When to Start Medicare: Enrollment Windows & Deadlines

The Initial Enrollment Period

Your Initial Enrollment Period (IEP) is a 7-month window around your 65th birthday: 3 months before, your birth month, and 3 months after. If you miss this window and don't have qualifying employer coverage, you'll face late-enrollment penalties — a 10% premium increase for each 12-month period you were eligible but didn't enroll.

If You're Still Working at 65

If you or your spouse have employer coverage through a company with 20+ employees, you can delay Medicare Part B without penalty. You'll get a Special Enrollment Period (SEP) when the employer coverage ends. However, you should still sign up for Part A (it's free) since it can provide secondary coverage.

Medicare Parts Explained

Part A covers hospital stays (free for most). Part B covers doctor visits and outpatient care (~$185/month in 2026). Part D covers prescriptions. Medicare Advantage (Part C) bundles A, B, and usually D into one plan from a private insurer.

Important: Medicare doesn't cover everything. Dental, vision, hearing, and long-term care are generally not covered. Many retirees purchase a Medicare Supplement (Medigap) policy to cover the gaps.

How Medicare Fits Into Your Retirement Plan

Healthcare is one of the biggest expenses in retirement. At ACM, we factor Medicare premiums, supplement costs, and out-of-pocket maximums into every retirement income plan we create. A couple can expect to spend $6,000-$12,000/year on healthcare costs beyond Medicare premiums.