How to Enroll in Medicare at 65
Enrolling in Medicare at 65 (IEP)
Your Initial Enrollment Period (IEP) is a 7-month window around your 65th birthday. Understanding when and how to enroll can save you from lifetime penalties.
Enrolling in Medicare at 65
Download PDF GuideYour Initial Enrollment Period (IEP) is a 7-month window: 3 months before your birthday month, your birthday month, and 3 months after. This is your primary opportunity to enroll in Medicare without penalties.
Are You Automatically Enrolled?
Yes — if you're already receiving Social Security
You'll be automatically enrolled in both Part A and Part B when you turn 65. Your Medicare card will arrive in the mail about 3 months before your birthday. You can decline Part B if you have qualifying employer coverage.
No — if you're not yet receiving Social Security
You'll need to actively sign up for Medicare. Apply online at SSA.gov, call Social Security at 1-800-772-1213, or visit your local Social Security office.
Common Scenarios at 65
On ACA/Marketplace Insurance
Enroll in Medicare at 65. Do it as soon as your IEP window opens — don't wait. ACA/Marketplace coverage is not coverage based on current employment, so it does not give you a Special Enrollment Period to delay Part B. For Part D, ask your Marketplace plan administrator whether the prescription drug coverage is creditable before assuming you can delay Part D enrollment.
Working for a Large Employer (20+ employees)
You may be able to delay Part B if you have qualifying employer group health coverage based on current employment. Compare costs carefully — sometimes Medicare is a better deal. Call Fred before making this decision.
Working for a Small Employer (<20 employees)
You'll need both Part A and Part B. Medicare becomes primary payer for small employers, so you must enroll.
On COBRA at 65
COBRA is not coverage based on current employment, so it does not qualify as employer group health coverage for Part B Special Enrollment Period purposes. You must enroll in Part A and Part B. Medicare becomes primary; COBRA can be secondary but rarely makes financial sense. For Part D, ask your COBRA plan administrator whether the prescription drug coverage is creditable. Call Fred for guidance.
On Social Security Disability (already have Medicare)
When you turn 65, you get a one-time, 6-month window to enroll in a Medicare Supplement without medical underwriting. Don't miss this opportunity!
Key Takeaways
- Don't just enroll because someone said you had to — make an informed decision
- The first question is: do you need or want Medicare Part A and/or Part B right now?
- Don't think about Medicare products (Supplement, Advantage, Part D) until you know you need Medicare itself
- Missing your IEP without creditable coverage can result in lifetime late enrollment penalties