This guide is a working checklist. For the story behind each step, with examples, see our longer blog post, Turning 65 in Idaho: your Medicare checklist.
About 6 Months Before Your Birthday Month
- Find out if you will be enrolled automatically. If you will be getting Social Security or Railroad Retirement Board benefits at least 4 months before turning 65, Medicare enrolls you in Part A and Part B and mails your card about 3 months before coverage starts. If not, you will sign up yourself through Social Security.
- Confirm Part A is premium-free for you. It is for most people who, or whose spouse, paid Medicare taxes for about 10 years. If not, Part A costs $311 or $565 a month in 2026. Our eligibility guide covers the details.
- If you are still working, ask HR two questions: how many employees does the company have, and is the drug coverage creditable? With 20 or more employees, the group plan generally pays first; with fewer than 20, Medicare generally pays first. The full rules are in working past 65.
- Stop Health Savings Account contributions on time. Premium-free Part A can be backdated up to 6 months from when you sign up (but not before the month you turn 65), so stop contributing 6 months before you apply for Part A or Social Security.
- Make lists. Every doctor, specialist, hospital and pharmacy you use, and every prescription with its dose. You will need them to compare plans.
3 Months Before: Your Initial Enrollment Period Opens
Your Initial Enrollment Period is 7 months long: the 3 months before your birthday month, the birthday month, and the 3 months after. Coverage always starts on the first of a month.
- Sign up for Part B before your birthday month if you want coverage to start the month you turn 65. Sign up later in the window and Part B starts the month after you sign up.
- If you are delaying Part B because of work coverage, make sure that coverage qualifies, and note that you will have 8 months after it ends to sign up without a penalty. Penalties are explained in our late enrollment penalties guide.
- Watch your mail for your Medicare card and welcome package, and keep your Medicare Number and Part A and Part B start dates handy.
Choose How You Will Get Medicare
With Parts A and B lined up, the big decision is how to fill the gaps. Original Medicare has no yearly out-of-pocket limit and does not cover most prescriptions, so most people choose one of two paths:
- Original Medicare + a Medigap policy + a Part D drug plan. Any provider that accepts Medicare, predictable costs, higher premiums.
- A Medicare Advantage plan, usually with drug coverage built in. A provider network, lower premiums for many plans, copays as you use care up to a yearly limit.
Our guide to Medicare Advantage vs. Medigap in Idaho compares them side by side, including Idaho’s birthday rule. Before you choose a plan, run your doctors and drugs through each option; here is how.
- Joining Advantage or Part D during your IEP: if you ask to join before Part A or B starts, plan coverage starts the same day Medicare does.
- Choosing Medigap: apply during your 6-month Medigap open enrollment period, which starts when Part B begins and you are 65 or older. An insurer generally cannot turn you down or charge more for health reasons in that window.
- Do not skip drug coverage unless you have creditable coverage. Going 63 days or more without it can mean a lifelong Part D penalty.
Your Birthday Month and the 3 Months After
- Confirm your cards: your Medicare card, plus your plan ID card if you joined Advantage, Part D or Medigap.
- Tell your doctors and pharmacy about your new coverage so claims go to the right place.
- Joined Medicare Advantage during your IEP and having second thoughts? Within the first 3 months you have Part A and Part B, you can switch to another Advantage plan or return to Original Medicare.
- Missed the window? The General Enrollment Period runs January 1 to March 31, with coverage the month after you sign up and a possible penalty.
Your First Year on Medicare
- Each fall, read your Annual Notice of Change and compare plans during Open Enrollment, October 15 to December 7. Changes take effect January 1.
- If you chose Medigap, note your birthday: Idaho Medigap holders get a 63-day guaranteed-issue window each year, starting on their birthday, to switch to a policy with the same or fewer benefits.
- Check whether you qualify for help. If income is limited, look at Medicare Savings Programs and Extra Help.
- Watch for IRMAA if your income two years earlier was high. Both are covered in the related guides below.
What to Have on Hand
Whether you sign up online, by phone or with us, it helps to have: your Social Security number; your Medicare card once it arrives; your current insurance cards and, if you are working, a note from your employer about the coverage; your list of doctors, hospitals and pharmacies; and your prescription list with doses. Our answer page on what to bring to a Medicare appointment has a printable version, and the enrollment window finder shows your exact dates.
Turning 65 in the next year?
Book a no-cost planning call. We will build your personal Medicare timeline and compare the plans we represent in your Idaho county.
Request a free comparison Call 208-350-9933Frequently Asked Questions
How early can I sign up for Medicare before turning 65?
Your Initial Enrollment Period starts 3 months before the month you turn 65. If you sign up for Part B before your birthday month, coverage starts the first day of the month you turn 65. Signing up during or after your birthday month starts coverage the month after you sign up.
Will I be enrolled in Medicare automatically at 65?
Only if you already get Social Security or Railroad Retirement Board benefits at least 4 months before turning 65. In that case your card arrives about 3 months before coverage starts. If you are not collecting benefits yet, you need to sign up yourself through Social Security.
Should I sign up for Part B if I am still working at 65?
It depends on your employer. If the employer has 20 or more employees and you are covered through current work, the group plan generally pays first and you can usually delay Part B without a penalty. If the employer has fewer than 20 employees, Medicare generally pays first, so delaying Part B can leave big gaps.
When should I buy a Medigap policy?
The safest time is your Medigap open enrollment period, the 6 months that start when your Part B begins and you are 65 or older. During that window an insurer generally cannot refuse you or charge more because of your health. In Idaho, once you hold a Medigap policy, you also get a yearly 63-day birthday window to switch.
What should I do if I contribute to a Health Savings Account?
Plan to stop HSA contributions 6 months before you apply for Part A or Social Security benefits, because premium-free Part A can start up to 6 months back from when you sign up, but no earlier than the month you turn 65. Check the tax details with your tax professional or HSA administrator.
Related Guides
Coverage pages for this topic: Medicare Advantage · Medicare Supplement · Medicare Part D. Other topics in the Learning Center: Health Insurance (ACA), Life Insurance, Final Expense, Annuities, Long-Term Care, Disability Insurance, Supplemental Health, Short-Term Medical, Travel Insurance.
Sources
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles (fact sheet)
- Medicare.gov — Get started with Medicare
- Medicare.gov — How do I sign up for Medicare?
- Medicare.gov — When does Medicare coverage start?
- Medicare.gov — Joining a plan (enrollment periods)
- Medicare.gov — Who pays first (coordination of benefits)
- Medicare.gov — Avoid late enrollment penalties
- Medicare.gov — What’s Medicare Supplement Insurance (Medigap)?
- Idaho Department of Insurance — Bulletin No. 21-04 (Medicare Supplement rating and eligibility)
Figures are labelled with the year they apply to and were checked against the official sources above on the review date. Rules and amounts change; confirm current figures with the agency that publishes them. This guide is general education, not individual advice.