If you’re turning 65 soon – or helping someone who is – you’re probably starting to hear a lot about Medicare. And if you’re like most people, you’re wondering:
What is Medicare, and when should I actually sign up?
Here’s a plain-English breakdown to help you avoid penalties, late fees, and coverage gaps – and get Medicare right the first time.
What Is Medicare?
Medicare is a federal health insurance program for people age 65 and older, as well as certain younger individuals with disabilities or end-stage renal disease.
There are four main parts of Medicare:
- Part A (Hospital Insurance): Covers hospital stays, skilled nursing care, hospice, and some home health care.
- Part B (Medical Insurance): Covers doctor visits, outpatient care, lab work, imaging, durable medical equipment, and preventive services.
- Part C (Medicare Advantage): Private insurance plans that replace Original Medicare and often include extra benefits.
- Part D (Prescription Drug Coverage): Helps pay for prescription medications.
Most people start with Original Medicare, which includes Part A and Part B and is managed by the federal government. From there, you can decide whether to add drug coverage, a Medicare Supplement, or switch to a Medicare Advantage plan.
When Should You Sign Up?
Most people should start the Medicare enrollment process around their 65th birthday. Here’s what you need to know:
Your Initial Enrollment Period (IEP)
This is your first chance to enroll in Medicare. It’s a 7-month window:
- Starts 3 months before your birthday month
- Includes your birthday month
- Ends 3 months after your birthday month
So if your birthday is in August, your enrollment window runs from May 1 through November 30.
What If You Miss It?
If you miss this window – and you don’t have employer coverage – you could face:
- Late enrollment penalties on your Part B and Part D premiums
- Delays in coverage that leave you uninsured
That’s why it’s important to review your timeline ahead of time. If you’re not sure when to start, book a free consultation and I’ll walk you through it.
Still Working at 65?
If you or your spouse are still working and covered under an employer plan, you may be able to delay some parts of Medicare without penalty. It depends on:
- The size of your employer (fewer than or more than 20 employees)
- Whether the plan is considered creditable coverage
- How the employer plan coordinates with Medicare
This can be tricky – and mistakes can be expensive. If you’re working past 65 and not sure how Medicare fits in, let’s talk through it. You can schedule a call here.
What Happens After You Enroll?
Once you’re signed up for Part A and Part B, the next step is deciding how you want to receive your benefits. You’ll have a choice between:
- Staying on Original Medicare and adding a Medicare Supplement and/or drug plan
- Choosing a Medicare Advantage Plan that replaces Original Medicare
Each path has pros and cons depending on your needs, budget, and coverage preferences. I can help you compare options and make a confident choice.
Final Thoughts
Medicare comes with deadlines, decisions, and fine print – and if you miss a step, you could end up with higher costs or gaps in coverage.
If you’re turning 65 soon or helping a loved one with Medicare, the best time to start planning is before that birthday window opens. A little preparation now can save you time, stress, and money later.
And you don’t have to figure it all out alone. I’m here to help.
Schedule your free Medicare consultation here.
Niki Feret is the founder of Brickhouse Agency, a boutique Medicare insurance agency licensed in 37 states. As one of the few female agency owners in the industry, Niki leads with clarity, compassion, and a commitment to education – not pressure. Learn more or book your free Medicare consultation at brickhouseagency.com.