I’m turning 65. When and how do I sign up for Medicare?
Your window opens three months before your birthday month and closes three months after. If you already get Social Security, Parts A and B start automatically. If not, you apply through Social Security. If you still have good employer coverage, you may be able to delay Part B without penalty, but check before deciding.
Your seven-month window
The Initial Enrollment Period runs from three months before the month you turn 65 through three months after it. Signing up in the first three months gives you coverage on the first day of your birthday month. Waiting until later in the window delays the start date, so earlier is better.
Automatic or not?
If you are already receiving Social Security or Railroad Retirement benefits, you are enrolled in Parts A and B automatically and your Medicare card arrives about three months before your birthday. If you are not yet receiving benefits, nothing happens on its own: you apply online at ssa.gov, by phone, or at a Social Security office. You can enroll in Medicare without starting your Social Security payments.
Still working with employer coverage?
If you or your spouse are actively working and covered by an employer plan from a company with 20 or more employees, you can usually delay Part B without a late penalty and enroll later through a Special Enrollment Period when the job or coverage ends. If the employer has fewer than 20 employees, Medicare generally pays first and you should enroll on time. COBRA and retiree coverage do not count as active employment, so they do not let you delay safely. This is the decision that most often goes wrong, and it is worth a conversation.
The HSA catch
You cannot contribute to a Health Savings Account once you are enrolled in any part of Medicare, and Part A can be backdated up to six months when you enroll after 65. If you are still contributing to an HSA, plan the timing of your enrollment so contributions stop in time.
Then choose how to fill the gaps
- Medicare Advantage: a private plan that replaces Parts A and B and usually includes drug coverage. Enroll during your Initial Enrollment Period.
- Original Medicare plus a Part D drug plan and, if you want one, a Medigap plan. Your best Medigap window is the six months starting the month you are 65 and have Part B; insurers cannot turn you down during it.
- Either way, get drug coverage, or other creditable coverage, within 63 days of your Part B start to avoid a permanent Part D late penalty.
A simple timeline
- 6 months before: confirm whether you will keep working and what your employer plan requires.
- 3 months before: enroll in Parts A and B if not automatic. Make a list of your doctors and prescriptions.
- 2 to 3 months before: compare Medicare Advantage versus Original Medicare with Part D and Medigap. This is the visit most offices in this directory are built for.
- Birthday month: coverage starts. Check that your cards arrived and your first premium is set up.
Common questions
Does Medicare cost anything at 65?
Part A is premium-free for most people who worked and paid Medicare taxes for ten years. Part B has a monthly premium that Medicare sets each year, and it is higher at higher incomes. Part D and Medigap plans have their own premiums.
What if my birthday is on the first of the month?
Your coverage starts the first day of the month before your birthday month, and your enrollment window shifts a month earlier as well.
Do I have to sign up if I am still working?
Not always. With active employer coverage from a company with 20 or more employees you can delay Part B. Many people still take Part A at 65 because it is free, unless they are contributing to an HSA.
Talk it through in person
Every office in this directory has licensed agents who will sit down with you, at no cost, and go through your situation. Find a Medicare office near you →