Medicare when you turn 65: how to sign up
Your Medicare window is 7 months: 3 months before your 65th birthday month, that month, and 3 months after. If you already get Social Security, you’re usually enrolled automatically. Part A covers hospital stays, B doctors, D drugs; Medicare Advantage (Part C) is a private all-in-one plan. If you have coverage from a current job, you may be able to delay Part B without a penalty. Your state’s SHIP program gives free help.
Your checklist
- Know your 7-month window
- Learn Parts A, B, C and D
- Compare Original vs Advantage
- Check before delaying Part B
- Get free help from SHIP
- Hang up on pushy callers
Rather read it? Here’s the whole thing.
When to sign up
Your Initial Enrollment Period is 7 months: the 3 months before the month you turn 65, that month, and the 3 months after. If you already get Social Security or Railroad Retirement benefits, you’re usually enrolled in Parts A and B automatically. Otherwise, sign up through Social Security.
The parts
- Part A: hospital, skilled nursing after a hospital stay, hospice. Usually no premium if you worked about 10 years.
- Part B: doctors, outpatient care, tests. Has a monthly premium.
- Part D: prescription drugs.
- Part C (Medicare Advantage): private plans that bundle A and B, and often D, usually with networks.
Two main paths
- Original Medicare (A and B), often with a Medigap supplement and a Part D plan.
- Medicare Advantage, an all-in-one plan with networks and sometimes extras.
Late penalties
Signing up late for Part B or Part D can mean higher premiums for life. If you have coverage from a current job (yours or a spouse’s), often at a larger employer, you may be able to delay without a penalty and sign up later in a special period. Retiree coverage and COBRA usually don’t count.
Help
Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling. Ask about Extra Help with drug costs and Medicare Savings Programs.
Avoid traps
Medicare doesn’t call to sell plans. Compare plans on Medicare.gov.
Official sources, and where to look
- Medicare.gov: get startedmedicare.gov
- Social Security: apply for Medicaressa.gov
- SHIP: free Medicare counselingshiphelp.org
[your state] SHIP Medicare counselingmedicare.gov plan finder
Common questions
Do I have to sign up for Medicare if I’m still working?
Many people sign up for premium-free Part A. Whether to delay Part B depends on your job coverage and employer size. Check with your employer and SHIP before deciding. More ›
Can I change Medicare plans later?
Yes, during set times each year, like the fall open enrollment period. Some changes have limits, especially for Medigap. More ›
When should I sign up for Medicare?
During your 7-month Initial Enrollment Period around your 65th birthday. Signing up in the 3 months before your birthday month helps coverage start on time. More ›
What is the Part B late enrollment penalty?
A higher Part B premium, often for as long as you have Part B, if you didn’t sign up when first eligible and didn’t have qualifying job coverage. More ›
What is the difference between Medigap and Medicare Advantage?
Medigap helps pay costs Original Medicare doesn’t cover. Medicare Advantage replaces Original Medicare with a private all-in-one plan. You can’t use both together. More ›
Is Medicare free?
Part A is usually premium-free if you worked about 10 years. Part B and most Part D and Medigap plans have premiums, plus deductibles and copays. More ›
Find Medicare help near you
Start with free SHIP counseling.
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Not yet reviewed by an expert. Last checked 2026-10-29. This is general help, not legal, medical or professional advice. Rules are different in every state.