Turning 65

Turning 65 and Medicare — What You Need to Know

Turning 65 is a big milestone, and it often comes with important Medicare decisions. My goal is to make the process simple, clear, and stress-free—so you know what to do, when to do it, and how to avoid penalties.

Medicare Basics: Parts A, B, C, and D

Medicare comes in several parts. Here’s the plain-English version I walk clients through:

  • Part A (Hospital Insurance): Inpatient hospital care, skilled nursing facility care, some home health and hospice. Most people pay no premium if they or a spouse worked enough quarters.
  • Part B (Medical Insurance): Doctor visits, outpatient care, lab work, preventive services, and durable medical equipment. Part B has a monthly premium and late-enrollment penalties if you delay without qualifying coverage.
  • Part C (Medicare Advantage): Private plans that bundle Parts A and B (often Part D), sometimes with extras like dental, vision, or fitness benefits. Plans use networks and have different costs/benefits.
  • Part D (Prescription Drug Plans): Standalone drug coverage that works with Original Medicare, or drug coverage embedded in many Medicare Advantage plans.

Your Timeline When Turning 65

I encourage clients to put these dates on the calendar:

  • Initial Enrollment Period (IEP): Seven months total—three months before your 65th birthday month, your birthday month, and three months after. This is the easiest time to enroll in Part A and/or Part B.
  • Part D (or MAPD) Timing: You typically enroll in Part D (or a Medicare Advantage plan that includes drug coverage) during your IEP if you need prescription coverage.

Still Working at 65?

If you have credible employer coverage through your (or your spouse’s) current job, you can often delay Part B and Part D without penalties. When that coverage ends, a Special Enrollment Period lets you sign up.

Avoiding Late-Enrollment Penalties

Penalties are the #1 surprise I help people avoid:

  • Part B Penalty: If you delay Part B without credible employer coverage, you may pay a higher premium for as long as you have Part B.
  • Part D Penalty: If you go 63+ days without credible drug coverage, a lifetime penalty may be added to your Part D premium.

I’ll help you confirm whether your current plan counts as “credible” so you can enroll on time and avoid extra costs.

Original Medicare + Medigap vs. Medicare Advantage

Two common paths I compare with clients:

  • Original Medicare + Medigap + Part D: Freedom to see providers who accept Medicare, predictable costs with a Medigap plan, and a standalone Part D plan for prescriptions.
  • Medicare Advantage (Part C): All-in-one alternatives from private insurers that include Parts A and B (often D), with networks, copays, an out-of-pocket maximum, and sometimes extra benefits like dental or vision.

There’s no one-size-fits-all choice. I’ll help you compare costs, doctors, prescriptions, and travel needs to decide what fits best.

Key Enrollment Windows You Should Know

  • Initial Enrollment Period (IEP): Around your 65th birthday (7 months total).
  • General Enrollment Period (GEP): Jan 1–Mar 31 each year if you missed Part B and don’t qualify for a Special Enrollment Period.
  • Annual Election Period (AEP): Oct 15–Dec 7 each year to add/switch/drop Part D or Medicare Advantage for next year.
  • Medicare Advantage Open Enrollment: Jan 1–Mar 31—switch MA plans or drop MA and return to Original Medicare (with/without Part D).
  • Special Enrollment Periods (SEPs): Triggered by events like losing employer coverage or moving out of your plan’s service area.

How I Help You Compare Plans

My process is simple and personal. I look at your doctors and hospitals, prescriptions, travel preferences, budget, and how you like to access care. Then I compare reputable carriers and explain the trade-offs clearly—no jargon, no pressure.

Next Steps When You’re Turning 65

  1. Put your IEP on the calendar. We’ll enroll on time and avoid penalties.
  2. Gather your info. Current coverage, doctors, prescriptions, and budget.
  3. Compare your paths. Original Medicare + Medigap + Part D vs. Medicare Advantage.
  4. Enroll with confidence. I’ll guide the enrollment so it’s smooth and hassle-free.

Have Questions About Medicare at 65?

I’m here to help you make confident, penalty-free choices. If you’re approaching 65—or helping a loved one get ready—let’s review your options together.

Schedule a Free Consultation

Licensed in 48 states and based in Pittsburgh, Pennsylvania.