Turning 65: your local Medicare guide

Your Medicare timeline at 65

Your Initial Enrollment Period lasts seven months. It begins three months before the month you turn 65, includes your birthday month and ends three months after it. If you sign up in the three months before your birthday month, coverage generally starts on the first day of your birthday month. If you sign up during your birthday month or later, coverage generally starts on the first day of the month after you sign up. Review Medicare's sign-up guidance.

Already receiving Social Security? If you have received Social Security or Railroad Retirement benefits for at least four months before you turn 65, you are usually enrolled in Part A and Part B automatically, and your Medicare card typically arrives about three months before your birthday month. Otherwise, you sign up through Social Security.

Still working at 65?

Whether you can delay Part B usually depends on the size of the employer and how the coverage is structured.

• Employer with 20 or more employees: coverage based on your or your spouse's current employment is usually primary. Many people can delay Part B without a late penalty and later use an eight-month Special Enrollment Period that starts when the employment or the coverage ends, whichever happens first.
• Employer with fewer than 20 employees: Medicare is usually primary, so delaying Part B can leave serious gaps. Ask the employer plan how it coordinates with Medicare before deciding.
• COBRA and retiree coverage do not count as coverage from current employment for this purpose. Waiting to take Part B while on COBRA can lead to a late penalty and a gap in coverage.
• Health Savings Accounts: you cannot contribute to an HSA once Medicare coverage begins. If you sign up for Part A after 65, it can be made retroactive for up to six months, so discuss when to stop contributions before you apply.

Penalties worth avoiding

• Part B: the late enrollment penalty generally adds 10% to your Part B premium for each full 12-month period you could have had Part B but did not, and it usually lasts as long as you have Part B.
• Part D: if you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period, a late enrollment penalty may be added to your drug premium for as long as you have drug coverage. Keep the annual creditable-coverage notice from any employer drug plan.

Read Medicare's guidance on avoiding late penalties.

Your first coverage decision

At 65 you generally choose between two paths:

1. Original Medicare (Parts A and B), often paired with a Medicare Supplement (Medigap) policy and a separate Part D drug plan.
2. Medicare Advantage (Part C), a Medicare-approved private plan that provides Part A and Part B benefits and usually includes drug coverage.

Medigap timing matters. Your federal Medigap Open Enrollment Period lasts six months, starting the first month you are 65 or older and enrolled in Part B. During that window, insurers generally cannot deny you or charge more because of health conditions. Outside it, medical underwriting may apply unless a guaranteed issue right applies. See Medicare's Medigap timing guidance.

What to have ready for your review

• Your Medicare card, or the date you expect Part A and Part B to start
• Current coverage details, including any employer plan and its end date
• A list of your doctors, hospitals and pharmacies
• Your prescriptions, with dosage and how often you fill them
• Questions about your budget, travel between WV and VA, or care you expect next year

Please do not send your Medicare number or medical records through the website form. We will arrange an appropriate way to share information when you are ready to apply. Call 304-252-2158 or use the form above to request a free turning-65 review.

General educational information. Coverage, eligibility and plan terms vary. Updated October 20, 2026.