What Happens When You Turn 65?

Turning 65 is when most people become eligible for Medicare. Here is what happens and what you may need to do.

A turning-65 checklist

1. About 4 months before: check whether you will be enrolled automatically. If you already get Social Security or Railroad Retirement Board benefits, you usually will be, and your Medicare card arrives in the mail about 3 months before your 65th birthday.
2. 3 months before your birthday month: your Initial Enrollment Period opens. If you are not enrolled automatically, sign up through Social Security.
3. Talk with your employer or HR if you are still working, to find out how your job-based coverage works with Medicare.
4. Decide how you want your coverage: Original Medicare with a Medigap policy and Part D plan, or a Medicare Advantage Plan.
5. Make sure you have drug coverage or other creditable coverage to avoid the Part D late enrollment penalty.
6. Mark your Medigap Open Enrollment Period: 6 months starting the month your Part B begins (if you are 65 or older).

Part A and Part B costs in 2026

Most people do not pay a premium for Part A because they or a spouse paid Medicare taxes long enough while working. The 2026 Part A hospital deductible is $1,736 per benefit period. The standard Part B premium is $202.90 a month and the Part B deductible is $283. People with higher incomes pay more for Part B and Part D.

If you are still working at 65

If you have coverage through your or your spouse's current employer, you may be able to delay Part B without a penalty. Many people still sign up for premium-free Part A. When the job or coverage ends, you generally have 8 months to sign up for Part B. Read when to sign up for Medicare.

If you have a health condition

Medicare covers pre-existing conditions. If you plan to buy a Medigap policy, your Medigap Open Enrollment Period is when you have the strongest protections. See Medicare and pre-existing conditions.

Frequently asked questions

Do I automatically get Medicare when I turn 65?

Only if you already receive Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65. Otherwise you need to sign up through Social Security.

When will I get my Medicare card?

If you are enrolled automatically, your Medicare card usually arrives about 3 months before your 65th birthday.

Is Medicare free at 65?

Part A is premium-free for most people. Part B has a monthly premium, which is $202.90 for most people in 2026, plus a $283 yearly deductible.

Do I need Medicare if I have insurance through work?

It depends on your employer’s size and coverage. Many people with current job-based coverage can delay Part B without a penalty. Ask your employer how its plan works with Medicare.

Talk with a licensed agent

Questions about your Medicare options? Call 1-844-438-6284 (TTY 711) or request a free, no-obligation quote. We do not offer every plan available in your area.

Sources for 2026 figures: CMS 2026 Medicare Parts A & B Premiums and Deductibles; Medicare.gov: Medicare costs; Medicare.gov: Part D costs. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).