Here’s when you’re eligible for Medicare.

Turning 65? Planning for retirement?

Chances are, you’ve thought about how much you will save for it, how much you will be able to spend once you’re in it, and how much you’ll receive from Social Security and other sources to live on during it. But . . .

Retirement planning is not complete without considering healthcare, and when you will be eligible for Medicare.

When are you eligible for Medicare?

You’re eligible to enroll in Medicare up to three months before you turn 65 years old.

There are, however, other factors besides your age that can affect your eligibility. For example, if you have certain health issues, you may qualify for Medicare even earlier.

The best thing to do is to discuss your personal financial needs and goals with your advisor. Understanding when you will be eligible for Medicare well before you become eligible is key to making the best decision possible.

In the Q&As below, we’ve highlighted a few important timeframes you should keep in mind, including: when you may be eligible for Medicare, when you can enroll, and when your coverage will start. And because we know not everyone’s situation is the same, we even address a few common “what if” situations.

Q: When are you eligible for Medicare?
A: You are eligible for Medicare if you are 65 years old and:

  • Are a U.S. citizen or
  • A legal resident who’s lived in the U.S. for at least five years
  • Currently receives Social Security or benefits from the Railroad Retirement Board (RRB) or
  • Have worked long enough to qualify for retirement benefits, but do not collect them yet

What if . . . you don’t qualify on your own or through your spouse, but are a U.S. citizen or have been a legal resident for at least five years?
You can purchase full Medicare benefits when you turn 65 (or older). Find out more at medicare.gov.

When can you sign up for Medicare?

Q: When can you sign up for Medicare?
A: You have up to seven months to sign up for Medicare (including your birth month). But this may not be as simple as it sounds.
First, during your Initial Enrollment Period (IEP), you can choose to sign up anytime between

  • ­­Three months before your 65th birthday and
  • Up until three months after

Both the day and the month you were born in can play a factor in your eligibility. For example, if your 65th birthday is on April 20, you will be eligible to enroll in Medicare between January–July.

Have a birthday on the first of the month?
Your seven-month IEP starts

  • Four months before you turn 65 and
  • Ends two months after your birthday month.

So, in this case, if your 65th birthday is on September 1, you will be eligible to enroll in Medicare between May-November.

When will your Medicare coverage start?

Q: When will your Medicare coverage start?
A: Coverage can start the month after you enroll.
In general, it always starts on the first of the month.

Tip: If you need the benefits as soon as possible, it may be best to sign up the month before you turn 65 years old, so your coverage will start the month you turn 65.

Here are a few more specifics that depend on the Medicare Part you sign up for:

For Medicare Part A
(No Premium)
Coverage starts at this time. . .Unless your birthday falls on the 1st of the month, then coverage starts…
     the month you turn 65the month before you turn 65  
For Medicare:
Part A (Premium)
Part B
If you sign up . . .Then your coverage starts . . .
 Before the month you turn 65

The month you turn 65

1 month after you turn 65

2 or 3 months after you turn 65
The month you turn 65

The next month

2 months later

3 months later

Source: medicare.gov

Want to estimate when you’re eligible for Medicare?
Use this helpful tool.

What If . . .

You do not sign up during your initial enrollment period?
Waiting may not be good for your health. Or your wallet. In fact, a delay can result in a gap in your health insurance or force you to pay late enrollment penalties, which increase the longer you wait to sign up.

You plan to work beyond your 65th birthday?
Your Initial Enrollment Period starts when you turn age 65, regardless of whether you still plan to work or not, or whether you have health insurance through your spouse. Depending on your specific situation, you may be able to put off enrolling in Medicare. Just be aware that there may be late enrollment penalties.

You are younger than 65 years old?
You may be eligible for Medicare if you:

  • Have received Social Security disability benefits for at least 24 months (total).
  • Draw a disability pension from the Railroad Retirement Board or
  • Suffer from Lou Gehrig’s disease or permanent kidney failure. 

You miss your IEP and don’t have a special event?
Unfortunately, you will have to pay late enrollment penalties (even if you are eligible for Medicare.) See medicare.gov for details.

Certain situations, however, create a Special Enrollment Period (SEP) which lets you sign up for Medicare without late enrollment fees.

What situations qualify for a SEP?What should you be aware of?When does
enrollment start?
What situations qualify for a SEP?
You have health insurance through your job and still workYou can sign up for Part A and Part B any time as long as:
 
 1) you have group health insurance or

 2) you or your spouse has health coverage through an employer
When you stop working, even if you choose COBRA or other non-Medicare coverage  8 months after you or your spouse      stop working
 or lose your group health insurance
(whichever comes first)  

You’re a volunteer, serving in a foreign country  
Contact Social Security for details.__

Certain events if you have TRICARE*  
Contact TRICARE for details.__
*Health plan for U.S. military and their families

Want more information about the different parts of Medicare or your eligibility? Connect with the Guided team for expert advice that can help you to make the best decision for your personal situation.

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Leave the insurance to us.

Resources

All health insurance sold is processed through the licensed entity of Baldwin Risk Partners.

Guided Solutions is not affiliated with or endorsed by Medicare or any government agency. Guided Solutions does not discriminate based on race, color, national origin, age, disability, or sex.