Turning 65: Your Medicare Checklist
Your Medicare window opens three months before your birthday month. Use the months before it to decide three things: whether to take Part B now or delay it because of employer coverage, whether you want Medigap plus Part D or a Medicare Advantage plan, and whether your doctors and prescriptions are covered by the plan you are leaning toward. Here is the timeline.
Six months before your birthday
- Confirm your work history gives you premium-free Part A (40 quarters) at my Social Security.
- If you are working, ask HR whether your employer has 20 or more employees. That decides whether you can delay Part B.
- List your doctors, hospitals and every prescription with dose. Plans are compared against this list.
Three months before (your window opens)
- Enroll in Parts A and B through Social Security if you are not enrolled automatically.
- Ask for quotes on Medigap Plan G and Plan N and a Part D plan, and on the Medicare Advantage plans in your county. The G vs N calculator shows the break-even.
- Check for IRMAA: if your 2024 income was above $109,000 single or $218,000 joint, your Part B premium will be higher than $202.90; if your income has dropped since (retirement), file form SSA-44.
Your birthday month
- Coverage starts the first of this month if you enrolled in the three months before. Your Medigap open enrollment, six months with no health questions, starts now.
- Keep your drug coverage continuous: a gap of more than 63 days starts the Part D penalty clock.
The three months after
- Last chance to enroll inside your Initial Enrollment Period; coverage starts the month after you sign up.
- Set up your Medicare.gov account and decide how premiums will be paid.
What it costs in 2026
| Item | 2026 amount |
|---|---|
| Part A premium | $0 for most people |
| Part A hospital deductible | $1,736 per benefit period |
| Part B premium | $202.90 per month (higher with IRMAA) |
| Part B deductible | $283 per year, then 20% |
| Part D deductible | Up to $615 |
| Part D out-of-pocket cap | $2,100 |
Source: CMS, 2026 Medicare Parts A & B premiums and deductibles.
Medicare 101: the complete guide
Every topic a person new to Medicare needs, each on its own page, written and reviewed by Christian Brindle.
Questions people ask about Turning 65: Your Medicare Checklist
When should I start the Medicare process if I am turning 65?
About six months before your birthday: confirm your work quarters, find out whether you can delay Part B, and build your doctor and prescription list. Your enrollment window opens three months before your birthday month.
Do I have to sign up for Medicare at 65?
You must enroll in Part B at 65 unless you are covered by a current employer plan with 20 or more employees; otherwise a lifetime penalty applies. Premium-free Part A is usually worth taking either way.
What is the first thing to decide when turning 65?
Whether you want Original Medicare with a Medigap plan and a Part D plan, or a Medicare Advantage plan. The answer depends on your doctors, your prescriptions, your travel and how you want to pay: a premium every month or copays when you use care.
How much is Medicare when I turn 65 in 2026?
Part A is free for most people. Part B is $202.90 a month with a $283 deductible. A Medigap or Medicare Advantage premium and a Part D premium come on top, depending on the plan you choose.
Can I keep my doctor when I go on Medicare?
With Original Medicare and Medigap, yes, if the doctor accepts Medicare. With Medicare Advantage, only if the doctor is in the plan’s network, which is why we check your list before you enroll.
Last updated: · Reviewed by Christian Brindle, CEO and Founder. Published by the Everything Senior Insurance Data Desk. Sources: 2026 Medicare Parts A & B Premiums and Deductibles · When does Medicare coverage start, Medicare.gov.