Turning 65 · New to Medicare
New to Medicare? Here's exactly what to do.
A step-by-step guide for New Jersey residents approaching their 65th birthday — what to do, when to do it, and how to avoid costly permanent penalties.
7 mo
Initial Enrollment Period
Your enrollment window
The 7-month Initial Enrollment Period
You have a single 7-month window centered on your 65th birthday. Enroll early — coverage starts promptly and there are no penalties.
- −3
3 months before
Your IEP opens. Enroll now for the smoothest start — coverage begins the month you turn 65. Best window for most people.
- 0
Birthday month
Your 65th birthday month. If you enroll now, coverage starts the following month. Still penalty-free.
- +3
3 months after
Final months of your IEP. Enrollment is still penalty-free but coverage is delayed 2–3 months after sign-up.
- !
Miss it → penalty
After the 7-month window closes, you enter the General Enrollment Period (Jan–Mar). Late penalties apply — and they're permanent.
Tip: enroll 3 months before your birthday month
Step by step
What to do when you're turning 65
Six steps — in order. Most people can complete this in under a month.
1. Confirm your IEP dates
Find your 7-month window. If you already receive Social Security, you're auto-enrolled in Parts A and B — watch for your red, white, and blue Medicare card.
2. Enroll in Parts A and B
Visit ssa.gov if you're not yet on Social Security. Apply for Medicare alone — you don't need to claim SS benefits at the same time.
3. Choose your coverage path
Decision point: Medicare Advantage (Part C) — or Original Medicare + Medigap + Part D? Both provide full coverage; trade-offs are in networks, flexibility, and monthly cost.
4. Enroll in Part D
Even if you take no medications today, enroll in a Part D plan during your IEP. Skipping locks in a permanent penalty of 1%/month without coverage.
5. Enroll in Medigap (if applicable)
If you chose Original Medicare, enroll in Medigap during your 6-month open enrollment (starts when you're 65+ on Part B). No carrier can deny you or charge more during this window.
6. Review annually during AEP
AEP runs Oct 15 – Dec 7 every year. Plans change premiums, networks, and formularies. Review and switch if a better plan is available — changes take effect January 1.
Key decision
Advantage vs. Original Medicare + Medigap
The biggest choice for most new enrollees. Both provide comprehensive coverage — the differences are in cost, flexibility, and network.
| Factor | Medicare Advantage | Original Medicare + Medigap★ popular |
|---|---|---|
| Monthly premium | Often $0 + Part B premium | Part B + Medigap premium |
| Network | In-network required (HMO) or preferred (PPO) | Any Medicare-accepting provider in the US |
| Referrals | Required for HMO | Not required |
| Out-of-pocket costs | Variable; capped annually | Near-zero with Plan G |
| Extra benefits | Dental, vision, OTC, fitness | Not included |
| Drug coverage | Often bundled (Part D) | Separate Part D required |
| NJ community rating | N/A | Same Medigap premium at any age |
| Best for | Lower monthly cost, local care | Flexibility, travel, complex conditions |
Avoid these permanent penalties
- Part B penalty: 10% surcharge per year delayed without qualifying employer coverage — added to your premium for life.
- Part D penalty: 1% of the national base premium per month without creditable drug coverage — also permanent.
- Medigap window: Your guaranteed 6-month open enrollment starts when you're 65+ on Part B. After it closes, carriers may apply medical underwriting.
Compare paths
Which path is right for you?
Medicare Advantage (Part C)
Lower monthly cost + extra benefits
- Often $0 premium plan (Part B premium still applies)
- Dental, vision, hearing, OTC, and fitness included
- Annual out-of-pocket cap (up to $8,850 in-network, 2025)
- Network-based — verify your doctors before enrolling
- NJ carriers: Horizon, Aetna, UHC/AARP, Humana, Clover
Original Medicare + Medigap + Part D
Maximum flexibility + predictable costs
- Any Medicare-accepting provider — no networks, no referrals
- Plan G covers deductibles and coinsurance — near-zero out-of-pocket
- NJ community-rated: same Medigap premium at any age
- Higher combined monthly cost than $0-premium Advantage
- Best for frequent travelers, complex conditions, or multiple specialists
FAQ
Turning 65 — common questions
Do I have to take Medicare when I turn 65?+
Part A (hospital) is generally penalty-free to take at no cost if you have 40+ work quarters — most people enroll at 65. Part B can be delayed without penalty if you have qualifying employer coverage through a current employer with 20+ employees. If not, delaying Part B triggers a permanent penalty.
What if I'm still working and have employer coverage?+
If your employer has 20 or more employees, your group plan pays first and you can delay Part B without penalty. When coverage ends, you have an 8-month Special Enrollment Period. If the employer has fewer than 20 employees, Medicare pays primary — do not delay Part B.
Should I choose Medicare Advantage or Original Medicare + Medigap?+
Advantage plans often have lower monthly premiums and extra benefits but restrict you to networks. Original Medicare + Medigap lets you see any Medicare-accepting provider in the US with predictable costs — but total monthly premiums are higher. NJ community rating makes Medigap particularly attractive here.
What is the Part B late-enrollment penalty?+
Your Part B premium increases 10% for each full 12-month period you delayed without qualifying coverage. It's permanent — applied every month for as long as you have Part B. A 2-year delay = 20% surcharge for life.
What is the Part D late-enrollment penalty?+
1% of the national base beneficiary premium multiplied by the number of months you went without creditable drug coverage. The penalty is rounded to the nearest $0.10 and added to your monthly Part D premium permanently.
When does my Medicare coverage actually start?+
If you enroll in months 1–3 of your IEP (before your birthday month), coverage starts the month you turn 65. If you enroll in your birthday month, coverage starts the following month. Months 5–7: coverage starts 2–3 months after sign-up.
Can I still contribute to my HSA after enrolling in Medicare?+
No. Once enrolled in any part of Medicare (including Part A), you cannot make new HSA contributions. Stop contributing 6 months before you plan to enroll to avoid retroactive enrollment issues.
Turning 65 soon? Let's talk.
A 30-minute conversation with a licensed NJ advisor can save you from a lifetime of avoidable penalties — at no cost.