Turning 65: Your complete guide to starting Medicare

What happens when you turn 65

For most people, 65 is the age you become eligible for Medicare. If you already receive Social Security, you're usually enrolled in Parts A and B automatically. If you're not yet collecting Social Security, you have to sign up yourself, and it does not happen on its own. Either way, the choices you make in the months around your birthday shape your coverage and costs for years.

The four parts, in one minute

Medicare has four parts. Part A covers hospital stays, Part B covers doctors and outpatient care, Part C (Medicare Advantage) is an all-in-one private plan alternative, and Part D covers prescription drugs. Most people pair Parts A and B with either a Medicare Advantage plan or a Medigap plan plus Part D.

• Part A: Hospital: Inpatient stays, skilled nursing, hospice. Usually $0 premium if you worked 10+ years.
• Part B: Medical: Doctor visits, outpatient care, preventive services. Has a monthly premium.
• Part C: Medicare Advantage: A private all-in-one alternative that bundles A, B, and usually D, often with extras.
• Part D: Drugs: Prescription coverage through a private plan. Skipping it can mean a permanent penalty.

Your three big decisions

At 65 you'll decide: (1) whether to enroll now or delay because you have creditable employer coverage; (2) Original Medicare plus a Medigap plan, or an all-in-one Medicare Advantage plan; and (3) which Part D drug plan fits your medications. There's no single right answer. It depends on your health, budget, doctors, and prescriptions.

The 7-month enrollment window

Your Initial Enrollment Period is a 7-month window centered on your birthday month: it opens 3 months before, includes your birthday month, and closes 3 months after. Enroll in the first 3 months so coverage starts the month you turn 65 and you avoid gaps. Miss it without qualifying employer coverage and you can face permanent late penalties.

Your turning-65 timeline

Give yourself runway. A simple schedule keeps you out of penalty territory and gives you time to compare plans instead of rushing.

• 6 months before 65: Learn the basics, check whether your employer coverage is creditable, and start comparing options.
• 3 months before 65: Your enrollment window opens. Enroll in Parts A and B (or confirm your automatic enrollment).
• Birthday month: Choose Original Medicare plus Medigap plus Part D, or a Medicare Advantage plan.
• 3 months after 65: Last chance in your Initial Enrollment Period. After this, penalties and coverage delays can apply.

Common mistakes to avoid

The costly ones: assuming enrollment is automatic when it isn't, skipping Part D because you don't take drugs today (the penalty is permanent), dropping employer coverage without checking whether it's creditable, and waiting until the last month of your window and getting a delayed start.

Related articles

• Medicare eligibility: are you eligible, and when?
• How to enroll in Medicare, step by step
• When to sign up for Medicare (enrollment periods)
• Medicare late-enrollment penalties, and how to avoid them
• The parts of Medicare, explained

Common questions