Turning 65

Learn about: Original Medicare (Parts A & B) vs Medicare Advantage (Part C); most people also add drug coverage (Part D) and may consider Medigap to reduce out-of-pocket costs.
Mark the key dates you can change coverage each year (MA Open Enrollment in Jan–Mar; Fall Open Enrollment Oct 15–Dec 7).
If you have other insurance, learn how it coordinates with Medicare (who pays first) so you time enrollment correctly

Your Initial Enrollment Period (IEP) is 7 months: the 3 months before, your birth month, and the 3 months after. If your birthday is on the 1st, the window shifts one month earlier.
When coverage starts depends on when you enroll:
– Enroll in the first 3 months → coverage usually starts the first day of your birth month (or the prior month if your birthday is the 1st).

You may be able to delay Part B without a penalty if you have group health coverage based on your or your spouse’s current employment. When the employment or coverage ends (whichever happens first), you generally have an 8-month Special Enrollment Period (SEP) to sign up for Part B.

Important employer-size rule (age 65+): –

Employer has 20 or more employees: Your employer group health plan generally pays first and Medicare pays second.
Employer has fewer than 20 employees: Medicare generally pays first. Check with your employer’s benefits administrator about whether you need to enroll in Part A and Part B when you turn 65.
- Medicare pays first (so you typically should not delay Part B).

Special Enrollment Periods (SEPs): You may qualify to enroll in Medicare after your IEP in certain situations, such as having job-based coverage from current employment, losing Medicaid, or experiencing certain exceptional circumstances. Eligibility and timing depend on your situation.
General Enrollment Period (GEP):
If you don’t qualify for an SEP, you can enroll January 1 – March 31. Coverage starts the first day of the month after you sign up.

Part B late-enrollment penalty: your premium may rise 10% for each full 12-month period you could’ve had Part B but didn’t—for as long as you have Part B. (SEPs usually avoid this.)
Part D late-enrollment penalty: if you go 63+ days without Part D or other creditable drug coverage after your IEP, a permanent penalty is added to your drug plan premium (calculated using the annual “base beneficiary premium”).

Part B standard premium: $202.90/month in 2026; higher-income enrollees may pay more due to IRMAA.
If you must buy Part A, 2026 premiums vary depending on your work history. A late-enrollment penalty may apply.
Part D out-of-pocket cap: $2,100 in 2026 for covered Part D drugs. After reaching the limit, you pay $0 out of pocket for covered Part D drugs for the rest of the calendar year. You can also choose the Medicare Prescription Payment Plan to spread your out-of-pocket drug costs across the calendar year.

Watch your Medicare card in the mail and bring the correct card to each visit (plan card if you join Medicare Advantage).
chedule your “Welcome to Medicare” preventive visit within the first 12 months you have Part B. After that, Medicare covers a yearly “Wellness” visit once every 12 months.
Each fall, review your coverage and costs; compare plans at Medicare.gov/plan-compare or call your SHIP for free one-on-one guidance.