Kleather: Start planning Medicare coverage at 64

With all the coverage choices and first-time enrollment deadlines, people should begin planning early — and not wait until their 65th birthdays to begin thinking about their retirement health insurance needs and options.”

Dr. Chris Kleather is a chief medical officer at UnitedHealthcare.

If you’re retiring soon or know someone who is, you’re not alone. In 2025, a record 4.18 million Americans will reach retirement age, which equates to over 11,000 people turning 65 each day. This phenomenon is sometimes referred to as “peak 65” or the “silver tsunami,” which began in 2024 and will continue over the next several years. This means a lot of people and their families will be looking for answers about Medicare.

Companies advertising Medicare plans and Medicare enrollment opportunities may open their commercials with someone asking, “I just turned 65. What are my coverage options?” With all the coverage choices and first-time enrollment deadlines, people should begin planning early — and not wait until their 65th birthdays to begin thinking about their retirement health insurance needs and options.

While there are resources that can help guide one’s decisions, the following are some tips to help you, a loved one or an employee begin planning for postretirement health care and to enroll in Medicare.

• Think “3-1-3” — You are eligible to apply for Medicare coverage starting the three months before your 65th birthday — the month you turn 65 — and the three months after. This is referred to as your initial enrollment period.
• Understand the consequences of your choices — While you don’t have to enroll in Medicare when you turn 65, if you decide not to and do not qualify for a special enrollment period, there may be penalties when you do sign up — and these can be costly.
• Celebrate your 64th birthday— Thinking about retiring and what the future holds can be stressful so take time to enjoy your 64th birthday, then start planning.
• Begin planning soon after your 64th birthday— The following are some questions to get you started: Am I required to get Medicare coverage? Can I get dental, vision and drug coverage, as well as medical coverage? What if I cannot afford Medicare? If I plan to work past 65, will I have coverage through my employer or spouse? How long am I covered under the plan I enrolled in during the initial enrollment period? What if my birthday falls during the annual enrollment period? Or just before? Do I need to enroll twice? What if I do not enroll in a Medicare plan before the end of my IEP deadline?

While beginning to plan early should help avoid the consequences of not enrolling on time, choosing the right Medicare plan may still seem confusing. Many pre-retirees may never have shopped for their own health insurance, having had health care coverage through their employers.

As you begin your research, Medicare.gov is one place to start. You may also visit UnitedHealthcare’s “Medicare Made Clear” guide, which provides information on plan benefits, details on various enrollment periods and other resources to answer your questions.

Medicare plays a key role in the lives of people as they age. Making the right decisions from the start and in a timely manner can have positive long-term financial and health consequences. So, plan early and enjoy your 65th birthday.

Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.