If you’re nearing your 65th birthday, you may be preparing to sign up for Medicare for the first time. Medicare has multiple enrollment periods, each with different dates. It can be confusing, especially when you’re new to the process. Here we’ll focus on the first period you’ll likely need to know about: the Initial Enrollment Period (IEP) for Original Medicare.
When Is the Initial Enrollment Period for Medicare?
The IEP is a seven-month window when you’re first eligible to sign up for Part A (hospital insurance) and Part B (medical insurance), collectively known as Original Medicare. Your IEP is based on your birthday, so it is entirely unique to you. It is not tied to any of the other Medicare enrollment periods and may fall completely outside of them.1
Your IEP spans the three months before your 65th birthday, your birthday month, and the following three months. For example, if you turn 65 on September 16, your IEP will begin on June 1 and end on December 31.
You may be eligible to sign up earlier than age 65 if you have a qualifying disability or certain medical conditions.2
While Medicare is administered by the Centers for Medicare and Medicaid (CMS), enrollment is managed through the Social Security Administration (SSA). For more information about signing up for Original Medicare, visit SSA.gov.
How To Prepare for the Medicare IEP
First, mark your IEP dates on your calendar. This is an important part of learning about your Medicare options and making the most of them, but it’s just one step in the process.
Next, do your research and get familiar with each of the four parts of Medicare (A, B, C and D) and how they work together. It pays to start early so by the time your IEP begins, you’ll be confident in your choices and avoid costly penalties.
Visit and download the Social Security Administration’s Checklist for Online Medicare Applications, a valuable resource that can help you gather all the information you need to get started.
Automatic Enrollment
If you collect Social Security or Railroad Retirement Board benefits, you’ll be automatically enrolled, and your coverage will begin the first day of the month you turn 65. You should receive a Medicare card in the mail up to three months before your coverage starts.1
If you do not collect Social Security or Railroad Retirement Board benefits, plan to sign up for Medicare during your IEP. If you need coverage to begin as early as possible (the first day of your 65th birthday month), make sure to enroll during the first three months of your IEP.
Working Past Age 65
If you or your spouse plan to work and receive health insurance through an employer after age 65, you may have additional decisions to make. Group health plans can work with Medicare in different ways. Depending on your existing coverage, you may want to delay enrollment in Part B coverage. There is also the possibility that your group health plan can function as your primary insurer and Medicare your secondary insurer. Talk with your employee health benefits administrator about your options before you sign up.3
Understanding Coverage Options
Original Medicare is a good starting point for healthcare coverage, but it may not cover everything you or your spouse need.
Medicare Part A typically covers in-patient hospital care, nursing facilities, hospice, and some home healthcare services. Medicare Part B helps cover doctor’s visits, outpatient care, and some preventative services.
After you enroll in Original Medicare, you can sign up for Medicare plans offered by private insurers to help cover potential added benefits. Part C (Medicare Advantage) and Part D (Prescription Drug Coverage).
Medicare Advantage (MA) includes the benefits of Parts A and B and adds other potential benefits such as dental, hearing and vision coverage. Some Medicare Advantage plans also include prescription drug coverage (MAPD).
What if I Miss My Initial Enrollment Period?
If you miss your IEP, you will need to enroll in Medicare during a Special Enrollment Period (SEP), Annual Enrollment Period (AEP), or Open Enrollment Period.
As the name suggests, an SEP is available for people in special cases, like when Medicaid coverage is lost or there is a natural disaster. There is typically no penalty to sign up during an SEP and the start and end dates depend on individual circumstances.
Frequently Asked Questions
Does Medicare start at age 65 or 67?
People often confuse Medicare eligibility age with full retirement age because they used to be the same: age 65. Full retirement age (the age at which you are entitled to 100% of your Social Security retirement benefits) is now 67, but Medicare eligibility still begins at age 65 for most people.4
Does Medicare Coverage Start the First Day of the Month You Turn 65?
Your Medicare coverage start date depends on when you sign up. If you enroll in the first three months of the Initial Enrollment Period, or if you are automatically enrolled, it will begin on the first day of your 65th birthday month. If you enroll later in your IEP or during one of the other enrollment periods, your coverage could begin as early as the first day of the month after you sign up.
What Happens if You Don't Enroll in Medicare at 65?
If you don’t sign up for Medicare during the seven-month window of your IEP, you may be charged a late enrollment penalty.5 Find out more about late enrollment penalties at Medicare.gov.
What Are the Medicare Enrollment Periods?
The enrollment periods include the Initial Enrollment Period (IEP), Annual Enrollment Period (AEP), Special Enrollment Period (SEP) and Medicare Advantage Open Enrollment Period (OEP).
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More About Enrollment
- How Much Is the Medicare Late Enrollment Penalty?
- What to Know About Medicare Special Enrollment Period
- What Is the Medicare Annual Enrollment Period (AEP)?
Sources
1 Medicare.gov When Does Coverage Start
2 What Is Medicare?
3 Medicare.gov Working Past 65
4 Starting Retirement Benefits Early
5 Medicare Costs and Avoiding Penalties