Triage
Turning 65? Let's get you the right info.
We know Medicare and Social Security rules can be confusing, especially as your 65th birthday approaches. Where are you at in your journey?
Overview
Everything that happens when you turn 65
- Medicare Enrollment: Most people should sign up for Medicare around age 65, even if they're still working (there are special rules for employer coverage!).
- Social Security: 65 is NOT your full retirement age (FRA). For most, FRA is 67. You can claim SS at 62 or wait for a bigger benefit.
- Medigap Open Enrollment: You get a one-time, 6-month window starting when you turn 65 & enroll in Medicare Part B to get any Medigap plan, no health questions.
- Medicaid: Turning 65? You may qualify for both Medicare and Medicaid (called "dual eligible") even if you never have before. Income/resource rules can change at 65.
Insider tip
65 is Medicare age, NOT full Social Security retirement age. Don't get tricked—waiting to 67 or even 70 can mean a much higher benefit.
Checklist
Turning 65: What and When
6 months before 65
- Review your current insurance: Will you need Medicare? Are you or your spouse still working at a big company?
- Check expected income for Medicare Savings Programs or Medicaid eligibility.
3 months before 65
- Your Medicare Initial Enrollment Period (IEP) opens!
- Start shopping for Medigap or Medicare Advantage plans if you want extra coverage.
- Consider a Part D drug plan — even if you don't take meds now!
Birthday month
- Sign up for Medicare (Parts A & B) if you haven't already.
- If you want a Medigap plan, your open enrollment window is active for 6 months.
- Consider Social Security options: claim now, or wait for a bigger check.
Within 3 months after 65
- Final chance to enroll in Medicare without penalty using your IEP!
- Review and choose a drug (Part D) or Medicare Advantage plan for the year.
Enrollment
Enrolling in Medicare at 65 — Don't Miss the Window!
- Your Medicare Initial Enrollment Period (IEP): 7 months — 3 months before, your birthday month, and 3 months after.
- Part A: Free if you have 40+ work credits. (Most people qualify.)
- Part B: $202.90/month in 2026. Covers doctors, outpatient care.
- Part D: Drug coverage — important to have, even if you take few or no prescriptions.
- Sign up online, by phone (SSA), or at your local Social Security office.
Insider tip
If you're already getting Social Security, Part A and Part B might be automatically started for you the month you turn 65. Look for your red, white, and blue Medicare card!
Missed your Initial Medicare Enrollment?
Don't panic — but you need to act fast!
Don't panic — but you need to act fast!
Late to sign up for Medicare at 65?
- Part B penalty: 10% higher premium for each full 12-month period late — this is permanent!
- General Enrollment Period (GEP): Sign up Jan-March, coverage starts July 1. Potential gap in coverage and penalties may apply.
- Special Enrollment Period (SEP): If you had employer coverage (20+ employees), you have 8 months to enroll after leaving job or coverage ends. (COBRA does NOT count!)
Insider tip
COBRA trap: Having COBRA does not protect you from the Part B penalty. Enroll in Medicare as soon as you're eligible — even if you have COBRA!
Still working?
Are you (or your spouse) still working at 65?
- If employed at a company with 20+ employees, you can delay Part B (saves monthly premium). You must apply for Part B with Form CMS-L564 when you retire/lose coverage.
- Most enroll in free Part A even if working.
- When you leave employment/coverage ends, you have an 8-month Special Enrollment Period to enroll in Part B without penalty.
- If your employer has fewer than 20 employees, you should enroll in Part A & Part B at 65 — your employer insurance may pay after Medicare or not at all!
Get Form CMS-L564 signed by your employer when you apply for Part B.
Social Security
Claiming Social Security at 65 — What changes?
- Full Retirement Age (FRA): For most folks born 1960+, FRA is 67. Claiming at 65 means a 13.33% reduction in your monthly benefit.
- Earnings Test: If you work and claim before FRA, there's an earnings limit: $24,480 (2026). Earn more, and SS withholds $1 for every $2 above that.
- Wait to 67 or 70: Monthly benefit rises the longer you wait. Waiting until 70 gets you the biggest check, but it’s a personal decision.
- You can apply for Medicare and wait on Social Security—they’re separate!
| Age Claimed | Reduction vs FRA |
|---|---|
| 62 | -30% |
| 65 | -13.33% |
| 67 (FRA) | 0% |
| 70 | +24% |
Help with Costs
Medicare Savings & Extra Help at 65
- QMB (Qualified Medicare Beneficiary): Pays Medicare premiums, deductibles, copays. Strict income/resource limits.
- SLMB & QI: Help pay Medicare Part B premium. Slightly higher income limits than QMB.
- Extra Help (LIS): Reduces costs for Medicare drug plans, often to $0 premium and low copays on covered meds.
- Even moderate incomes can sometimes qualify, especially with high medical costs—apply!
Insider tip
Apply for Medicare Savings even if you think you might be over the limit—states use different rules, and many people are approved who thought they wouldn't be!
Medicare FAQ at 65
Your biggest questions answered