Turning 65 is a major Medicare milestone. For the first time, you're eligible to enroll in Medicare — and the decisions you make during this Initial Enrollment Period can affect your coverage and costs for years to come. Here's everything you need to know.
When Can You Enroll in Medicare?
Your Initial Enrollment Period (IEP) is a 7-month window that begins 3 months before your 65th birthday month, includes your birthday month, and extends 3 months after. Enrolling early (before your birthday month) means coverage starts on the first day of your birthday month.
| Enrollment Timing | Coverage Start Date |
|---|---|
| 3 months before birthday month | First of your birthday month |
| Your birthday month | First of the following month |
| 1 month after birthday month | Two months after enrollment |
| 2–3 months after birthday month | Three months after enrollment |
What Are the Parts of Medicare?
Medicare Part A covers inpatient hospital care, skilled nursing facility stays, hospice, and some home health care. Most people get Part A premium-free if they've worked and paid Medicare taxes for at least 10 years (40 quarters).
Medicare Part B covers doctor visits, outpatient services, preventive care, and medical equipment. Part B has a monthly premium ($185/month in 2026 for most people). You choose whether to enroll in Part B during your IEP.
Medicare Part C (Medicare Advantage) is an alternative to Original Medicare, offered through private insurers approved by Medicare. These plans bundle Parts A, B, and usually Part D — often with extra benefits like dental, vision, and hearing.
Medicare Part D covers prescription drugs. You can add Part D to Original Medicare, or it may be included in a Medicare Advantage plan.
Should You Enroll in Medicare at 65 If You Have Employer Coverage?
If you're still working at 65 and covered by a qualifying employer health plan (from a company with 20 or more employees), you may be able to delay Medicare Part B without penalty. You'll have a Special Enrollment Period to sign up when employment ends.
However, if your employer has fewer than 20 employees, Medicare becomes the primary payer — and delaying could leave gaps in your coverage.
What Happens If You Miss Your Initial Enrollment Period?
If you miss your IEP without a qualifying reason, you may face:
- Late enrollment penalty for Part B: Your premium increases by 10% for each full 12-month period you were eligible but didn't enroll — permanently.
- Late enrollment penalty for Part D: 1% of the national base beneficiary premium per month you went without creditable drug coverage — also permanent.
Medicare Advantage vs. Original Medicare at 65
Many people turning 65 choose Medicare Advantage (Part C) over Original Medicare because it often provides more comprehensive benefits — dental, vision, hearing, and fitness programs — at competitive premiums. Medicare Advantage plans are offered through private insurers and must cover everything Original Medicare covers.
The right choice depends on your health needs, preferred doctors, budget, and where you live. A licensed Medicare advisor can help you compare options in your zip code.
Next Steps When You Turn 65
- Apply for Medicare 3 months before your 65th birthday at SSA.gov or by calling Social Security at 1-800-772-1213.
- Decide between Original Medicare and Medicare Advantage.
- Add a Part D drug plan if you choose Original Medicare.
- Consider a Medicare Supplement (Medigap) plan to cover cost-sharing under Original Medicare.
- Call a licensed Medicare advisor to compare all options in your area.
Call 1-866-340-3441 to speak with a Senior Benefit Assistance advisor who specializes in helping people enroll in Medicare for the first time.