What Are the 3 Decisions You Have To Make Before Turning 65?

If you’re approaching 65, Medicare starts to show up fast—and with it comes a lot of questions.
Most people don’t need to understand everything all at once.
But there are three key decisions you need to make before turning 65 that will shape how your Medicare works.

What People Are Asking

● Do I have to sign up for Medicare at 65?
● Can I stay on my employer coverage?
● When exactly should I enroll?
● How do I actually sign up?
● What happens if I get it wrong?
These are the questions that matter—and getting them right can help you avoid costly mistakes.

1. Do I Have To Sign Up for Medicare?

This depends largely on your current health coverage, especially if you’re still working.

If You Have Employer Coverage

The size of your employer matters.
20 or More Employees:
● Your employer coverage is usually primary
● Medicare is secondary
● You may be able to delay Part B without penalty
medicare.gov
Fewer Than 20 Employees:
● Medicare becomes primary
● Your employer coverage may be secondary
● You are generally expected to enroll in Medicare

Other Situations

You may also need to enroll at 65 if:
● You’re retiring
● You have COBRA coverage
● You have individual or marketplace insurance
👉 These types of coverage do not replace Medicare, and delaying enrollment could lead to penalties.

Why This Decision Matters

Not signing up when you’re supposed to can result in:
● Late enrollment penalties
● Gaps in coverage
● Higher long-term costs

2. When Do You Sign Up?

Timing is critical.
Medicare has a 7-month Initial Enrollment Period (IEP):
● 3 months before your 65th birthday
● Your birthday month
● 3 months after

Why Timing Matters

If you enroll:
Before your birthday month: Coverage can start on time
After your birthday month: Coverage may be delayed

Missing the Window

If you don’t qualify for a delay and miss your enrollment window:
● You may have to wait for a later enrollment period
● You may face permanent penalties
👉 This is one of the most common and costly mistakes people make.
medicare.gov

3. How Do You Sign Up for Medicare?

Once you’ve decided you need Medicare—and when to enroll—the next question is:
👉 “How do I actually do it?”

Option 1: Online

The easiest way is through the Social Security
Administration website.
You can apply for Medicare online in most cases.
ssa.gov

Option 2: Local Office

You can also:
● Visit your local Social Security office
● Schedule an appointment for assistance

Option 3: By Phone

You can contact Social Security directly and apply over the phone.

Automatic Enrollment

If you are already receiving Social Security benefits:
● You may be automatically enrolled in Medicare Part A and Part B

Why These 3 Decisions Matter

These decisions are connected:
● Whether you need Medicare affects when you enroll
● When you enroll affects when coverage begins
● How you enroll determines how smoothly the process goes
Getting these right helps you:
Avoid penalties
Prevent coverage gaps
Start Medicare with confidence

Key Takeaways

● Not everyone has to enroll in Medicare at 65—but many do
● Employer size plays a major role in that decision
● You have a 7-month window to enroll
● Timing affects when your coverage starts
● Signing up can be done online, by phone, or in person

Common Questions

Do I have to sign up for Medicare if I’m still working?

It depends on your employer size and type of coverage.

You may face penalties and delays in coverage.

Yes, through the Social Security website.

Only if you are already receiving Social Security benefits.

Final Thought

Turning 65 doesn’t mean you need to know everything about Medicare.
But understanding these three decisions can make the entire process much easier.
And more importantly—it can help you avoid mistakes that are difficult to fix later.

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:
  • Original Medicare (Parts A & B): Allows you to see any doctor or
    hospital that accepts Medicare but does not include prescription drug
    coverage (Part D) or additional benefits.
  • Medicare Advantage (Part C): Offers bundled coverage with
    potential extra benefits but may require using a network of providers.
  • Medigap (Medicare Supplement Insurance): Helps cover
    out-of-pocket costs not covered by Original Medicare, such as
    copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:
  • Initial Enrollment Period (IEP): A seven-month window starting
    three months before your 65th birthday month.
  • General Enrollment Period (GEP): From January 1 to March 31
    each year for those who missed their IEP.
  • Annual Election Period (AEP): From October 15 to December 7,
    allowing you to switch or enroll in Medicare Advantage and Part D
    plans.
  • Open Enrollment Period(OEP): From January 1 to March 31 for
    those who missed AEP and want to make certain changes.
  • Special Enrollment Period(SEP): Can be used anytime during the
    calendar year for those that meet certain criteria such as moving to a
    new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.
By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.
Do I have to sign up for Medicare?
It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.
No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.
There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
Scroll to Top

Your Medicare Guide Is Ready!