Medicare eligibility when turning age 65: Get to know your Initial Enrollment Period (IEP) window

When you turn age 65, you become eligible for Medicare. Here’s how you can get coverage by signing up during the Initial Enrollment Period and other important things to know.

Do you know when to sign up for Medicare? It can be tricky if you aren’t sure when you’re eligible. Let’s look at the enrollment time periods you need to know and how to get covered when it’s your time.

Medicare eligibility and your time to sign up

You become eligible for Medicare when you turn age 65 or due to another qualifying circumstance, such as having a disability. To receive full benefits, you need to be a U.S. citizen or a permanent, legal resident. You also must currently be receiving or be eligible to receive Social Security or Railroad Retirement Board benefits

Does Medicare coverage start the month you turn 65?

If you need coverage the month you turn 65, you’ll need to sign up for Medicare during the 3-month window before your birthday month.

When you can sign up for Medicare before turning 65

Not every person benefiting from Medicare is age 65 and older – in fact, there are a few circumstances where people younger than 65 might be eligible to enroll. You may qualify for Medicare early if you have a disability, end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease).

Are you automatically signed up for Medicare when you turn 65?

The short answer is “no” – you won’t be automatically signed up for Original Medicare unless you’re already receiving Social Security or Railroad Retirement Board benefits. If you are, you’ll receive your Medicare card in the mail before your 65th birthday.

Otherwise, you’ll have to sign up for Medicare on your own and you may or may not be notified about your eligibility. This is also the case if you’re interested in a private plan, like Medicare Advantage, as an alternative to Original Medicare. That’s why it’s even more important to know your Initial Enrollment Period (IEP) dates so you’re ready to enroll when it’s your time.

What is the Initial Enrollment Period for Medicare?

The Medicare Initial Enrollment Period (IEP) is your seven-month window to apply for Medicare and enroll in a Medicare plan. The period starts three months before the month of your 65th birthday and ends three months after. (For example, if your birthday falls on June 10, your IEP will start on March 1 and end on Sept. 30.) Choosing your Medicare plan during the IEP is your best way to avoid late-enrollment penalties.

Dates and deadlines you need to know for your Medicare Initial Enrollment Period: Three months before your 65th birthday to three months after. See explanation in body copy.

What happens if you miss your IEP?

If you don’t enroll in Medicare when you’re first eligible, you can still sign up later, but you may end up paying a late penalty for Medicare Part B and/or D. Here are your other enrollment options:

  • There is a Medicare General Enrollment Period (GEP), from Jan. 1 – March 31 every year.
  • There is a Special Enrollment Period, but there are restrictions and you must qualify to be eligible.

What if you change your mind after you enroll?

If you aren’t happy with your Medicare plan, you’ll likely be able to make changes during the Medicare Annual Enrollment Period. This only applies if you have Original Medicare or a Medicare Advantage, Cost or Part D plan.

Parts of Medicare you can sign up for during IEP

During your seven-month Medicare Initial Enrollment Period window, you can enroll in Original Medicare (Parts A and B) which includes coverage for inpatient hospital, skilled nursing facility and long-term hospital care, as well as coverage for medical services.

You can also sign up for more extensive health insurance options, such as a Medicare Advantage, Cost or Supplement plan. Depending on which you choose, these private plans can offer more benefits, often covering health services Original Medicare doesn’t.

Common Medicare plans people enroll in during IEP

If Original Medicare doesn’t cover all of your health care needs, IEP is also your opportunity to enroll in a plan from a private insurer that offers additional coverage. The most common types of plans are:

Medicare Advantage plans (Medicare Part C)

Medicare Advantage plans combine Parts A and B into one simple plan. They also often bundle in Part D and extras like dental, travel and fitness benefits.

Medicare Cost plans

In counties where Medicare Advantage plans are limited, you may have the option to enroll in a Medicare Cost plan. Like Medicare Advantage plans, Medicare Cost plans work alongside Original Medicare to provide additional benefits.

Medicare Supplement (Medigap) plans

Also known as Medigap, Medicare Supplement plans help bridge the gaps between what Original Medicare provides and what you may need.

Medicare Part D: Prescription drug coverage

Since Original Medicare does not cover prescription drugs, signing up for a Part D plan during IEP is a good idea to ensure your medications are covered right away.

With so many options to consider, take a look at our 10 things to do before you enroll in a Medicare plan for a simple guide to help you make the best decision for your needs.

Is Medicare mandatory when you turn 65?

Technically no, but once you enroll in Social Security, you are required to sign up for Medicare Part A. However, Medicare Parts B, C and D are optional and can be delayed if you have other creditable coverage.

Delaying Medicare coverage without penalty

You can delay your Medicare Part B (medical coverage) enrollment without penalty, if you have health insurance through a current job or are a dependent on your spouse’s active plan. Once the spouse with employer coverage stops working – whether it’s you or your partner – you have eight months to sign up for Part B.

Have more Medicare questions?

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