Turning 65 This Year?

Here's what to do to get prepared for Medicare

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Turning 65 and Medicare Enrollment Checklist

Turning 65 and Medicare can seem daunting. Suddenly, you’re getting hundreds of pieces of mail about Medicare plans, retirement accounts, and maybe even retirement villages! You’re constantly asking people to stop calling you about all the amazing benefits you’re supposed to get, and you’re probably tired. We’re hoping that we can answer most of your questions and give you an idea about your next steps.

Click to Read Sections of our Turning 65 Checklist:

The Advantages of Turning 65 and Medicare

While getting older can feel a bit inhibiting, turning 65 is a huge milestone that should be celebrated! One of the biggest advantages of turning 65 that you’ll notice is that you’ll start to reap the benefits of all of the hard work you’ve completed throughout your life. Those Medicare and Social Security taxes that you’ve paid for all these years will finally start to benefit you. You can start withdrawing from your IRA or your 401k. You’ll finally be able to take advantage of all of the “senior discounts” at movie theaters, restaurants, and more. Most importantly though, you’ll be able to take advantage of government programs, like Medicare! Here's what to do when you turn 65.

Turning 65 and New to Medicare FAQ

One of the first things you should do as you age is learn about turning 65 and Medicare enrollment. Medicare is a federal health insurance program for seniors and other eligible United States residents. Some people can qualify for Medicare before turning 65 if they are diagnosed with End-Stage Renal Disease, receive Social Security Disability Insurance, or have ALS.

Enrolling in Medicare may seem daunting, but we can answer your questions and help you through the process.

Turning 65 Medicare

What is the Difference Between Medicare and Medicaid?

Medicare and Medicaid are often confused, but they are two vastly different programs. Medicare is for all seniors and some disabled people, but Medicaid is for low-income adults and children. While Medicare is purely a federal program, Medicaid is both federally and state-funded. That means that all states are required to cover certain health benefits under Medicaid, but each state also has the ability to add additional benefits and to set their own eligibility requirements.

What are the Different Parts of Medicare?

It’s important to first recognize the difference between the federal Medicare program and privately-owned insurance company Medicare plans. The federal program is what everyone with Medicare has to start with. It includes Part A, which covers hospital-related services, and Part B, which covers doctor’s appointment-related services. Those are the only parts included in the federal program - everything else comes separately.

Once you’re enrolled in Original Medicare, you can decide whether or not you want to add additional benefits. The most important benefit that most people will need to add is prescription drug coverage. You can get drug coverage in one of two ways: enroll in a “Part C” plan that includes prescription coverage, or enroll in a “Part D” plan. To enroll in Part C, you must enroll in both Part A and Part B, first. To enroll in Part D, you must enroll in either Part A or Part B, first.

Parts A through D are the four main parts. The final part is Medigap, or Medicare Supplements. Medigap is different because it does not provide additional health benefits. Instead, it covers financial items such as your Part A and B copayments and deductibles.

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When can I Sign up for Medicare?

The first turning 65 Medicare enrollment period is called the “Initial Enrollment Period (IEP).” If you qualify for Medicare dure to your age, your IEP begins three months before your 65th birthday and ends three months after.  During your “IEP,” you can enroll in Original Medicare for the first time and make a selection for your additional benefits (Medicare Advantage, Medicare Supplements, or Part D). If you do not enroll during your IEP, you may face a late enrollment penalty fee. The penalty fee is meant to encourage you to enroll as soon as you are eligible so you can start taking advantage of your benefits. Most people can get premium-free Part A anyway, so there’s no reason NOT to sign up.

You can still make changes to your benefits after your IEP. Most people will have to wait until the fall of each year to do this during the “Annual Enrollment Period (AEP).” AEP runs from October 15 through December 7. During AEP, you can make virtually any change to your Medicare coverage. You can enroll in a new Medicare Advantage plan, a new Part D plan, etc. This is a good time to review your benefits every year and decide whether or not you want to make changes.

Some people are also able to make changes during two other enrollment periods. The Open Enrollment Period (OEP) runs from January 1 through March 31 and is designed for people who enrolled in Medicare Advantage during the Annual Enrollment Period and do not like their plan. You can’t make just any change during OEP; you can only change from one Medicare Advantage plan to another (or drop your current Medicare Advantage plan). Then, there’s the Special Enrollment Period (SEP). SEP is for people who have a special circumstance (like a chronic illness or a major life change, like moving to a new state) and need to make a plan change. Your SEP can occur during any time of year, depending on the circumstances that granted you a SEP.

Paying for Medicare at 65

There are two parts to Original Medicare – Part A and B. If you have worked and paid Medicare taxes for at least 40 quarters (about 10 years), you can have premium-free Part A. If you did not work the 40 quarter minimum, then you will have to pay the Part A premium. For 2020, the Part A premium is $458 for 30+ quarters or $252 for 30-39 quarters.

The standard Part B premium for 2020 is $144.60, but you may pay more or less based on your own set of circumstances. An estimated 3.5% of beneficiaries will have a lower premium due to the Social Security “hold harmless” provision which prevents premiums from exceeding Social Security benefits. Plus, if you make more than $87,000 a year, your monthly Part B premium will be adjusted based on your income. The income-based 2019 Part B premiums are as follows:

2020 Part B Premiums

How do I Sign up for Medicare When I Turn 65?

The turning 65 Medicare enrollment process will be different depending on what you want to enroll in. If you are enrolling in Medicare for the first time and just need Parts A and B, you can do that through Social Security. If you want a Medicare Advantage or Medicare Supplement plan, the best way to enroll is through an insurance agent.

To enroll in Parts A and B, visit the Social Security website or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You can also visit your local Social Security office. Once you’re enrolled, you’ll receive a Medicare card in the mail (it may take a few months).

Turning 65 Medicare

Do I get Medicare Automatically at 65?

If you currently receive Social Security benefits, you will be automatically enrolled in Medicare Parts A and B the month you turn 65. However, if you do not receive Social Security benefits, you will need to enroll yourself. Medicare enrollment begins three months before your 65th birthday and will end three months after. This is called your initial enrollment period.

It’s important to act right away because delaying your enrollment can result in a 10% Part B premium increase for every year you’re eligible but don’t enroll. If you don’t select prescription drug coverage and later enroll, you may have a penalty of 1% the national base Medicare Part D monthly premium for each month you were not enrolled.

Should I use an Insurance Agent?

We advise that anyone turning 65 speak to an insurance agent. Your plan(s) won’t be any more expensive whether you speak to an agent or not, so you have nothing to lose. We do recommend that you work with an agent who can sell a large variety of plans so that there is no bias. 

Can I Sign up for Medicare Online?

Yes, you can sign up for Original Medicare (parts A and B) online at SocialSecurity.gov as long as you are at least 64 years and nine months old and you do not already have Medicare coverage. You cannot use the online Medicare enrollment application if you are currently receiving or want to receive Social Security benefits.

The administration claims that the Medicare enrollment application takes less than 10 minutes to complete! Unlike applying for Medicaid, you should not need any additional forms or documentation - it can all be done online very quickly. So, don’t wait!


Medicare Enrollment Application

You must contact Social Security either in person or online/by phone to enroll in Part A. However, once you have Medicare Part A, you can download the Medicare enrollment application for Part B (medical insurance). You must already have Part A to complete this form. This form is valid for 2019.

Is it Mandatory to Sign up for Medicare at age 65?

While it is not technically mandatory to sign up for Medicare at age 65, it is advised. If you wait to enroll, you can face a penalty fee of up to 10% of your premium costs. There are penalty fee exceptions for those who are still working.

When will my Medicare Coverage Begin?

If you sign up during the three months before your 65th birthday, your Medicare coverage will begin on the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will begin on the first day of the month before your birthday.

When will my Medicare Coverage Begin? | Medicare Plan Finder

Turning 65 and Still Working?

If you’re still working when you turn 65, you may be able to hold off on your turning 65 Medicare enrollment without facing a late enrollment penalty fee.

If your company has less than 20 employees and you have a group health insurance plan, Medicare will generally pay first, and your group plan will pay second. If your company has more than 20 employees and you have a group health insurance plan, your group health plan will generally pay first, and your Medicare plan will pay second.

Since most people who have worked through most of their lives will get premium-free Part A, there is usually no harm in enrolling regardless of your current employment status.

Can I get Medicare at 62?

It depends. You may be able to get Medicare at age 62 if you qualify for a reason other than age (like having ESRD, having ALS, or receiving SSDI for 25+ months).

Be careful to understand the differences between Social Security benefits and Medicare. You may be able to start collecting your Social Security benefits at age 62 even if you don't qualify for Medicare (though your Social Security benefit amount may be reduced at that age).


Employer Retiree Coverage

When you leave your job, you’ll also have the option to enroll in COBRA. COBRA allows you to continue to belong to your employer’s group plan for a temporary period after you leave the company. The company can “kick you off” at any time, so this is not a permanent option. However, COBRA can help you out while you figure out what your other options are.

Ask your employer or your HR representative to find out what COBRA might look like for you.

Some employers offer retiree coverage after you leave the company. However, retiree coverage and Medicare are not the same. Retiree coverage is health coverage that is provided to former employees of a company. This typically pays second to Medicare, which means you still need to enroll in Medicare to be fully covered. However, retiree coverage can help with health-related expenses if you retire before 65.

Not every employer offers retiree coverage. Since it isn’t required, your employer (or former employer) can cancel or change your retiree plan at any time. It’s safest for you to have Medicare as well. Plus, if you don’t enroll in Medicare when you first become eligible, you will face a penalty fee. Some retiree plans automatically stop when you turn 65 and become eligible for Medicare.

If your employer does not offer retiree coverage, retiring or losing your job gives you a SEP. A Special Enrollment Period means that you don’t have to wait for AEP, the Annual Enrollment Period, to buy coverage. You will have 60 days from your last day of work to enroll in a marketplace health plan. After those 60 days are over, you’ll have to wait until AEP (October 15 – December 7) to buy a marketplace plan, at which point you will be charged a penalty fee for having a lapse in coverage.

FERS/CSRS Retirement and Medicare

The CSRS, or Civil Service Retirement Act, became effective on August 1, 1920. It was replaced by the Federal Employees Retirement System (FERS) on January 1, 1987. Some people may still belong to CSRS. Both programs are for government employees only.

Both FERS and CSRS allow you to retire at age 62 if you have five or more years of service or at age 60 if you have 20 or more years of experience. Under FERS, you can retire between ages 55 and 57 (depending on your birth year) if you have 30 or more years of service.

Regardless of your FERS or CSRS status, if you’re 65, you’ll qualify for Medicare. You’ll also qualify for Medicare if you have a qualifying disability. If you are under 65 and do not qualify for Medicare, you can receive your FERS or CSRS benefits but will have to wait until you reach Medicare qualifying age.

Until then, you may qualify for the Federal Employees Health Benefits Program (FEHB). Once you do become eligible for Medicare, you may want to enroll in Part A anyway because there is no premium if you’ve worked for at least 40 quarters.

Discount Drug Card

Turning 65 Social Security Benefits

In 2019, the full retirement age is 66. You can still claim your Social Security retirement benefits at age 65, but you’ll lose 6.67%, so it’s best to wait if you can. The longer you wait, the more benefits you can receive (payments can go up by as much as 8% for every year you wait). Additionally, claiming Social Security before you actually quit working can hurt you. If you earn more than $17,640 in 2019, you’ll lose $1 in benefits for every extra $2 you earn.

Turning 65 Tax Breaks

When you turn 65, single filers can get an extra $1,600 and married filers can get up to $2,600 in tax returns. Additionally, those 65 and older can get a tax credit for the elderly between $3,750 and $7,500 based on income. To qualify for this tax break, your yearly income and benefits (Social Security, pensions, annuities, disability) cannot exceed:

  • Single - $17,500 (and $5,000 in benefits)
  • Married, only one person over 65 - $20,000 (and $5,000 in benefits)
  • Married, both people over 65 - $25,000 (and $7,500 in benefits)
  • Married but filing separately and living apart - $12,500 (and $3,750 in benefits)
Turning 65 Medicare

Turning 65 Checklist: Take These Steps ASAP

Turning 65 and Medicare are different experiences for everyone. Some people are already retired when turning 65, and others plan on working well into their 70’s! Regardless, 65 is still the average age for most Americans to retire and start looking for benefits. Below is a list of things you should start thinking about now. Consider downloading our checklist of items you should complete before you turn 65 for more information!

  1. Have a retirement strategy. If you don’t already have a strategy, start thinking about how you’re going to support yourself after leaving your job. Take advantage of Social Security retirement benefits.
  2. Downsize and declutter. As you retire, it’s time to start thinking about ways to cut back on living costs and ways to make your life easier. It may make sense for you to move to a smaller home and to take the time to declutter. Maybe you even want to move closer to family members before you start looking at the benefits available in your area!
  3. Prepare legal documents. None of the paperwork involved in retirement and aging is fun, but it’s necessary to make sure that you and your family members have a plan in place. Take the time to set up a will, be sure that your life and final expense insurance policies are set up properly with a trustworthy beneficiary, and consider designating a “power of attorney,” a person who can make medical and financial decisions for you once you are no longer able to do so.
  4. Enroll in Medicare. At the very least, you should start learning about the different parts of turning 65 and Medicare and thinking about what plans you may want to enroll in. The summary at the top of this page can get you started, but it’s a good idea to read more through the “Medicare” section at the top of this web page. Also, it’s never too early to meet with an agent to start discussing your options.
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