Turning 65 in the Next 6 Months? Your Medicare Timeline

Your Initial Enrollment Period, or IEP, is your first chance to sign up for Medicare. It lasts 7 months:

• the 3 months before your birthday month,
• the month you turn 65, and
• the 3 months after.

Say you turn 65 on August 15. Your IEP runs from May through November. You can sign up any time in those 7 months, but as you'll see next, when you sign up changes when your coverage starts.

Birthday on the 1st? Everything shifts one month earlier. Medicare treats you as turning 65 in the month before your birthday. If you turn 65 on August 1, your IEP runs from April through October. The date tool above does this for you.

Birthday early in the year? Your window can start the year before. If you turn 65 on January 10, your IEP runs from October through April of the next year. It's easy to miss because the first three months fall during the holidays.

It depends on which part of your IEP you sign up in:

• In the 3 months before your birthday month: coverage starts the first day of your birthday month.
• In your birthday month or the 3 months after: coverage starts the first day of the month after you sign up.

Using the August 15 example: sign up by July 31 and your coverage starts August 1. Sign up in September and it starts October 1. That could leave you without coverage for two months.

The takeaway: sign up early. Signing up in the 3 months before your birthday month is the simplest way to avoid a gap, especially if other coverage is ending when you turn 65.

Maybe. If you already get Social Security (or Railroad Retirement) benefits at least 4 months before you turn 65, you're usually enrolled in Parts A and B automatically, and your Medicare card comes in the mail.

If you don't get those benefits yet, you need to sign up yourself through Social Security. Nothing happens on its own, so mark the start of your IEP on your calendar.

One common mix-up: 65 is not "full retirement age" for Social Security. Medicare and Social Security can start at different times. You can sign up for Medicare at 65 even if you wait to take Social Security.

Signing up is only part of it. Here are the four choices to make before your coverage starts.

Part A is hospital insurance. Part B covers doctor visits, outpatient care and many tests. Together they're called Original Medicare, and they're the base for everything else. If you're not enrolled automatically, this is the part you sign up for through Social Security.

Next, decide how you want the rest of your coverage to work. A Medicare Advantage plan bundles your coverage into one private plan, often with a network of doctors. Or you can keep Original Medicare and add a Medigap (Medicare Supplement) policy to help with costs Original Medicare doesn't cover. Each path has trade-offs. Learn more about your Medicare choices.

Original Medicare doesn't cover most prescriptions you fill at a pharmacy. You get drug coverage through a separate Part D plan, or it may come included in a Medicare Advantage plan; many include it. Check that your drugs and pharmacy are covered before you choose.

Your 6-month Medigap Open Enrollment Period starts the month you're 65 or older and enrolled in Part B. During those 6 months, insurance companies can't turn you down or charge you more because of your health. After it ends, health questions may apply in many states. That's why this window is worth knowing about even if you start with Medicare Advantage.

Here's a simple order to work in. Your own dates come from the tool above.

1. Before your IEP starts: decide whether you're keeping a job's health plan. If you are, the still-working lesson is the one for you. If not, list your doctors, prescriptions and pharmacy so you can check them against any plan you look at.
2. When your IEP opens: sign up for Parts A and B through Social Security, or check whether you'll be enrolled automatically.
3. Before your birthday month: choose Medicare Advantage or Original Medicare with Medigap, and make sure drug coverage is in place. Signing up by the last day of the month before your birthday month means coverage starts with no gap.
4. If you have a Marketplace plan: report your Medicare start date so the plan ends when Medicare starts.
5. Once Part B starts: your 6-month Medigap window is open. If you want Medigap, this is the time to buy it.

Two penalties catch people who sign up late. Both can last a long time.

• Part B late enrollment penalty. 10% is added to your Part B premium for each full 12 months you could have had Part B and didn't. You usually pay it for as long as you have Part B. There are exceptions if you had qualifying job-based coverage. See Turning 65 but still working? for how that works.
• Part D late enrollment penalty. If you go 63 days or more in a row without Part D or other creditable drug coverage after your IEP ends, a penalty is added to your premium. You pay it for as long as you have Medicare drug coverage.

Here's how the Part B penalty adds up. Say you could have had Part B but waited two full years to sign up. That's two full 12-month periods, so 20% is added to your Part B premium, and it usually stays for as long as you have Part B. Wait less than a full 12 months and that period doesn't count toward the penalty, but you may still go months without coverage.

For drug coverage, the clock is shorter. Once your IEP ends, going 63 days or more in a row without Part D or other creditable drug coverage is enough to trigger the Part D penalty. If you're unsure whether coverage you have now counts as creditable, ask before you let it go.

The best way to avoid both is simple: sign up during your IEP, and make sure drug coverage is in place when your Medicare starts.

If you buy your own health insurance through the Marketplace, plan for that coverage to end when your Medicare starts.

• Once you're eligible for premium-free Part A, you generally can't keep getting Marketplace subsidies to help pay for your plan.
• Report your Medicare start date to the Marketplace so your plan ends at the right time.

Line the two up so there's no gap and no overlap.

If your IEP has passed and you didn't sign up, there's still a way in. The General Enrollment Period runs January 1 to March 31 every year. Your coverage starts the month after you sign up.

Late penalties may apply, and you may have gone months without coverage. If you're past your window, talk to someone before you decide what to do next.

Already on Medicare and reviewing your plan this fall? Use the free Medicare AEP Checklist. Keeping job coverage instead? Get the Medicare Timing Sheet for people still working.