If you are turning 65 in 2026, you have a critical seven-month window to sign up for Medicare — and missing it can be an expensive mistake. While some people are enrolled automatically, millions of others must take proactive steps to avoid gaps in their health coverage.

With new 2026 changes now in effect — including a $2,100 out-of-pocket cap on prescription drugs and lower negotiated prices for high-cost medications — there has never been a more important time to get your enrollment right. Here is exactly how to sign up, what documents you need, and the deadlines you cannot afford to miss.

This article will focus on those who become eligible for Medicare upon turning 65. There are people under the age of 65 who qualify for Medicare due to disability or a limited slate of diagnoses. This article doesn’t address those circumstances.

Automatic enrollment for (most) people already receiving benefits

You will generally be automatically enrolled in both Medicare Part A and Part B if you are already receiving Social Security (SS) benefits at least four months before you turn 65.

There are two groups of 65-year-olds that need to sign-up on their own: those that haven’t signed up for Social Security and those who must pay a premium for Part A.

Here’s what happens when you are automatically enrolled:

What to do if you don’t want Medicare- If you are automatically enrolled but choose to decline Part B, usually because you have coverage through a current employer, you must follow the instructions on your welcome package/card to opt out.

You can’t disenroll from Part A. This would only be a problem if you are employed and want to continue to contribute to a health savings account (HSA). Otherwise, most people sign up for Part A because it is free for most enrollees, and can serve as secondary hospital insurance that might pick up the costs not covered by your employer-provided health insurance.

Enrollment if you are NOT receiving benefits

If you are not yet collecting Social Security when you become eligible for Medicare at age 65, you must sign up yourself. You have three primary ways to enroll in Part A and Part B through the Social Security Administration (SSA):

Online: This is generally the fastest and easiest method.

By phone: You can call the SSA to apply or to schedule an appointment to apply in-person.

In person

Signing up for Medicare Advantage and Part D drug plans

Once you are enrolled in Medicare, you can choose to enroll in a Medicare Advantage plan or top up your original Medicare coverage with a Part D drug plan and/or Medigap insurance.

Part C - Medicare Advantage

Part D - Prescription drug coverage

Medigap - Medicare supplemental

Regardless of how you sign up, you must do so during a valid enrollment period to avoid potential late enrollment penalties.

Although most people become eligible for Medicare when they turn 65, not all people decide to enroll at this point. If you have employer-provided coverage through yourself or your spouse, you can delay enrolling until that coverage ends. As long as you have credible coverage, you won’t pay late enrollment penalties when you do switch to Medicare.

Initial Enrollment Period (IEP)

Special Enrollment Period (SEP)

General Enrollment Period (GEP)

You’re near the finish line

Whether you choose to apply online via SSA.gov, by phone, or through an appointment at your local SSA office, the key is to be proactive. Starting your preparation at least three months before your 65th birthday ensures a seamless transition without gaps in your healthcare.

Ultimately, while the technical steps are your gateway into the system, the peace of mind that comes with secure, lifelong health coverage is the real reward. Once your enrollment is confirmed, your next step is to look forward to your “Welcome to Medicare” visit, where you can partner with your doctor to build a personalized health care prevention plan for the years ahead.

(Donna LeValley is a retirement writer for Kiplinger.com.)

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