Your 7-month Initial Enrollment Period
For most people becoming eligible at 65, the Initial Enrollment Period begins 3 months before the month you turn 65, includes your birthday month, and ends 3 months afterward. Your actual Medicare start date depends on when you enroll.
About 6 months before 65
- Confirm whether you will be automatically enrolled or need to apply.
- Gather employer coverage information if you or your spouse will still be working.
- Make a list of doctors, hospitals and prescriptions.
About 3 months before 65
- Decide whether to enroll in Part B now or delay based on qualifying current-employment coverage.
- Compare Original Medicare + Medigap + Part D with Medicare Advantage.
- Check your preferred providers and prescriptions.
During your birthday month
- Confirm your Part A and Part B effective dates.
- Make sure any Medigap, Medicare Advantage and/or Part D coverage is coordinated to avoid gaps.
- Keep confirmation letters and plan documents.
After coverage begins
- Bring your correct Medicare/plan card to appointments.
- Confirm prescriptions process through the right drug coverage.
- Review your Annual Notice of Change each year.
Working past 65?
Do not assume you should automatically delay Part B—or automatically enroll. Whether you can delay without penalty depends on the type of employer coverage and whether it is based on your or your spouse's current employment.
- Ask the employer benefits administrator how the group plan coordinates with Medicare.
- Ask whether the group coverage is considered creditable prescription drug coverage for Part D.
- Keep written proof of coverage.
- Plan the Part B application before employment or job-based coverage ends so you do not create a coverage gap.
Health Savings Account (HSA) caution
Once you have Medicare, you are no longer eligible to make HSA contributions. If you enroll in premium-free Part A after age 65, Part A can be retroactive for up to six months, but not earlier than your first month of Medicare eligibility. Medicare advises people working past 65 with an HSA to plan contributions carefully before applying for Medicare or Social Security benefits.
Three decisions people often confuse
1. When to start Part B
This is mainly about Medicare eligibility, current-employment coverage and avoiding gaps or penalties.
2. How to receive Medicare
Choose between Original Medicare (often with Medigap + Part D) and Medicare Advantage.
3. Drug coverage
Make sure you have Part D or other creditable drug coverage so you do not inadvertently create a late-enrollment penalty.
Official Medicare resources
Medicare rules can change. These pages were written from current Medicare.gov guidance and should be reviewed periodically.