Your complete guide to starting Medicare.
Approaching 65 brings an important set of healthcare decisions. This guide explains when to enroll, what Medicare Parts A, B, C and D mean, how Medicare Advantage differs from Original Medicare, and where Medicare Supplement insurance may fit.
Help Me Understand My Options →Start learning before your birthday month.
Turning 65 doesn't mean everyone should make the same Medicare decision.
For many Americans, age 65 is when Medicare eligibility begins. But enrolling in Medicare and deciding how you want to receive your Medicare benefits are two different decisions.
Some people are automatically enrolled in Medicare. Others need to actively enroll. People who continue working—or who have health coverage through a spouse's active employment—may have additional considerations before enrolling in Part B.
After establishing Medicare eligibility, you'll generally decide whether to receive your benefits through Original Medicare or through a private Medicare Advantage plan. If you choose Original Medicare, you may also consider separate prescription drug coverage and Medicare Supplement insurance.
That's why it's useful to start learning several months before your 65th birthday rather than waiting until you need coverage.
A seven-month window centered around your 65th birthday.
For most people first becoming eligible for Medicare at 65, the Initial Enrollment Period begins three months before the month they turn 65 and ends three months afterward.
Initial Enrollment Period begins.
You can enroll before turning 65.
Prepare for your Medicare start date.
Your birthday month.
Your enrollment period continues.
Don't overlook enrollment deadlines.
Initial Enrollment Period generally closes.
Coverage start dates depend on when you enroll. Special rules also apply to birthdays on the first day of a month and to certain people with qualifying employer coverage.
What are Parts A, B, C and D?
The letters become much easier to understand once you know what role each part plays.
Part A — Hospital Insurance
Part A helps cover eligible inpatient hospital care, skilled nursing facility care, hospice and certain home healthcare services.
Part B — Medical Insurance
Part B helps cover eligible physician services, outpatient care, preventive services and other medically necessary services and supplies.
Part C — Medicare Advantage
Medicare Advantage plans are offered by Medicare-approved private insurance companies as another way to receive Medicare Part A and Part B benefits. Many include prescription drug coverage and may offer additional benefits.
Part D — Prescription Drugs
Part D provides prescription drug coverage. It may be obtained through a stand-alone drug plan with Original Medicare or included within many Medicare Advantage plans.
Original Medicare or Medicare Advantage?
There isn't one answer that's right for everyone. The two approaches organize your healthcare coverage differently.
Original Medicare
Original Medicare consists of Part A and Part B and is administered by the federal government.
- Use Medicare-participating providers nationwide.
- Consider a separate Part D prescription drug plan.
- You may choose to purchase Medicare Supplement insurance.
- Supplemental coverage can help with certain Original Medicare out-of-pocket costs.
Medicare Advantage
Medicare Advantage is offered by Medicare-approved private insurers and provides Part A and Part B benefits through the plan.
- Plans may use provider networks.
- Many plans include prescription drug coverage.
- Plans may offer additional benefits not included in Original Medicare.
- Premiums, networks, benefits and out-of-pocket costs vary by plan and location.
Where does Medigap fit?
Medicare Supplement Insurance—usually called Medigap— is private insurance designed to help pay certain out-of-pocket costs associated with Original Medicare.
Medigap isn't the same thing as Medicare Advantage. You generally use Medigap with Original Medicare, not with a Medicare Advantage plan.
One of the most important timing rules for someone turning 65 is the federal Medigap Open Enrollment Period. It lasts six months and starts the first month you're 65 or older and enrolled in Medicare Part B.
During your federal Medigap Open Enrollment Period, an insurer generally can't deny you a Medigap policy it sells or charge you more because of pre-existing health problems. After this one-time period, your ability to obtain a policy may be more limited and medical underwriting may apply unless you have another protected right.
Six questions worth asking.
Which doctors matter to me?
Consider whether particular physicians, hospitals or health systems are important to you.
Do I travel frequently?
Your need for healthcare access outside Nevada may influence how you evaluate coverage.
What medications do I use?
Prescription formularies and pharmacy costs can differ significantly between drug plans.
How do I prefer to budget?
Compare premiums with potential deductibles, copayments, coinsurance and annual out-of-pocket exposure.
Am I still working?
Active employer coverage can affect when you should enroll in certain parts of Medicare.
Do I want supplemental coverage?
If choosing Original Medicare, understand Medigap timing before your initial enrollment opportunity passes.
Don't automatically assume you should—or shouldn't—enroll.
Many Nevadans continue working after age 65 or remain covered through a spouse's employer. Medicare enrollment rules can differ depending on the type of employer coverage you have.
Before delaying Medicare Part B, verify whether your current coverage qualifies you for a Special Enrollment Period later and understand how your employer coverage coordinates with Medicare.
Medicare enrollment can affect eligibility to make Health Savings Account contributions, and Medicare Part A can sometimes be retroactive when enrollment is delayed. If you're contributing to an HSA around age 65, this deserves particular attention before you enroll.
Turning 65 in Nevada and not sure what comes next?
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No Medicare number, Social Security number or medical information is needed.
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Turning 65 and Medicare FAQs
When should I sign up for Medicare if I'm turning 65?
For most people becoming eligible at age 65, the Initial Enrollment Period lasts seven months: the three months before the month you turn 65, your birthday month and the three months afterward. Different rules may apply if you have qualifying employer coverage or other circumstances.
Am I automatically enrolled in Medicare at 65?
Some people are automatically enrolled, particularly when already receiving certain Social Security or Railroad Retirement Board benefits. Others need to actively enroll. Check your individual status rather than assuming enrollment will occur automatically.
Do I need Medicare if I'm still working?
Not necessarily in every situation. Employer size, the type of coverage you have and whether the coverage is based on current employment can affect Medicare enrollment decisions. Verify your specific circumstances before delaying Part B.
What's the difference between Medicare Advantage and Medigap?
Medicare Advantage is another way to receive your Medicare Part A and Part B benefits through a Medicare-approved private plan. Medigap is supplemental insurance used with Original Medicare to help cover certain out-of-pocket costs. They are fundamentally different approaches.
When can I buy Medicare Supplement insurance?
Under federal rules, your six-month Medigap Open Enrollment Period starts the first month you're at least 65 and enrolled in Medicare Part B. Other rights may apply in particular circumstances.
Are Medicare plans the same throughout Nevada?
No. Private Medicare Advantage and prescription drug plan availability, premiums, networks and benefits can vary by geographic service area and can change from year to year.
Can I change Medicare coverage later?
There are specific enrollment periods during which eligible beneficiaries can make certain changes. Medicare's annual Open Enrollment Period runs October 15 through December 7. Other enrollment periods and Special Enrollment Periods may apply depending on your situation.
Explore your Medicare options.
Important: NevadaHealthPlans.com provides general educational information and is not currently acting as a licensed insurance agency. This website is not connected with or endorsed by the U.S. government or the federal Medicare program. Information on this page is not individualized insurance, legal, tax or financial advice. Medicare rules, plan availability, benefits, premiums, networks and enrollment requirements can change. For official Medicare information, visit Medicare.gov.