 65th birthday month and closes 3 months after — a 7-month window total. Enrolling in the 3 months before your birthday ensures your coverage starts the month you turn 65. If you enroll during or after your birthday month, your start date may be delayed.
What happens if I miss my Medicare enrollment window at 65?
If you don't sign up during your 7-month Initial Enrollment Period and don't have qualifying coverage elsewhere, you may face lifetime premium penalties and gaps in coverage. Part B penalties add 10% to your monthly premium for each 12-month period you were eligible but didn't enroll — and those penalties never go away.
Do I have to take Medicare when I turn 65 if I still have employer coverage?
No — if you're still working and have employer health coverage through an active employer (yours or your spouse's), you may be able to delay Medicare without penalty. The rules depend on the size of your employer. Once that employer coverage ends, you have a Special Enrollment Period of 8 months to sign up without penalty. Retiree coverage and COBRA do not protect you from penalties.
Should I choose Original Medicare or Medicare Advantage when I turn 65?
The right choice depends on your situation. Medicare Advantage (Part C) bundles hospital, medical, and often drug coverage in one plan, frequently with $0 premiums, but uses provider networks. Original Medicare lets you see any doctor who accepts Medicare nationwide and can be paired with a Medigap supplement and Part D drug plan. Comparing your doctors, medications, and how often you use care is essential before choosing.
What is the Medigap enrollment window when turning 65?
You have a guaranteed right to buy any Medicare Supplement (Medigap) plan during the first 6 months after you're enrolled in Part B. During this window, insurers cannot deny you or charge more based on your health history. After this window closes, insurers can medically underwrite you — meaning they can deny coverage or charge higher premiums based on pre-existing conditions.
Is Medicare free when you turn 65?
Part A is usually premium-free if you (or your spouse) worked and paid Medicare taxes for at least 10 years. However, Part B has a monthly premium set by Medicare each year. Even with Medicare, you'll have deductibles, copays, and coinsurance. Planning for these out-of-pocket costs is an important part of your Medicare decision.
How do I pick the right Part D drug plan when turning 65?
Each Part D plan has a formulary — a list of covered medications. Before choosing a plan, check that all your current prescriptions are on the plan's formulary, compare the copays or coinsurance for those drugs, and confirm your preferred pharmacy is in-network. Choosing a plan based on premium alone can result in paying far more than expected for your medications.