I’m Turning 65. How Do I Enroll in Medicare?
Your guide to when, how and why to enroll in Medicare.
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If your 65th birthday is approaching, it’s time to start thinking about enrolling in Medicare.
Medicare is a federal health insurance program that’s designed to support people age 65 and older, as well as some younger individuals living with disabilities or certain conditions.
We’ll walk you through enrollment timelines and options. Understanding them will help you pick the right coverage options for your needs, while also avoiding any penalties for enrolling late.
This guide will cover:
When you can enroll in Medicare
What your coverage options are
How to enroll
What to think about before you enroll in Medicare
Other frequently asked questions
When Should I Enroll in Medicare?
Medicare has three options for you to enroll. They are:
Initial Enrollment Period
Special Enrollment Period
General Enrollment Period
Initial Enrollment Period (IEP)
The Medicare Initial Enrollment Period, or IEP, is your first and best chance to sign up. Your IEP is a 7-month window around your 65th birthday. The window includes:
The three months before the month you turn 65
Your birthday month
The three months after the month you turn 65
For example, say your 65th birthday is any day in June. Your IEP would run from March 1-Sept. 30.
Here is when you can expect to get Medicare coverage, based on when you enroll during IEP:
The first day of the month of your 65th birthday, IF you enroll in the three-month window before your birthday month
The first day of the month after you sign up, IF you wait until the month of your 65th birthday, or the three months afterward
During the IEP you have the chance to sign up for a variety of Medicare plans:
Original Medicare: Parts A (hospital) and B (medical) coverage
Original Medicare plus a Medicare Prescription Drug Plan (Part D)
Medicare Advantage (Part C), which can include Original Medicare, a prescription drug plan and other benefits
Special Enrollment Period (SEP)
An SEP allows you to enroll in Medicare at any time if you meet certain conditions.
The most common SEP for those newly eligible for Medicare involves your present employment and insurance status. You might delay Medicare because you’re working at 65 and have employer health coverage.
In that case, once you (or your spouse) stop working or lose that coverage, you get an 8-month SEP to sign up for Part A and/or Part B without penalty. Tip: It’s best to enroll before your job coverage ends to avoid any gaps in care.
The SEP for work coverage only applies if the employer has 20+ employees and the coverage was “creditable.” Also, COBRA or retiree insurance don’t count for an SEP. So, if this isn’t your situation, make sure to enroll during your IEP.
General Enrollment Period (GEP)
If you missed your IEP and don’t qualify for an SEP, you can enroll during the General Enrollment Period. The GEP runs from January 1-March 31 every year.
During that period, you can sign up for Medicare Parts A and B. Coverage begins on the first of the month after you enroll.
One thing to remember: in most cases, enrolling during GEP means you will have to pay late enrollment penalties. They’re not a one-time fee. You’ll be paying extra for your Original Medicare coverage as long as you have it.
What Are My Medicare Coverage Options?
When you enroll in Medicare, you have some important choices about how you receive your benefits. Here’s a breakdown of the main options:
What is Original Medicare?
This is the traditional Medicare program provided directly by the federal government.
Part A (hospital) covers hospital inpatient care, skilled nursing facility care, hospice, and some home health. Part B (medical) covers doctor visits, outpatient services, preventive care, medical equipment, and other medical services.
With Original Medicare, you can go to any doctor or hospital nationwide that accepts Medicare – no networks or referrals needed.
However, Original Medicare does not cover prescription drugs or services like routine dental, vision, hearing, or long-term care. You’ll also pay deductibles and typically 20% coinsurance on Part B services, which means you’ll likely have to pay fees each time you make a medical visit.
Parts A and B are the default coverage you receive if you choose no other options. Many people on Original Medicare add supplemental coverage to help with these gaps.
What coverage can I add to my Original Medicare?
There are two kinds of policies you can buy through private insurance companies that are add-ons to Original Medicare:
Part D Prescription Drug Plan: A standalone plan that covers outpatient prescription medications. If you choose Original Medicare, adding a Part D plan is required for prescription drug coverage.
Medigap (Medicare Supplement): An optional insurance policy from a private company that helps pay your Original Medicare deductibles, coinsurance, and copays.
What is Medicare Advantage?
There is one other option for Medicare enrollment that combines Original Medicare with additional benefits: Medicare Advantage.
Medicare Advantage (Part C) plans are available through private insurance companies. They provide HMO and PPO options that include the benefits of Original Medicare. Plus, unlike Original Medicare, they can provide:
Part D prescription drug coverage
Routine dental, vision, hearing, gym memberships, transportation and other benefits not provided by Original Medicare
An out-of-pocket maximum protecting you from catastrophic costs
A Part B “giveback,” meaning your Medicare Advantage plan covers some of the cost of your Part B monthly premium
What Do I Need to Know Before I Enroll in Medicare?
Before starting the enrollment process, keep these key points in mind:
Am I eligible for Medicare?
You’re eligible for Medicare at age 65:
If you’ve worked at least 10 years, or 40 calendar quarters
If during that time you paid Medicare taxes
What is my Medicare Initial Enrollment Period?
Your personal 7-month IEP period is based on your 65th birthday (3 months before your birth month through 3 months after). Mark these dates on your calendar.
What documents do I need to enroll in Medicare?
Generally, few or none. Have your Social Security number, date of birth, and employment/insurance information handy when you apply. If you’re enrolling in Medicare online, you’ll create or use your Social Security account. The application for Medicare usually takes less than 10 minutes to complete.
Once enrolled in Original Medicare, to add a part D, Part C or Medigap plan, you will need your Medicare Beneficiary Identifier (MBI) from your card sent by Medicare. You can use HealthSpring's Medicare Enrollment Guide to help you choose a Medicare plan.
What Medicare coverage do I choose?
Even before your IEP begins, you can begin researching your coverage options. Would Original Medicare work for you, or do you want to add other benefits? To figure out what Medicare coverage works best for you, think about:
Health Care Usage: Do you visit doctors frequently or require specialist care?
Prescription Drugs: Are you taking medications regularly?
Preferred Doctors and Hospitals: Do you have specific providers you want to continue seeing?
Additional Benefits: Are services like dental, vision, or hearing important to you?
Travel Considerations: Do you spend time in multiple states or travel often?
Chronic Conditions: Are you living with a chronic condition that may require more frequent medical care?
Hospitalizations: Are you planning to have surgery—either in a hospital or as an outpatient?
Reflecting on these questions can help you identify which plan aligns best with your lifestyle. You can use HealthSpring’s guide to choosing a Medicare plan to assist you in your decision.
You might also seek guidance from a State Health Insurance Assistance Program (SHIP) counselor for free help choosing a plan.
Do I enroll in Original Medicare if I’m choosing options besides Parts A and B?
Yes. You must enroll in Original Medicare to be eligible for a Medicare Part D or Part C plan. After enrolling in Original Medicare, you can shop for Part D or Part C plans during your IEP.
Do I sign up for a Part D plan if my Medicare Advantage plan includes prescription drug coverage?
Never sign up for a separate Part D plan if your Medicare Advantage plan already includes drug coverage. It will cause you to be disenrolled from the Advantage plan.
Do I enroll in Medicare if I already have health insurance?
If you have other health coverage, find out how it works with Medicare. For those still working, check if your employer coverage is “primary” or “secondary” to Medicare. “Primary” means it will be the first option for your health coverage.
Generally, large employer plans (20+ employees) remain primary at 65, meaning you can delay Part B if you stay on that plan, whereas small employers require Medicare to pay first, so you must enroll to avoid coverage gaps. Also, if you have a Health Savings Account (HSA) and want to keep contributing, know that enrolling in any part of Medicare will stop your HSA contributions.
What if I don’t enroll for Medicare because I’m working, or just don’t want it?
If you’re working at 65, know your rights and timing: you’re allowed to delay Medicare if you have qualifying coverage, but you must be diligent to enroll once that coverage ends. Many find it helpful to consult with their employer’s benefits administrator about how Medicare will work with their current insurance. You can also call Medicare to double-check scenarios.
Keep in mind that if you are eligible to enroll in Medicare, and you don’t have qualifying coverage, you will pay a penalty on your monthly premium as long as you’re covered by Medicare.
How Do I Enroll in Original Medicare?
You enroll for Original Medicare through Social Security:
Visit SSA.gov to apply online (usually the fastest way)
Call Social Security’s national number or your local SSA office
Or visit a Social Security office in person, if you prefer
If you already receive Social Security benefits, and you plan to enroll in Original Medicare only, you will be automatically enrolled in the program. So, you do nothing but wait for your Medicare card to come in the mail.
Do I enroll in Original Medicare if I’m getting Part C or Part D coverage?
Yes. You need to enroll in Original Medicare to be eligible for Part C (Medicare Advantage) or Part D (prescription drug plan). Remember: if prescription drug coverage is included in your Medicare Advantage plan, you should NOT choose a Part D option on your application.
How much does Medicare coverage cost?
Part A is typically premium-free. Part B has a monthly premium that changes annually. Part D coverage comes with a small monthly free. If you have a Medicare Advantage plan, you’ll still pay the Part B premium, but the Part C plan often comes at no extra cost.
Your monthly premium is taken out of your Social Security check if you are collecting benefits.
Frequently Asked Questions
When should I enroll in Original Medicare?
You should enroll during your Initial Enrollment Period (IEP) – the 7-month window that starts 3 months before the month you turn 65. For example, if your 65th birthday is in June, your IEP runs from March 1 through Sept. 30. To have coverage effective when you turn 65, it’s best to sign up in those 3 months before your birthday month. You can technically enroll during your birth month or the 3 months after, but then your Part B (and Part A) start date will be slightly later (the month after you enroll).
Bottom line: Mark your calendar and try to enroll a little early – no later than your 65th birthday month – to ensure your Medicare kicks in promptly when you need it.
What other Medicare options are available for someone retiring and turning 65?
If you’re retiring and turning 65, your Medicare options, besides Original Medicare only, are:
Original Medicare (Parts A & B) plus an additional plan:– You can add a Part D prescription drug plan and optionally a Medicare Supplement (Medigap) policy for more complete coverage.
Medicare Advantage (Part C): – It’s an all-in-one alternative offered by private insurers that includes Part A, Part B, and usually Part D, often with extra benefits like dental, vision, etc.
Both options cover the core hospital and medical benefits. The best choice depends on your personal needs:
If you value maximum choice of doctors and might travel in retirement, Original Medicare and Medigap might suit you (virtually no provider is off-limits, as long as they accept Medicare).
If you prefer simplicity and extra perks (and your doctors are in a plan’s network), a Medicare Advantage plan could be attractive. MA plans also have a cap on out-of-pocket costs, which Original Medicare doesn’t have (unless you get Medigap).
Should I enroll in Medicare Parts A and B if I want a Part D or Part C plan?
When retiring at 65, make sure to enroll in Part A and B via Social Security (unless you’re already auto-enrolled). Then, during your IEP, add a Prescription Drug plan (Part D) or pick a Medicare Advantage (Part C) plan.
What is the penalty for late enrollment in Medicare?
The penalties for late enrollment depend on the part of Medicare:
Part B late enrollment penalty: If you delay Part B without qualifying coverage, you’ll pay an extra 10% of the Part B premium for each full year you delayed. This is a lifetime surcharge. This can add up over time, so it’s a costly penalty to avoid.
Part D late enrollment penalty: If you go 63+ days without drug coverage after your IEP, you accrue a penalty of 1% of the national base premium per month delayed. For example, 12 months without coverage ~ 12% penalty. In dollar terms, if the base premium is $37, a 12% penalty is about $4.40, which gets added to your plan’s premium. That amount recalculates each year as the base premium changes, and you pay it for life (or as long as you have Part D). It’s smaller than the Part B penalty typically, but still something to avoid.
Part A late enrollment penalty: This only applies if you must buy Part A (not free) and delay it. It’s a 10% premium increase for twice the years delayed. For instance, delay Part A for 2 years = pay 10% higher premium for 4 years. Since most get Part A free, few people encounter this.
Why do these penalties exist? They are meant to encourage timely enrollment, so people don’t wait until they’re sick to get coverage. The good news is if you meet an exception (like you had employer insurance past 65), you won’t pay these penalties. Also, there are occasional relief programs or Special Enrollment Periods for certain cases (for example, if you missed Part B due to bad advice from an employer, Social Security could grant a SEP now without penalty in some circumstances).
Bottom line: Enroll when first eligible to steer clear of late fees. If you must delay due to other coverage, ensure that coverage is creditable and use your SEP promptly when that coverage ends. By doing so, you’ll never have to pay a penalty at all.
Can I delay Medicare Part B if I’m still working?
Yes, you can delay Part B past 65 if you meet certain conditions – primarily, that you have current employer-sponsored health insurance (from your job or your spouse’s job) and the employer has 20 or more employees. In this scenario, you are exempt from the usual requirement to take Part B at 65 and won’t incur a late penalty for waiting. You would enroll in Part B later during a Special Enrollment Period once you (or your spouse) stop working or lose that employer coverage, as discussed above.
However, there are a few caveats:
Your employer coverage must be active employment coverage. COBRA or retiree insurance you elect after retiring do not count as active employer coverage. You cannot use those as a reason to delay Part B without penalty.
The employer should generally be a large employer (20 or more employees). If it’s a small employer plan, Medicare is primary and you shouldn’t delay Part B.
It’s always a good idea to double-check with the employer plan benefits administrator to ensure your coverage is considered creditable and that delaying Medicare won’t leave you with unpaid claims.
If you’re a government employee with federal health benefits (FEHB), similar rules apply – you can delay Part B while you keep FEHB as an active employee. Many federal employees even delay Part B until retirement because FEHB is comprehensive. Just be sure to enroll in Part B during your SEP to avoid penalties.
Should I enroll in Medicare if I have a Health Savings Account (HSA)?
Part A enrollment is often delayed by people who want to keep contributing to an HSA. Once you enroll in any part of Medicare, you must stop HSA contributions.
Are Medicare and Social Security tied together when I turn 65?
Even though you apply for Medicare through Social Security, they operate separately. Turning 65 triggers Medicare eligibility and (for many) an important enrollment period, whereas Social Security can start based on your financial needs anytime from 62 to 70 (with different benefit amounts).