Medicare 101: Everything You Need to Know Before Turning 65

Medicare 101: Everything You Need to Know Before Turning 65

Turning 65? Here’s your step-by-step guide to Medicare with confidence.

“The best preparation for tomorrow is doing your best today.” — H. Jackson Brown Jr.

Turning 65 is more than just a birthday—it’s a milestone that unlocks access to one of the most important benefits in retirement: Medicare. Whether you're planning well in advance or just realizing you’re close to enrollment, this guide will help you understand the basics, avoid costly mistakes, and take control of your healthcare future.

What is Medicare?

Medicare is a federal health insurance program for individuals aged 65 or older, as well as certain younger people with disabilities or specific medical conditions like End-Stage Renal Disease (ESRD). It’s not just one plan—it’s made up of several parts that serve different purposes.

The Parts of Medicare

Medicare is divided into four main parts:

• Part A (Hospital Insurance): Covers inpatient hospital care, skilled nursing facilities, hospice, and some home health care. Most people don’t pay a premium for Part A if they worked at least 10 years.

• Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and some home health. Most people pay a standard monthly premium (starting at $174.70/month in 2025).

• Part C (Medicare Advantage): Offered by private insurance companies, these plans bundle Parts A and B—and often Part D—into a single plan with extra benefits like dental, vision, and hearing.

• Part D (Prescription Drug Coverage): Helps pay for prescription medications and is purchased separately unless bundled in a Medicare Advantage plan.

When to Enroll

You have a 7-month window to enroll in Medicare, known as your Initial Enrollment Period (IEP):

• Begins 3 months before the month you turn 65

• Includes the month of your birthday

• Ends 3 months after your birthday month

Missing this window could result in permanent penalties, especially for Part B and Part D.

How to Enroll

You can enroll in Medicare through the Social Security Administration:

• Online at ssa.gov/medicare

• By calling 1-800-772-1213

• By visiting your local Social Security office

If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Part A and B. Otherwise, you’ll need to take action.

Do I Need to Do Anything if I’m Still Working?

Yes! If you’re still working past 65 and have employer coverage, your decision to enroll may depend on the size of your company. If your employer has 20 or more employees, you may be able to delay enrolling in Part B without penalty.

Talk to your HR department and a Medicare advisor to understand how your group plan works with Medicare.

Avoid These Common Mistakes

• Waiting too long to enroll and incurring penalties

• Assuming Medicare is free (it’s not—there are premiums, deductibles, and copays)

• Not understanding what’s covered, especially in terms of prescriptions and dental/vision needs

• Failing to explore Medigap or Advantage plans to fill the gaps in coverage

Final Thought:
Medicare isn’t something to leave to chance. With early preparation and the right guidance, you can make informed choices that protect your health and your wallet for years to come.