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65th Birthday Brings Key Decisions Regarding Health Care


(StatePoint) Your 65th birthday is an important milestone. That’s when you become eligible for the federal Medicare health insurance program.

Medicare is a popular, affordable health insurance program for Americans 65 and older, and those under 65 with certain disabilities, providing hospital coverage (Part A) and physician visits (Part B) to those who qualify. But it can be complicated. To decide what coverage is best for you, take inventory of your current and future health, work and economic standing, including your personal preferences and goals.

Here are a few tips to consider from Cigna, which serves hundreds of thousands of Medicare customers nationwide.

1. Timing is important! Medicare has a seven-month window around your 65th birthday called the Initial Enrollment Period. It begins three months before your 65th birthday and extends three months past your birthday month. Enrolling outside this window could result in higher premiums on Medicare Part B for the rest of your life.

If you’re still working, your path forward depends on the size of your company. If you work for a company with fewer than 20 employees, generally, you must sign up for Medicare at 65. If you work for a larger company, you can keep your company’s plan and enroll in Medicare without penalty later – usually when you retire – or enroll in Medicare immediately. However, by switching, your spouse could lose coverage if they’re currently on your company’s insurance.

If you’re not working and you’ve already filed for Social Security, the process is much easier. You’ll automatically be enrolled in Medicare Parts A and B when you turn 65. Sometimes called Original Medicare, this doesn’t include prescription drug coverage.

2. Original Medicare doesn’t cover everything. Original Medicare covers hospital and physician expenses, but there are cost-sharing requirements and limits on what’s covered. Consider how you’ll cover things like dental, vision, hearing and pharmacy. You can buy supplemental plans, or you can buy a Medicare Advantage plan (also known as Part C), which covers everything that Medicare does and provides additional benefits, including, in many cases, prescription drugs (also known as Part D).

3. You have many options. With Original Medicare, Medicare Advantage, Medicare Supplement (also known as Medigap), and Prescription Drug Plans, there are many choices to make. Understanding your budget, health needs, doctor preferences and lifestyle will be important in making the best choice for you.

4. Get help. For more information, call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048. Or visit the Medicare Plan Finder website at Find local assistance through the State Health Insurance Assistance Program (SHIP) at You can also contact individual Medicare plans. For instance, you can learn more about Cigna plans at Consult your benefits administrator at work and talk with friends and family members who’ve been through the process.

5. Use it. Know your available benefits. Find out about wellness checks and preventive screenings needed for your age and health status, and get them. Take advantage of Medicare Advantage extras, like gym memberships, to actively engage in your health and well-being.

As you turn 65, it’s important to do your homework regarding health insurance. However, if you find out that the plan is not the right fit, all is not lost. You can make changes during Medicare’s Annual Election Period, which occurs every year from October 15 to December 7.

PHOTO SOURCE: (c) Jfanchin / iStock via Getty Images Plus

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