Turning 65 & New to Medicare

Turning 65? Let's Make Medicare Simple.

If you’re approaching 65, you’ve probably started receiving a lot of information about Medicare.

And probably a lot of mail.

The good news is that getting started with Medicare doesn’t have to be complicated.

Before we talk about Medicare Supplements, Medicare Advantage plans or prescription drug coverage, we want to answer the questions almost everyone asks first:

Let’s take them one at a time.

1. When Can I Enroll in Medicare?

For most people, Medicare eligibility begins at age 65.

Your first opportunity to enroll is called your Initial Enrollment Period.

It lasts for seven months:

For example, if your 65th birthday is in June, your Initial Enrollment Period generally runs from March through September.

Our Advice: Start Early

You don’t need to wait until your 65th birthday to start planning.

We recommend beginning the Medicare conversation about three months before your Medicare effective date.

That gives you time to understand Medicare, complete your enrollment and evaluate your additional coverage options without feeling rushed.

2. Do I Have to Enroll at 65?

Not necessarily.

This is one of the most important things to understand when you’re turning 65.

If You’re Retiring or Don’t Have Employer Coverage

In most situations, you’ll want to enroll in Medicare when you first become eligible.

If You're Still Working

You may be able to delay Medicare Part B without a late-enrollment penalty if you have qualifying group health coverage based on your current employment or your spouse’s current employment.

But don’t simply assume that because you have health insurance, you should delay Medicare.

The size of the employer, type of coverage, HSA participation and who is actively employed can all matter.

Before delaying Medicare, make sure you understand how your current insurance works with Medicare.

That’s something we can help you determine.

3. How Do I Enroll in Medicare?

This depends on whether you’re already receiving Social Security benefits.

Instead of immediately talking about insurance plans, we first look at Original Medicare itself.

Already Receiving Social Security?

If you’ve been receiving Social Security benefits for at least four months before turning 65, you’ll generally be automatically enrolled in Medicare Part A and Part B.

Your Medicare card should arrive before your coverage begins.

Not Receiving Social Security Yet?

You’ll generally need to enroll in Medicare yourself.

You enroll in Medicare Part A and Part B through Social Security — not through an insurance company.

You can apply online through Social Security, by phone or through a Social Security office.

And here’s an important distinction:

You do not have to start collecting Social Security retirement benefits just because you’re enrolling in Medicare.

You can enroll in Medicare at 65 while waiting until later to begin your Social Security retirement benefits.

4. When Does My Medicare Start?

For most people who enroll on time, Medicare begins on the first day of the month they turn 65.

For example:

There is one important exception.

Born on the First Day of the Month?

If your birthday is on the first day of the month, Medicare generally treats your eligibility differently and your coverage can begin on the first day of the previous month.

Instead, you’re asking:

Timing also matters if you wait until your birthday month or later to enroll in Part B. Your coverage may not begin until the following month.

That’s another reason we encourage clients to start the process early.

5. How Much Does Medicare Cost?

Now we get to one of the most common questions:

"What am I actually going to pay for Medicare?"

Let’s start with Medicare Part A and Part B.

Medicare Part A — Hospital Insurance

For most people, Part A has a $0 monthly premium because they or their spouse worked and paid Medicare taxes for a sufficient amount of time.

That’s why you will often hear Part A referred to as premium-free Part A.

If you haven’t accumulated enough qualifying work history, you may have to pay a monthly Part A premium.

Medicare Part B — Medical Insurance

Part B does have a monthly premium.

For 2026, the standard Medicare Part B premium is $202.90 per month.

The amount generally changes each year.

Some people pay more because of their income.

This is known as IRMAA — the Income-Related Monthly Adjustment Amount.

If your income exceeds certain thresholds, an additional amount can be added to your Medicare Part B premium.

6. Is $202.90 My Total Medicare Cost?

No — and this is where our Medicare 101 education becomes important.

Your monthly Part B premium is simply the cost to have Medicare Part B.

It doesn’t mean Medicare pays 100% of your medical expenses.

Original Medicare still leaves you responsible for certain:

For example, in 2026, Medicare Part B has a $283 annual deductible.

After that deductible, for many covered Part B services, Medicare generally pays 80% of the Medicare-approved amount and you’re responsible for the remaining 20%.

Most importantly, Original Medicare doesn’t have an annual out-of-pocket maximum.

That’s the financial exposure we discussed in Medicare 101.

7. Medicare Is the Foundation — Now We Build Around It

Once your Medicare Part A and Part B enrollment is established, we can move to the next step.

We already know:

WHEN your Medicare starts.

HOW you enroll.

WHAT Medicare costs.

Now we need to understand:

Once we identify that financial exposure, we can decide how you want to protect yourself from it.

That’s when we begin discussing additional coverage options such as:

Medicare Supplement (Medigap)

Medicare Advantage

Medicare Part D Prescription Drug Coverage

Instead of starting with an insurance plan, we start by helping you understand Medicare itself.

1

Determine when you're eligible for Medicare

2

Decide whether you should enroll at 65 or delay because you're still working

3

Enroll in Medicare Part A & Part B

4

Confirm your Medicare effective date

5

Understand what Medicare costs and covers

6

Identify your financial exposure

7

Choose the coverage that best protects you

You Don't Have to Figure This Out Alone

At Health Coverage Solutions, our goal isn’t to overwhelm you with insurance plans.

Our goal is to simplify Medicare through education.

We’ll help you understand when to enroll, how Medicare works, what it costs and what your options are — so you can make an informed decision about your coverage.

Turning 65 Soon?

Let’s start the conversation before you have to make a decision.

Turning 65 & New to Medicare

Turning 65? Let's Make Medicare Simple.