What to do 3 months before turning 65: a month-by-month Medicare checklist

Reading the checklist from top to bottom

The table runs on one date: your birthday month. Every row counts from it. If your birthday is on the 1st, Medicare treats you as turning 65 a month early, so move every row back one month.

The row you are in now is the one marked "3 months before." That is when the seven-month window opens. Medicare calls it the Initial Enrollment Period.

The rows above it are things the book puts earlier, a year out and ten months out. If you skipped them, do them now. Checking your earnings record still matters, because it decides whether Part A costs you nothing.

The rows below it are what comes next. Your birthday month, the three months after, and the clocks that keep running once you have Medicare.

Three months out: the three jobs for this month

Sign up, or confirm. If you are getting Social Security or Railroad Retirement benefits, and they started at least 4 months before you turn 65, Medicare signs you up on its own. If not, you sign up through Social Security, online at SSA.gov/medicare/sign-up or by appointment. You can contact them 3 months before you turn 65 to set one up.

Check your drug coverage. Part D, the drug coverage, runs on this same window. If you have drug coverage through a job or union, the plan must tell you whether it is "creditable," meaning Medicare counts it as at least as good as standard Part D. Keep that letter. Medicare's page on the Part D late enrollment penalty explains what happens without it.

Gather your list. Before you compare Original Medicare and Medicare Advantage, write down your doctors and hospitals, your prescriptions with doses, and where you spend time each year. Medicare's Plan Finder is at Medicare.gov/plan-compare.

And one small job that saves trouble later. Keep proof of the date you signed up. Save the online confirmation. If you call, write down the name of the person you spoke with.

If your card arrives and you want to wait on Part B

If Medicare signs you up on its own, the card can arrive about 3 months before coverage starts. Some people still covered by a current job want to wait on Part B. The book gives Social Security's two deadlines for saying no.

• If you got the welcome package with your card, you must refuse Part B before the start date printed on the card.
• If you got a Medicare award notice, a letter confirming your Medicare, you have two full calendar months after the date on that letter.

The refusal has to be in writing. If it arrives late, Social Security treats it as canceling Part B, and Part B ends at the end of the following month. Saying no can lead to a late penalty unless you have the right kind of coverage in its place, so read our page on still working at 65 first.

If your coverage now is COBRA or a retiree plan

This is the row people get wrong most often. COBRA and retiree plans feel like your old job's insurance, but Medicare does not count them as coverage from current work.

That means two things. Once you are eligible, Medicare pays first, and the old plan pays second. And when COBRA or the retiree plan ends, no new window opens to sign up for Part B. So if this is your path, the seven-month window around your birthday is the one to use.

Ask your COBRA or retiree plan what it will pay once you are eligible for Medicare. Most retiree plans expect you to sign up as soon as you can.

The calendar on the fridge

You put a sticky note on the fridge that says "Medicare." That was a month ago. It is still there, curling at the edges.

Every time you walk past, you feel a little behind. Not because you did anything wrong. Because nobody handed you a list, and the mail is full of ads that all want a different first step.

Here is the honest part. You don't have to learn all of Medicare this month. You need the three jobs above, and the dates for the rows below them. This page centers on that one row, and we chose it for a reason: it is the month the window opens, and it is the month most worth getting right.

The Medicare & You 2027 handbook is the official reference for every step on the list.

What waits for your birthday month and after

When your birthday month comes, check the card. Read what it says. Guard the Medicare Number. Note the start dates for Part A and Part B.

If you chose Original Medicare, mark your Medigap window. It lasts 6 months from the first month you have Part B and are 65 or older, and it comes once.

After that, two more clocks. If you are married, your spouse has a separate window built around their own birthday. And if a letter says your Part B premium is higher because of income, that surcharge is built from your tax return from 2 years ago. There is a form to ask for a newer year.

The book behind this checklist

This is the problem The Year You Turn 65 was written for. Nancy Whitaker's whole book is sorted by month, so this checklist is its backbone.

Three Months Out: The Seven-Month Window Opens covers the sign-up itself: how to sign up, what each month of the window does, the 2023 rule change and the 1st-of-the-month birthday.

The Same Window: The Drug Coverage Question explains Part D, the 63-day penalty rule with 2026 figures, and the creditable coverage letter.

The Month You Turn 65 is a short checklist for the birthday month itself: the card, the number, how the Part B premium gets paid and the clocks still running.

Your 65 Calendar collects every date and document from the book on fill-in pages, including a month-by-month checklist and a log of everyone you talk to.

The book is not affiliated with Medicare or Social Security. Your State Health Insurance Assistance Program (SHIP) gives free counseling, and Social Security can look at your own file to confirm your sign-up and your start dates.