What Happens at 65 with Medicare

November 25, 2024•3 min read

Understanding Medicare When You Turn 65

Turning 65 is a significant milestone, especially when it comes to your health insurance. At this age, you're eligible for Medicare, the federal health insurance program that helps cover many medical expenses. But what does this mean for you? Let's explore what happens at 65 with Medicare and how you can get started with your enrollment process.

Eligibility for Medicare

When you turn 65, you automatically become eligible for Medicare. Here's what you need to know:

If you have been receiving Social Security benefits, you will be automatically enrolled in Medicare Part A and Part B.
If you're not yet receiving Social Security benefits, you will need to sign up to get Medicare.
Eligibility is also extended to individuals under 65 with certain disabilities or those with End-Stage Renal Disease (ESRD).

Get Started with Medicare Enrollment

Your initial enrollment period for Medicare starts three months before the month you turn 65 and lasts for seven months. It's important to sign up for Medicare during this time to avoid any late enrollment penalties. Here’s how to get started:

Visit your local Social Security office or sign up online to ensure you receive your Medicare benefits.
If you're still working or covered by a health plan through your employer, you might qualify for a special enrollment period.
Consider whether you want to sign up for Medicare Advantage Plans (Part C) or Medicare Supplement plans for additional coverage.

Understanding Medicare Coverage

Medicare coverage includes several parts, each offering different benefits:

Part A: Covers hospital stays, skilled nursing facility care, hospice care, and some home health care.
Part B: Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Part C (Medicare Advantage Plans): Offers an alternative way to receive Medicare benefits through private companies that contract with Medicare.
Part D: Provides prescription drug coverage.

Enrolling in Medicare

To enroll in Medicare, you have several options depending on your situation:

If you're receiving Social Security benefits, you'll be automatically enrolled in Medicare Parts A and B.
If you're not automatically enrolled, contact the Social Security Administration or visit their website to sign up for Original Medicare.
Consider enrolling in Medicare Advantage or a Medicare Supplement to get more coverage.

Medicare Benefits and Social Security

Medicare benefits are closely tied to Social Security benefits. Here's how:

Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working.
Part B coverage requires a monthly premium, which can be deducted from your Social Security benefits.
If you're eligible for Social Security, you're likely eligible for Medicare once you turn 65.

Special Enrollment Periods and Late Enrollment Penalties

If you miss your initial enrollment period, you may face late enrollment penalties. However, special enrollment periods are available in certain situations:

If you're covered under a group health plan based on current employment, you might qualify for a special enrollment period when that coverage ends.
Late enrollment penalties can increase your Part B premium, so it's crucial to understand your options and enroll on time.