Medicare Enrollment at 65: What You Need to Know Before You Enroll in Medicare Coverage

If you are turning 65 soon, you may be wondering how Medicare works and what you need to do to enroll. Medicare is a federal health insurance program for people who are 65 or older, disabled or have certain medical conditions. Medicare has four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage).

We explain the basics of Medicare enrollment at 65, including whether you're eligible for Medicare, when and how to sign up, what coverage options you have, and how to avoid late enrollment penalties.

When to Sign up for Medicare: Initial Enrollment Period

The best time to enroll in Medicare is during your initial enrollment period, which is a seven-month window that starts 3 months before you turn age 65 and ends three months after you turn 65. For example, if your birthday is in June, your initial enrollment period is from March to September.

If you enroll in Medicare during your initial enrollment period, your coverage will start on the first day of the month you turn 65, or the month before if your birthday is on the first day of the month. For example, if your birthday is on June 15, your coverage starts the month of June. If your birthday is on June 1, your coverage will start on May 1.

If you miss your initial enrollment period, you can still sign up for Medicare coverage during the general enrollment period, which runs from January 1 to March 31 each year. However, your coverage will not start for months after you sign up. For instance, you'll wait until July 1 of that year, and you may have to pay a late enrollment penalty for Part A and/or Part B.

How to Enroll in  Medicare Part And B

The process of enrolling in Medicare depends on whether you are already receiving Social Security benefits or not.

If you are already receiving Social Security benefits (or Railroad Retirement Board benefits) when you turn 65, you will be automatically enrolled in Medicare Part A and Part B. You will receive your Medicare card in the mail about three months before your 65th birthday. You can choose to keep or decline Part B coverage by following the instructions on the card. If you keep Part B, the premium will be deducted from your Social Security check.

If you are not receiving Social Security benefits when you turn 65, you will need to sign up for Medicare Part A and Part B yourself. You can do this online at the Social Security Administration website, by phone at 1-800-772-1213, or in person at your local Social Security office. You should apply for Medicare three months before you turn 65 to ensure that your coverage starts on time.

Medicare Advantage Plan  Options You Have

Once you are enrolled in Medicare Part A and Part B, also known as Original Medicare, you have two main options for additional coverage: Medicare Advantage and Medicare Part D.

Medicare Part C is an alternative way to get your Medicare benefits through a private insurance company that contracts with Medicare. Medicare Advantage Plans may offer extra benefits such as vision, dental, hearing, and wellness programs. They may also have lower out-of-pocket costs than Original Medicare. However, they may also have more restrictions on which doctors and hospitals you can use.

You can enroll in a Medicare Advantage Plan during your initial enrollment period or during the annual open enrollment period from October 15 to December 7 each year. You can compare and choose a plan using the Medicare Plan Finder tool on the Medicare website.

Medicare Part D is prescription drug coverage that helps pay for the medications you need. You can get Part D coverage either through a stand-alone prescription drug plan (PDP) or as part of a Medicare Advantage Plan that includes drug coverage (MA-PD). You can enroll in a Part D Plan during your initial enrollment period or during the annual open enrollment period from October 15 to December 7 each year. You can compare and choose a plan using the Medicare Plan Finder tool on the Medicare website.

How to Avoid Late Enrollment Penalties

If you don’t sign up for Medicare Part A and/or Part B when you first become eligible, you may have to pay a monthly late enrollment penalty for as long as you have Medicare. The penalty amount depends on how long you delayed enrolling.

The Part A penalty is equal to 10% of the monthly premium for each full 12-month period that you could have had Part A but didn’t sign up. The penalty applies only if you have to pay a premium for Part A, which most people don’t because they or their spouse paid Medicare taxes while working.

The Part B penalty is equal to 10% of the monthly premium for each full 12-month period that you could have had Part B but didn’t sign up. The penalty applies to everyone who enrolls in Part B after their initial enrollment period, unless they qualify for a special enrollment period.

A special enrollment period or eligibility period is a time when you can sign up for Medicare Part B without a penalty, if you have a valid reason for delaying enrollment. The most common reason is that you or your spouse are still working and have health insurance from your employer or union. In that case, you can enroll in Part B anytime while you have employer coverage or within eight months after the coverage ends.

To avoid late enrollment penalties, you should enroll in Medicare as soon as you become eligible, unless you have a special enrollment period. You should also notify the Social Security Administration if you have employer coverage or if your coverage changes.

Conclusion

Medicare enrollment at 65 can be confusing, but it doesn’t have to be. By following these steps, you can make sure that you get the coverage you need and avoid unnecessary penalties.

·        Enroll in Medicare during your initial enrollment period, which starts three months before you turn 65 and ends three months after you turn 65.

·        Choose between Original Medicare (Part A and Part B) and Medicare Advantage (Part C) for your basic coverage.

·        Add Medicare Part D (prescription drug coverage) to help pay for your medications.

·        Sign up for Part B during a special enrollment period if you have employer coverage and want to delay enrollment.

·        Notify the Social Security Administration of any changes in your health insurance status.