Medicare Made Simple: What to Know Before You Turn 65
Congratulations—you’re approaching a major milestone: turning 65! While this birthday comes with plenty of reasons to celebrate, it also marks an important transition in your healthcare journey: becoming eligible for Medicare. If you’re feeling a bit overwhelmed by the idea of navigating this new world of insurance options, you’re not alone. At TrustInsure, we’re here to break it down for you and help you make informed decisions about your coverage. Let’s dive into the essentials you need to know as you prepare for this exciting chapter.
When Do You Become Eligible for Medicare?
Most people become eligible for Medicare when they turn 65. Your Initial Enrollment Period (IEP) is a 7-month window that includes the three months before your birthday month, your birthday month, and the three months after. For example, if you turn 65 in June, your IEP runs from March 1st to September 30th. Signing up during this period ensures you avoid penalties and gaps in coverage.
Pro Tip: If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Medicare Parts A and B. If not, you’ll need to take action to sign up—don’t worry, we’ll cover how to do that in a moment!
What Is Medicare, Anyway?
Medicare is a federal health insurance program designed primarily for people 65 and older (though it also covers some younger individuals with disabilities or specific conditions). It’s divided into four main parts:
Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people get Part A premium-free if they’ve worked and paid Medicare taxes for at least 10 years.
Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and medical supplies. Part B has a monthly premium (typically $185 in 2025, though this can vary based on income).
Part C (Medicare Advantage): An alternative to Original Medicare (Parts A and B), offered by private insurers. These plans often include additional benefits like dental, vision, and prescription drug coverage.
Part D (Prescription Drug Coverage): Helps cover the cost of medications. You can add this to Original Medicare or get it bundled with a Medicare Advantage plan.
Should You Enroll Right Away?
If you’re turning 65 and still working with employer-provided health insurance, you might wonder if you need Medicare yet. The answer depends on your situation:
If your employer has 20 or more employees: Your group plan is likely your primary coverage, and you can delay Part B without penalty until you retire.
If your employer has fewer than 20 employees: Medicare typically becomes primary, so enrolling in Parts A and B at 65 might be your best move.
Not sure what applies to you? We’d be happy to review your circumstances and guide you through your options.
Medicare Supplement vs. Medicare Advantage: What’s the Difference?
One of the biggest decisions you’ll face is choosing between a Medicare Supplement (Medigap) plan and a Medicare Advantage plan. Here’s how they compare:
Medicare Supplement (Medigap): These plans work alongside Original Medicare (Parts A and B) to “fill the gaps” by covering costs like copayments, coinsurance, and deductibles. Medigap offers flexibility—you can see any doctor who accepts Medicare, no referrals needed. However, it doesn’t include extras like prescription drugs (you’d need a separate Part D plan), and premiums can be higher depending on the plan you choose.
Medicare Advantage (Part C): These all-in-one plans replace Original Medicare and are offered by private insurance companies. They often bundle Parts A, B, and D, and many include perks like dental, vision, or hearing coverage. The trade-off? You’ll typically need to stay within the plan’s network of providers, and out-of-pocket costs can vary. Premiums might be lower—or even $0 in some cases—but you’ll want to check the details.
Which is right for you? It depends on your health needs, budget, and preferences. At TrustInsure, we specialize in helping you weigh these options to find the perfect fit.
How to Get Started
Ready to enroll? You can sign up for Medicare through the Social Security Administration’s website (ssa.gov) or by calling 1-800-772-1213. But before you do, take a moment to think about what you want from your healthcare coverage. Original Medicare with a Medigap plan offers flexibility but may cost more upfront. Medicare Advantage might save you money and add benefits but limits you to a network.
This is where we come in. At TrustInsure, we’re experts in helping people just like you find the Medicare plan that matches your needs, budget, and lifestyle. Whether you’re looking for low premiums, robust drug coverage, or extra perks like gym memberships, we’ll walk you through the choices and handle the details.
Don’t Miss Your Window
One of the biggest mistakes we see is people waiting too long to explore their options. If you miss your Initial Enrollment Period and don’t qualify for a Special Enrollment Period (like leaving employer coverage), you could face late enrollment penalties—higher premiums that stick with you for life. Let’s make sure that doesn’t happen to you.
Turning 65 Is a New Beginning
Reaching 65 is more than just a number—it’s a chance to take control of your healthcare and enjoy peace of mind. Medicare can feel complicated at first, but you don’t have to figure it out alone. At TrustInsure, we’re committed to making this transition as smooth as possible for you. Have questions? Want to explore your options? Give us a call at 910-994-6464 or visit www.trustinsuregroup.com to schedule a free consultation. We’re here to help you celebrate 65 with confidence!