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You become eligible for Medicare when you turn 65. As you get closer to your 65th birthday, Medicare will send you information about how to sign up and about your options.

You can select your Medicare plan during that initial enrollment period, which runs from three months before your 65th birth month until three months after your birth month. You have a total of seven months to sign up.

Do you automatically get Medicare when you turn 65?

Medicare eligibility is automatic, but you should take the time to choose a Medicare plan when you turn 65. Medicare will automatically enroll you in Original Medicare if you don’t select a plan.

People can choose an Original Medicare plan (Part A and Part B) or a Medicare Advantage plan:

  • Original Medicare is Parts A and B. Part A handles hospital coverage. Part B covers physicians, outpatient services and preventive care. Parts A and B don’t offer prescription drug coverage. Instead, eligible Medicare beneficiaries with Original Medicare can get a  Part D prescription drug plan. Private companies offer Part D plans.
  • Medicare Advantage is Part C. Private insurance companies like UnitedHealthcare and Humana offer these plans. The federal government pays the insurers to provide plans and the insurers, in turn, have contracts with providers to pay for services. Medicare Advantage plans cover both hospitals and physicians. Most Medicare Advantage plans may also provide prescription drug benefits and supplemental benefits, such as dental and vision. There are several options of Medicare Advantage plans from which to choose.

If you go with Original Medicare, you can turn down Part B coverage and keep Part A. People who get health insurance through another source, such as a spouse’s employer, may want to skip Part B coverage for now. If you don’t take Part B but later enroll in that coverage, you’ll pay a 10% fine on your Part B premium for every 12 months that you forgo Part B coverage.

Key Takeaways

  • Newly eligible Medicare members have between three months before their 65th birthday month to three months after to choose a Medicare plan. 
  • Eligible Medicare beneficiaries can get Parts A and B or they can decide to go with a Medicare Advantage plan from a private insurance company.
  • Eligible Medicare beneficiaries can also decline Part B coverage, but they will likely pay a penalty once they sign up for Part B.
  • Part A is free to most Americans who qualify for Medicare.
  • After you sign up for Medicare, you can make changes to your Medicare coverage during Medicare Annual Enrollment.

Is Medicare free at age 65?

For eligible beneficiaries, Part A is free, as long as you paid Social Security taxes for at least 40 quarters. In other words, you would have needed to work and pay those taxes for at least 10 years.

How much does Medicare cost at age 65?

Medicare doesn’t base premiums on age. You pay the same amount whether you’re 65 or 95.

Part B’s monthly premiums are $174.70 for most Americans in 2024. However, Medicare beneficiaries with incomes more than $91,000 or $206,000 for joint filers pay higher Part B premiums. Both Parts A and B also have deductibles that you’ll have to pay before Medicare begins helping pay for care.

Once you reach a deductible, Medicare pays for a portion of your care. People with Original Medicare plans can get a Medigap plan that helps pay Medicare costs.

Medicare Advantage (Part C) also has monthly premiums, although cost varies by plan.

Part D additionally has premiums and deductibles.  

Before signing up for a Medicare Advantage or Part D plan, make sure to read the fine print to understand how much you’ll pay in premiums, deductibles, coinsurance and out-of-pocket costs. These costs vary by plan, so run those numbers to figure out which one is better for you.

Find out more about Medicare costs.

What happens if you don’t sign up for Medicare at 65?

If you don’t choose a plan at 65, you’ll get enrolled in Original Medicare — Parts A and B.

As we mentioned, Part A is free to most Americans who are eligible for Medicare – as long as you paid at least 10 years of Social Security taxes. You’d have to pay Part B premiums if you don’t deny that coverage or don’t choose a Medicare Advantage plan.

Can you make changes to Medicare after you turn 65?

You’re not locked into the Medicare plan for life. Instead, you can make changes each year during Annual Enrollment.

Medicare has an Annual Enrollment Period (AEP) from October 15 to December 7 each year. During that time, you can:

  • Change plans
  • Move from Original Medicare to Medicare Advantage or vice-versa
  • Sign up for a Part D plan

There’s a second open enrollment period from Jan. 1 to March 31, but you’re limited to only changing Medicare Advantage plans or switch from Medicare Advantage to Original Medicare during this timeframe.

Another time when you can make changes to your Medicare insurance is if you experience a qualifying event for a special enrollment period. A special enrollment period could kick in if your spouse dies, you move to another state or you lose other health benefits.

Source: “Costs.” Accessed August 2022.

Disclaimer: is not affiliated with or endorsed by the government or Federal Medicare program. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Currently we represent 10 organizations which offer 100 products in your area. Please contact, 1800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Not all plans offer all of these benefits. Benefits and availability may vary by carrier and location. Limitations and exclusions may apply. Every year, Medicare evaluates plans based on a 5-star rating system. Part B Premium give-back is not available with all plans. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply. Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a Special Enrollment Period. 

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Les Masterson


Les, a former managing editor, insurance, at QuinStreet, has more than 20 years of experience in journalism. In his career, he has covered everything from health insurance to presidential politics.