Turning 65: Start here.

If you're approaching 65 and feeling like you have no idea what happens next, that's normal — Medicare is genuinely confusing, and the mail you're about to start getting will make it worse. Use the quick navigator below to get directive steps for your exact situation, or read the full walkthrough underneath it. By the end you'll know the handful of decisions that matter, what to gather, and who to call for free help.

The full walkthrough, step by step

Prefer to read it all, or want the detail behind the navigator? Here's the complete walkthrough.

Step 1 — The one thing to understand first

Medicare is individual, not a family plan. Unlike the employer or Marketplace coverage you may be used to, there is no "family Medicare." You get your own Medicare based on your own age and work history. Your spouse gets theirs, on their own timeline. So if you're turning 65 but your spouse is younger — or is on their own insurance — you each make separate decisions. Keep that in mind the whole way through: this page is about your coverage; your spouse works through the same steps on their own clock.

The other foundational idea: "Medicare" is really a few separate pieces (Parts A, B, D, and the private options that package them). You don't have to master them yet — just know that the decisions below are about which pieces you take and how.

Step 2 — Your timeline (this is the part with deadlines)

The single most important date is your Initial Enrollment Period (IEP): a 7-month window that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. This is when you can sign up without hassle. Missing it can cause permanent late penalties and a gap in coverage — so even if you decide to delay some parts (a valid choice in certain situations), you need to make that decision on purpose, within the window.

Step 3 — Which situation are you in?

Your best path depends on what coverage you (and your household) already have. Find yourself below and follow the link — each guide picks up exactly where your situation matters. You may match more than one.

Step 4 — Information to have ready

Before you sign up or talk to a counselor, gather these. Having them in one place makes every later step faster and prevents mistakes.

• Your Social Security number and, if you have one, your Medicare number.
• Your work history — roughly how long you (or a spouse) paid Medicare taxes (this decides whether Part A is free).
• Details of any coverage you have now: employer/retiree plan, COBRA, VA health care, TRICARE, or a spouse's plan — and whether it counts as "creditable" (the plan or HR can tell you; it determines whether you can safely delay Part B or Part D).
• A list of your doctors and whether keeping them matters to you.
• A list of your prescription drugs and your pharmacy (this drives your drug-coverage choice).
• Your spouse's coverage details and age (because they're on their own Medicare timeline).
• If money is tight: recent income and household size (for help-paying programs).

Step 5 — The decisions you'll actually make

Boiled down, Medicare comes to a short list of decisions. Here they are in plain terms. (None of this is advice — it's what to weigh. A free SHIP counselor can walk through your specifics with you.)

1. Take Part A? Almost always yes. Part A (hospital) is premium-free for most people who worked enough, so there's usually no downside. (One exception: if you contribute to a Health Savings Account, enrolling in Part A stops new HSA contributions — see Working Past 65.)
2. Take Part B now, or delay? This is the big one. Part B (doctors/outpatient) has a monthly premium. You can delay it without penalty only if you have other creditable coverage — generally active employer coverage from a large employer. Retiree plans, COBRA, and VA health care do not let you delay Part B safely. Delay without qualifying coverage and you face a lifelong penalty and a coverage gap.
3. Original Medicare or Medicare Advantage? Two ways to get your benefits: Original Medicare (often paired with a Medigap supplement and a Part D drug plan) versus an all-in-one Medicare Advantage plan. Neither is "better" — it depends on whether you value provider freedom and predictability (Original + Medigap) or bundled extras and a spending cap (Advantage).
4. How will you cover prescriptions? Through a Part D plan, built into a Medicare Advantage plan, or — for veterans — possibly through VA pharmacy. Missing drug coverage without a creditable alternative also carries a permanent penalty.
5. Do you want a Medigap supplement? If you choose Original Medicare, your 6-month Medigap window (starting when you're 65 and enrolled in Part B) is the one time you can buy any supplement without medical underwriting. It's easy to miss and hard to get back.
6. What about your spouse? They repeat these same decisions on their own timeline. If your spouse has private insurance now — through their own job, your former job, or the Marketplace — that coverage is separate from your Medicare, and separate from your VA care. When each of you nears 65 (or loses that coverage), each of you runs through these steps. See Working Past 65 and Retiring or Losing Coverage.

Step 6 — Your next actions

1. Put your 7-month window on the calendar and set a reminder 3 months before your birthday month.
2. Create your accounts at ssa.gov and medicare.gov.
3. Confirm whether your current coverage is "creditable" for delaying Part B and Part D — ask your HR/benefits office, or the VA for VA health care. This one fact drives your timing.
4. Gather the Step 4 list for both you and your spouse.
5. Call your free SHIP counselor to review your specific situation before you enroll — find yours here or call 1-800-MEDICARE (1-800-633-4227). SHIP is free, unbiased, and doesn't sell anything.
6. Read the one or two situation pages that match you from Step 3, then enroll (or make a deliberate, documented decision to delay) before your window closes.