Turning 65
Turning 65 starts a clock. Get the timing right and everything else is manageable. Miss it and you can pay a penalty for the rest of your life — so let’s walk through it together.
Your Initial Enrollment Period runs seven months: the three months before your birthday month, your birthday month, and the three months after.
Nothing is due yet, and that is exactly why this is the easiest time to look. Make a list of your doctors and your prescriptions with doses. If you are still working, ask your HR department one question in writing: is our plan creditable coverage for Medicare?
Enrolling now means your coverage generally starts on the 1st of your birthday month, with no gap. If you were born on the 1st, Medicare treats you as turning 65 the month before, so everything shifts back a month.
This is also when we should sit down and compare plans, while you have time to think rather than react.
You can still enroll, but Part B generally will not start until the 1st of the following month. If you enrolled earlier, this is the month your coverage begins and your card should already be in hand.
Your window closes at the end of the third month after your birthday month. Enroll here and coverage starts the 1st of the next month — which can leave you uninsured for a stretch.
If you did not enroll and you do not have creditable coverage elsewhere, you may have to wait for the General Enrollment Period and pay a Part B late enrollment penalty — added to your premium for as long as you have Part B. It does not expire.
If you think you have missed it, call me anyway. Special Enrollment Periods exist and people qualify for them more often than they expect.
This is the most common question I get, and the answer genuinely depends on the size of the employer.
If you have active coverage through your own or your spouse’s employer and that employer has 20 or more employees, you can generally delay Part B without a penalty and pick it up later through a Special Enrollment Period.
Most people still take premium-free Part A, since there is rarely a reason not to.
With a smaller employer, Medicare usually becomes your primary payer at 65. Skipping Part B can leave you with far less coverage than you think you have — and a penalty later.
Confirm with your plan administrator before you decide anything.
Medicare looks like a hundred choices. It is really three.
Original Medicare (Parts A & B) lets you see any provider nationwide who accepts Medicare — no networks, no referrals. Most people pair it with a Medigap policy to cap the out-of-pocket costs, and a Part D plan for prescriptions.
Medicare Advantage (Part C) bundles it all into one private plan, usually with drug coverage and extras like dental, vision and hearing, often at a low or $0 premium beyond Part B. The trade-off is a network and prior authorizations.
Neither is better. It depends on your doctors, your prescriptions, your budget, and how much you travel.
Part D plans differ by formulary, pharmacy network and cost — two people on the same medications can pay very different amounts. Bring me your list and we will price it out properly rather than guessing.
Even if you take nothing today, going without creditable drug coverage builds a Part D penalty over time.
Your Medigap open enrollment is a six-month window that starts when you are 65 and enrolled in Part B. During it, you can buy any Medigap policy sold in your state regardless of your health history.
After that window, in most states insurers can ask health questions and turn you down. This is the deadline people most often do not know exists.
Nothing formal. Whatever you have is a fine place to start.
Most consultations are completely free, and you’re welcome to bring a friend or family member. We’ll go at your pace.