Your Initial Enrollment Period: a 7-month window
Your first chance to sign up for Medicare is called your Initial Enrollment Period. It lasts seven months. It starts three months before the month you turn 65, includes your birthday month, and ends three months after it.
When your coverage begins depends on when you sign up:
- In the three months before your birthday month: coverage starts the first day of your birthday month.
- In your birthday month or the three months after: coverage starts the first day of the next month.
If your birthday is on the 1st of the month, your coverage can start the month before you turn 65. Want your exact dates? The free enrollment-window tool on our home page works them out from your birthday in a couple of minutes.
Part A and Part B, in plain words
Part A is hospital insurance. It helps cover inpatient hospital stays, skilled nursing facility care, hospice care and home health care.
Part B is medical insurance. It helps cover doctor visits, outpatient care, medical equipment like walkers and wheelchairs, and many preventive services, like screenings and yearly wellness visits.
Together, Parts A and B are called Original Medicare. From there, you can add a Part D drug plan and a Medicare Supplement, or choose a Medicare Advantage plan instead.
Still working at 65?
If you or your spouse are still working and covered by that job's health plan, you may be able to wait to sign up for Part B without a penalty. Three details matter:
- Employer size. If the employer has 20 or more employees, the job-based plan pays first. With fewer than 20, Medicare pays first, and your work coverage might not pay for care unless you have both Part A and Part B.
- A Health Savings Account (HSA). Medicare.gov advises that you and your employer stop HSA contributions six months before you retire or apply for Social Security benefits, to avoid a tax penalty.
- When the job ends. You'll have 8 months to sign up for Part B, starting the month after the job or the coverage ends, whichever comes first. COBRA and retiree plans don't count as coverage from current work, so choosing COBRA doesn't give you more time.
When you sign up later, you'll fill out an extra form showing you had job-based coverage.
Avoiding late-enrollment penalties
Penalties mostly come from waiting to sign up without other qualifying coverage.
- Part B: If you don't sign up when you're first eligible, and you don't qualify for a Special Enrollment Period, a penalty can be added to your monthly Part B premium. It goes up the longer you wait, and you may pay it for as long as you have Part B.
- Part D: If you go 63 days or more in a row without Medicare drug coverage or other creditable drug coverage after your Initial Enrollment Period, a penalty may be added to your drug plan premium for as long as you have Medicare drug coverage. Creditable means coverage that's expected to pay, on average, at least as much as Medicare's standard drug coverage. Your job-based plan's yearly notice tells you whether yours is. Keep it.
What to do in the months before your birthday
- Six months or so ahead: Check your dates with our enrollment-window tool. If you're working, ask your benefits office how your plan works with Medicare.
- Make two lists: your doctors and your prescriptions. They are the starting point for comparing plans.
- When your window opens: If you aren't enrolled automatically and aren't delaying Part B for job coverage, sign up so your coverage starts on time.
- Before your coverage starts: Decide how you'll round out your coverage. Your one-time, 6-month Medigap Open Enrollment Period begins the first month you have Part B and are 65 or older.