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Answers to the Most Common Questions About Medicare and Turning 65

Enrolling in Medicare and turning 65 are two of life’s major milestones. Both come with major decisions, including when to retire and how to ensure you have affordable healthcare coverage. We’re here to help with answers to your biggest questions.

  1. What’s the difference between Medicaid and Medicare?
  2. You’re most likely eligible for Medicare when you turn 65 years of age. Medicare is a health insurance program governed by the Federal Government for people who are:

    • 65 or older
    • Under 65 with disabilities
    • Any age with End Stage Renal Disease (ESRD) or ALS

    Medicaid is a federally funded, state governed program that helps pay healthcare costs for low-income individuals and families. Medicaid eligibility and optional benefits vary by state.

    If you qualify for both Medicaid and Medicare, you’re considered dual eligible.

  3. Am I automatically enrolled in Medicare?
  4. You’ll automatically be enrolled in Medicare Parts A and B, also known as Original Medicare, if you’re already receiving benefits from Social Security or the Railroad Retirement Board on the first day of the month you turn 65. If you turn 65 on the first day of your birthday month, you’ll automatically be enrolled on the first day of the previous month.

    If you won’t receive Social Security benefits before your Initial Enrollment Period, you’ll have to apply for Medicare Parts A and B manually before you turn 65 by either:

  5. How do I avoid penalties when enrolling in Medicare and turning 65?
  6. Your Medicare Initial Enrollment Period starts three months before you turn 65 and ends three months after you turn 65. It’s a 7-month window that includes the month of your 65th birthday. The first step, whether or not you’re still working, is to verify you’re signed up with Social Security, so you’re eligible to enroll in Medicare Parts A and B. If you don’t enroll during your Initial Enrollment Period, you may incur fees and higher costs as well as face a potential gap in your healthcare coverage.

    Learn more about your options if you miss your Medicare Initial Enrollment Period.

    Read on to understand what is, and isn’t, covered under Medicare Parts A and B and why you’ll want to get information about all your options, including Medicare Advantage Plans to make sure you have all the coverage you need.

  7. What’s covered with Medicare?
  8. You have options when it comes to choosing Medicare coverage. Here’s a summary of the various parts and what each includes:

    • Part A—Medicare Part A includes care and inpatient services in a hospital or skilled nursing facility
    • Part B—Medicare Part B includes doctor visits, outpatient services, and possible preventative care
    • Part C—Medicare Advantage Plans, also known as Part C, combine both Medicare Part A and Part B, and often include additional benefits, like vision, dental, hearing, and prescription drug coverage (Part D), all in one convenient plan.
    • Part D—Medicare Part D helps you pay for prescription drugs. Prescription Drug Plans are offered by Medicare-approved private insurance companies.
  9. Where can I get help with enrolling in Medicare and turning 65?
  10. You can research Medicare, including Medicare Advantage Plans online or contact a licensed agent. Keep in mind there’s a lot of information to sort through if you do the research yourself, and many agents only represent one provider, which may mean you miss out on finding your best-fit plan. Our Medicare Advocates are available to assist you, including helping you find, compare, and enroll in Medicare plans. For assistance, call 1-800-991-4407 / TTY 711 from 10 a.m. to 9 p.m. ET, Monday through Friday.

    You can also find and compare Medicare plans through our convenient Medicare Online Enrollment Portal.