Newly eligible Medicare beneficiaries can start to sign up for a Medicare plan three months before their 65th birthday.

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 your options.

You can choose a 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 seven months to sign up.

Do you automatically get Medicare when you turn 65?

Medicare eligibility is automatic, but you should 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 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, 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 also provide prescription drug benefits and supplemental benefits, such as dental and vision. Most Americans have dozens of Medicare Advantage options. 

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

  • New Medicare members have between three months before their 65th birthday to three months after to choose a Medicare plan.
  • Medicare beneficiaries can get Parts A and B or they can decide to go with a Medicare Advantage plan from a private insurance company.
  • 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.
  • After you sign up for Medicare, you can make changes to your Medicare coverage during open enrollment.

So, if you don’t sign up for Part B for two years, you could get with a 20% monthly penalty on your premiums once you join Part B. 

Is Medicare free at age 65?

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.

If you didn’t pay the taxes, you will have to pay monthly Part A premiums. People who paid fewer than 30 quarters’ worth of Social Security taxes must pay $458 monthly for Part A. Those who paid taxes between 30 and 39 quarters pay $252 monthly.

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 $158.50 for most Americans in 2022. However, Medicare beneficiaries with incomes more than $87,000 or $174,000 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.

Part A’s deductible is $1,484. Part B’s deductible is $217 in 2022. 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 also has monthly premiums. The exact amount depends on the plan, but the average monthly Medicare Advantage premiums are $19 in 2022. Deductibles also vary by plan but can be much higher than Original Medicare deductibles.

Part D additionally has premiums — an average of $33 a month — 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 and your 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 put on Original Medicare — Parts A and B.

As we mentioned, Part A is free to most Americans — 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 open enrollment.

Medicare has an open enrollment period between Oct. 15-Dec. 7. During that time, you can:

  • Change plans Medicare Advantage 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. 

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.

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