Turning 65 Checklist
Step by step, month by month, so you don't miss anything.
Timeline at a glance
- 1
6 months before 65
Review employer coverage, HSA status, and start comparing Medigap vs. Advantage.
- 2
3 months before 65
Enroll in Medicare unless auto-enrolled. Pick and enroll in a Part D or Advantage plan.
- 3
1 month before 65
Confirm your card arrived and coverage start date. Ask HR for a creditable-coverage letter if you're keeping employer insurance.
- 4
Birthday month
Coverage begins on the 1st of your birthday month (or the 1st of the following month if your birthday is on the 1st).
- 5
3 months after 65
Last day of your Initial Enrollment Period. Miss this without qualifying coverage and penalties start accruing.
The 7-month Initial Enrollment Period
Your Initial Enrollment Period (IEP) is 7 months long: it starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Enrolling in the first 3 months means your coverage starts the first day of your birthday month. Enrolling in the last 4 months can delay the start of your coverage by 1 to 3 months.
If you already collect Social Security
You'll be enrolled in Parts A and B automatically. Your red-white-and-blue Medicare card arrives in the mail about 3 months before you turn 65. If you don't want Part B (because you have employer coverage, for example), follow the instructions in the packet to opt out — otherwise the Part B premium will be deducted from your Social Security check.
If you aren't collecting Social Security yet
You have to actively enroll. Sign up online at ssa.gov/medicare, call Social Security at 1-800-772-1213, or visit a local office. Enrolling during the 3 months before your birthday month is the safest path to on-time coverage.
Decide the shape of your coverage
Before your birthday, decide between Original Medicare + Medigap + Part D, or a Medicare Advantage plan. Look at your doctors' networks, medications, expected out-of-pocket costs, whether you travel, and how important it is to have predictable monthly costs versus lower premiums with more variability.
If you have employer coverage past 65
If your employer has 20 or more employees and you plan to keep working, you can usually delay Part B without penalty. Get written confirmation of "creditable coverage" from HR. Most people still enroll in premium-free Part A. Note that any Medicare enrollment ends HSA contributions.
Coordinate Medigap timing
Your one-time 6-month Medigap Open Enrollment Period starts when you're 65 AND enrolled in Part B. During that window, insurers can't deny you coverage or charge more for pre-existing conditions. After the window closes, that protection ends in most states.
Common mistakes to avoid
Assuming COBRA is creditable coverage (it isn't), assuming a retiree plan protects you from Part B penalties (usually it doesn't), waiting past your IEP without a Special Enrollment Period, and picking a Part D plan without confirming your medications are on the formulary.