Turning 65 is an important milestone. It’s also a good time to learn about your Medicare coverage options. Whether you're new to Medicare or preparing to enroll soon, understanding how Medicare works can help you make informed decisions about your health coverage. Medicare offers different coverage choices. The right option depends on your needs, budget and eligibility.
What do I need to know about signing up for Medicare?
For most people, the first chance to sign up for Medicare is during the Initial Enrollment Period (IEP). This seven-month enrollment window begins three months before your 65th birthday month, includes your birthday month and ends three months after it.
Enrolling during your IEP can help you avoid late enrollment penalties and gaps in coverage. If you have health coverage through an employer or another source, review how that coverage works with Medicare before deciding whether to delay enrollment.
When can you delay Medicare enrollment?
Some people may not want to enroll in Medicare right away to avoid the cost of these premiums. But it’s important to keep a few things in mind. First, the premiums give you access to Medicare health and drug coverage. Second, if you wait until after your Initial Enrollment Period to enroll in Medicare, you might have to pay a late enrollment penalty for coverage.
One common exception applies to people who are actively working and have health coverage through an employer or union. If you don't enroll in Medicare Part B or Part D during your Initial Enrollment Period and don't qualify for a Special Enrollment Period, you may have to pay a late enrollment penalty. Here's how employer coverage can affect when you enroll.
Do I have to sign up for Medicare at 65 if I already have health insurance?
You need to understand how your current coverage works with Medicare to truly understand if you need to enroll in Medicare. To answer questions about your current insurance, contact your benefits administrator or plan provider.
You’ll want to understand:
- Whether your prescription drug coverage is considered creditable coverage under Medicare. And whether the two insurances can work together
Generally:
- If you have retiree coverage, Medicare recommends you sign up for Part A and Part B when you’re first eligible.
- If you have coverage through an employer where you (or your spouse) are currently working, the size of the employer determines if you can delay enrolling in Medicare without penalty.
- If coverage is through a company with 20 or more employees, you may be able to delay enrollment in Medicare without penalty.
- If coverage is through a company with less than 20 employees, Medicare recommends signing up for Part A and Part B when you’re first eligible to avoid late penalties.
If you or your spouse are still planning to work past 65, you can read about the five things you should know about signing up for Medicare.
Learn more about when you should sign up for Original Medicare on Medicare.gov
There are also specific rules that apply to whether you pay a penalty for late enrollment in Medicare Part D. Do you have prescription drug coverage through your employer that pays, on average, at least as much as Medicare’s standard? If not, then you could be subject to a penalty if you don’t register for prescription drug coverage when you first become eligible for Medicare at 65. Once again, if you aren’t sure whether your prescription drug coverage meets this requirement, contact your plan provider or benefits administrator.
Should I delay Medicare enrollment or not?
Ultimately, only you can determine when it’s best for you to enroll in Medicare once you become eligible.
Before deciding to delay enrollment, make sure you understand whether your current health coverage qualifies you for an enrollment exception. If you don't qualify for an exception, delaying enrollment could result in late enrollment penalties for Medicare Part B or Part D.
If you're covered through an employer or union plan, check with your benefits administrator to understand how your coverage works with Medicare before making a decision.
Your retirement plans may also affect when you should enroll. If you're planning to keep working past age 65 or leave your job after becoming eligible for Medicare, learn more about how to avoid coverage gaps when retiring after 65.
If you're concerned about Medicare premiums, remember to consider the coverage and benefits you may receive in return.
For more information on how and when to enroll, go to our guide to Medicare enrollment
Commonly asked questions about when to sign up for Medicare
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You are likely still in your Initial Enrollment Period (IEP), which lasts for seven months around your 65th birthday. It includes the three months before your birthday month, your birthday month and the three months after. If you are within this window, you can still enroll without a late enrollment penalty, but your coverage start date may be delayed depending on when you sign up.
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You can start the enrollment process three months before the month you turn 65. This early window helps ensure your coverage begins on time. Planning ahead also gives you time to review your coverage options and choose a plan that fits your needs.
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If you have health coverage through an employer with 20 or more employees, you may be able to delay enrolling in Part B without a late enrollment penalty. Your employer coverage may work with Medicare, but you should confirm how your plan coordinates benefits. Before delaying, review your options with your benefits administrator to avoid gaps in coverage.
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If you're 64 and will become eligible for Medicare within the next several months, now is a good time to start preparing. You can use this time to learn about Medicare, understand your enrollment timeline and review your current health coverage.
Starting early may help you avoid coverage gaps and late enrollment penalties, while giving you time to compare your Medicare coverage options.
If you're only a few months away from becoming eligible for Medicare, learn more about how to prepare for Medicare enrollment.
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