Getting your Medicare coverage squared away shouldn’t make you crazy.

Turning 65? Your Medicare Options Explained

Turning 65 is a major milestone, and it also marks an important time for your healthcare coverage. As you approach Medicare eligibility, understanding your options can help you make informed decisions about your care as well as your financial needs.

When Can You Enroll?

Your Initial Enrollment Period (IEP) begins three months before your 65th birthday and lasts for three months after your birthday month—a total of seven months. During this time, you can sign up for Medicare without penalties.

For example, if your birthday is September 10th, your IEP would begin on June 1st and extend through December 31st.

Your Medicare Coverage Options

There are several ways to receive Medicare coverage, and choosing the right plan depends on your healthcare needs and budget:

1. Original Medicare (Parts A & B)

  • Medicare Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing care, hospice care, and some home health care.

  • Medicare Part B (Medical Insurance) covers doctor visits, outpatient care, preventive services, and some medical supplies.

Costs: Most people do not pay a premium for Part A if they have worked and paid Medicare taxes. Part B requires a monthly premium.

2. Medicare Advantage (sometimes referred to as Part C)

  • Offered by private insurance companies approved by Medicare

  • Combines Part A, Part B, and often prescription drug coverage (Part D)

  • May include additional benefits like vision, dental, and wellness programs

  • Requires staying within a provider network (varies by plan)

3. Medicare Prescription Drug Plans (Part D)

  • Helps cover the cost of prescription medications

  • Available as a standalone plan to complement Original Medicare

  • Plans vary in coverage and cost

4. Medicare Supplement Insurance (Medigap)

  • Private insurance plans that help cover out-of-pocket costs from Original Medicare (like copayments, coinsurance, and deductibles)

  • Can be used with Original Medicare but not with Medicare Advantage plans

  • Offers different levels of coverage depending on the plan you choose

Avoid Late Enrollment Penalties

If you don’t enroll in Medicare when you’re first eligible and you don’t have other qualifying health coverage, you may face permanent late enrollment penalties for Part B and Part D.

How to Get Started

Navigating Medicare can be overwhelming, but you don’t have to do it alone. At Plan Insight, we specialize in helping individuals turning 65 understand their options and choose a plan that fits their healthcare needs and budget.

We’re here to make Medicare simple for you!