Turning 65 Medicare Checklist — Personalized Enrollment Dates

1

Research & Awareness

2–3 years before your 65th birthday

Learn Original Medicare vs. Medicare Advantage Original Medicare (Parts A & B) gives you flexibility to see any doctor nationwide. Medicare Advantage (Part C) is managed care — usually lower premiums but with networks and prior authorization.

Know what Medicare does NOT cover Routine dental, vision, hearing, and most long-term care are not covered by Original Medicare. Budget accordingly or find supplemental coverage.

Understand your current employer plan and Medicare interaction If you have employer coverage now, learn whether it will remain primary or secondary once you turn 65. Coordination rules vary by employer size.

Research Medigap (Medicare Supplement) plans Your Medigap Open Enrollment Period is a one-time window — insurers cannot deny you or charge more based on health during this window. Missing it means medical underwriting applies.

Review your Social Security statement at ssa.gov Medicare Part B premiums are deducted from your Social Security benefit. Know your estimated benefit amount and check your earnings record for errors.

2

Prepare & Gather

6 months before your 65th birthday

Mark your IEP open date on your calendar calculate dates above Your Initial Enrollment Period opens 3 months before your birth month. This is the earliest you can sign up.

Create or verify your my Social Security account Visit my.ssa.gov — you'll use this to enroll online in Medicare Part A and Part B if you're not already receiving Social Security benefits.

Gather your documents Birth certificate or proof of age, photo ID, Social Security card, and your Medicare card when it arrives (automatically mailed ~3 months before your 65th birthday).

Check IRMAA income thresholds If your 2023 income exceeded $106,000 (single) or $212,000 (married filing jointly), you'll pay Income-Related Monthly Adjustment Amount (IRMAA) surcharges on Part B and Part D.

Research Part D prescription drug plans Compare plans at medicare.gov/plan-compare. Even if you take no medications, enroll in a low-cost Part D plan to avoid the permanent late enrollment penalty.

Check your medications against Part D formularies Different plans cover different drugs at different costs. Run your full medication list through medicare.gov/plan-compare to find the best-fit plan for your prescriptions.

3

Enroll — Initial Enrollment Period

7-month window around your 65th birthday

Enroll in Part A (Hospital Insurance) see your dates above Part A is usually premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters). Enroll even if you're still working.

Choose: Original Medicare or Medicare Advantage? Original Medicare = maximum flexibility, nationwide access. Medicare Advantage = usually lower premiums, often includes dental/vision, but with network restrictions. This is one of the most important decisions you'll make.

Enroll in Part B (Medical Insurance) Part B covers outpatient care, doctor visits, preventive services, and durable medical equipment. The standard 2026 premium is $202.40/month. Avoid delaying without qualifying coverage — the penalty is permanent.

If choosing Original Medicare: select your Medigap plan during OEP calculate dates above Your 6-month Medigap Open Enrollment Period starts when Part B becomes effective. During this window, any insurer must sell you any plan at the same rate as a healthy person — no medical underwriting.

Enroll in Part D (Prescription Drug Plan) Required even if you take no medications — it protects you from the permanent 1% per month late penalty. A bare-bones plan can cost as little as $5–$15/month.

Confirm your Part B effective date with Social Security Your Part B effective date determines when your Medigap OEP begins. Verify it in writing — mistakes happen and they matter.

4

If Still Working — Special Enrollment Period

Delays are allowed while you have qualifying employer coverage

Confirm your employer plan qualifies as "creditable coverage" To delay Part B without penalty, your employer plan must be primary to Medicare and the employer must have 20+ employees. Get written confirmation from your HR department.

Understand your SEP window: 8 months after employer coverage ends When you retire or lose employer coverage, you have exactly 8 months to enroll in Part B without penalty. This is not extendable. Mark the date coverage ends on your calendar immediately.

Get your Certificate of Creditable Coverage before retiring Your employer must provide written documentation of your coverage. You'll need this when you enroll through your SEP to avoid delays or penalties.

⚠ Do NOT use COBRA to extend your SEP window COBRA is NOT considered employer-sponsored creditable coverage for Medicare purposes. Once your active employer coverage ends, your 8-month SEP clock starts — COBRA does not pause it.

Note: Medigap OEP timing changes if you delay Part B If you delay Part B via SEP, your Medigap OEP starts when Part B becomes effective — not at 65. In some states you may face medical underwriting if you delay. Plan ahead.

4

Post-Enrollment — First Year

Ongoing after your Medicare coverage begins

Review your Medicare Summary Notice (MSN) quarterly Your MSN summarizes all claims filed on your behalf. Review it for billing errors, duplicate charges, and services you didn't receive. Report discrepancies to 1-800-MEDICARE.

Create your account at Medicare.gov Track your claims, check coverage, find doctors, and access your Medicare Summary Notices online. Setting it up early makes everything easier.

Mark the Annual Enrollment Period: Oct 15 – Dec 7 Every year during AEP you can switch from Original Medicare to Medicare Advantage (or back), and change your Part D plan. Review your options annually — costs and formularies change each year.

Turning 65? Your Medicare Checklist.

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