About to celebrate your 65th birthday? How to transition to Medicare

Justin Stoltzfus


The 65th birthday is a milestone -- the day most Americans become eligible for Medicare benefits. Yet just as the golden years are different for everyone, so is the transition into Medicare. Here are some tips for making it a smooth one.

If you're already receiving Social Security

If you already are receiving Social Security benefits or benefits from the Railroad Retirement Board, you automatically will start getting Part A (hospital) and Part B (medical) Medicare benefits start on the first day of the month when you turn 65, according to Medicare.gov. In other words, if your birthday is June 15, you'll start receiving Medicare benefits on June 1. If your birthday happens to be on the first of the month, Medicare coverage would start on the first day of the month before your birthday month.

Most people will not have to pay a premium for Part A. But Part B will require a premium. If you don't want Part B, you'll need to contact Medicare and specifically reject it.

If you are not receiving Social Security

If you are not already getting Social Security benefits (because, for example, you're still in the workforce), things are a bit more complicated. You won't be enrolled automatically in Medicare and will need to apply for it. To avoid delays in coverage, you'll need to know when your enrollment period is.

The enrollment period for Medicare is seven months long. It starts on the first day of the month three months before your 65th birthday. It ends on the last day of the month three months after your birthday.

Seven months may seem like plenty of time. But planning pays off. If you enroll early (during the three months before your birthday month), you won't experience delays in coverage.

If you enroll within the seven-month period but during the final four months (your birthday month or the three months following it), you'll experience a delay in coverage. The length of the delay depends on when you enroll. For example, according to Medicare.gov, if you enroll during your birthday month, your coverage won't start until the following month. If you enroll three months after your birthday month, your coverage will take three months to kick in (that's six months after your 65th birthday).

If you miss your open enrollment period altogether, you'll have to wait until January of the following year for the regular Medicare annual enrollment period. You won't be covered until July, and you may have to pay a late-enrollment penalty, according to Medicare.gov.

The enrollment process for Medicare Part C (Medicare Advantage) and Part D (prescription drug coverage) is similar to that of Parts A and B. You can enroll during open enrollment. Or you can enroll during their regular annual enrollment periods and face coverage delays and penalty fees.

Welcome to Medicare

Once you're covered, you can make an appointment for a "Welcome to Medicare" physical exam. Like your yearly Medicare wellness visits, this exam is now free under the health care reform law. According to Medicare.gov, your doctor likely will do the following during your "Welcome to Medicare" exam:

  • Ask about your health history and your family's.
  • Counsel you about existing conditions and preventive health care.
  • Check your vision, weight and blood pressure.
  • Make sure you are up to date with shots and screenings, and order any additional tests that you need.