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Tam NguyenINSURANCE SERVICES

Turning 65? Here's where to start.

Medicare comes with deadlines, and the first one arrives before your birthday. This guide covers what happens when, and what you actually need to decide.

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Your first deadline

You get a seven month window.

It is called your Initial Enrollment Period, and it is built around the month you turn 65.

  1. 3months before
  2. 2months before
  3. 1month before
  4. 65birthday month
  5. 1month after
  6. 2months after
  7. 3months after

Sign up in the three months beforeYour coverage starts on the first day of your birthday month. This is the smoothest route.

Sign up in your birthday month or the three months afterYour coverage starts on the first day of the month after you sign up, so you may have a gap.

Born on the first of the month? Your window and your start date both shift one month earlier.

The basics

Medicare has four parts.

You will hear these letters constantly. Here is what each one means.

Part A

Hospital insurance

Helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no monthly premium for Part A if they or a spouse paid Medicare taxes long enough while working.

Part B

Medical insurance

Helps cover doctor visits, outpatient care, preventive services, and medical equipment. Part B has a monthly premium.

Part C

Medicare Advantage

Plans from private insurers, approved by Medicare, that bundle Part A and Part B. Most also include prescription drug coverage.

Part D

Prescription drug coverage

Helps pay for prescription medications. It is offered through private plans, either on its own or as part of a Medicare Advantage plan.

Parts A and B together are called Original Medicare. That is the starting point for everyone, whichever path you choose next.

The main decision

Then you choose a path.

There is no single right answer. It depends on your doctors, your prescriptions, and how you like to budget.

Original Medicare

Often paired with a Medicare Supplement plan and a Part D drug plan

Doctors
You can see any doctor or hospital in the country that accepts Medicare.
Your costs
You generally pay a share of each service, with no yearly limit unless you add a Medicare Supplement plan.
Prescriptions
Not included. You add a separate Part D plan.

Medicare Advantage

An all-in-one alternative offered by private insurers

Doctors
Many plans use a network, so it matters whether your doctors are in it.
Your costs
Plans set a yearly limit on what you pay out of pocket for covered services.
Prescriptions
Included in most plans. Some also add extras such as dental, vision, or hearing benefits.

Want the fuller comparison? See how the Medicare options work.

A man in his sixties still at work at his desk
A common question

Still working at 65?

You may not need to do everything right now. It depends on the coverage you have through work.

Covered through an employer

If you or your spouse are still working and covered by a group health plan, you can often delay Part B without a penalty. The size of the employer matters, so check before you decide.

When that coverage ends

You get a Special Enrollment Period to sign up for Part B. It lasts eight months, starting when the job or the coverage ends, whichever comes first.

Have a health savings account? Medicare enrollment affects whether you can keep contributing to it. Bring it up before you sign up for anything.

In order

Your turning 65 checklist.

Five steps, starting about six months before your birthday. I can walk through each one with you.

Go through it with Tam Call 949-345-0776

  1. Find your window.

    Count three months back from your birthday month. That is the first day you can sign up.

  2. Check whether you are enrolled automatically.

    If you already receive Social Security benefits at least four months before you turn 65, you are signed up for Parts A and B without doing anything. Otherwise you need to sign up yourself.

  3. Settle the employer coverage question.

    If you have coverage through work, find out how it fits with Medicare before you decide on Part B.

  4. Choose your path.

    Original Medicare with a Supplement and a drug plan, or a Medicare Advantage plan. Bring your list of doctors and prescriptions.

  5. Review it every fall.

    Plans change each year. Medicare's Open Enrollment runs from October 15 to December 7, and it is your chance to adjust.

Let's plan it together

Know your dates before
your birthday arrives.

Book a time and we will map out your window, your options, and your next step.

Book a consultation 949-345-0776