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Turning 65 & Medicare
Written By John O'Hara 6/11/2025
Key Points
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Everyone has different Medicare needs when approaching 65
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You don't always have to make Medicare your primary insurance at 65
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Medicare Penalties can be avoided with proper guidance
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Assess all of your secondary options before you decide on a Medicare secondary plan
Introduction
Congratulations on turning 65! While it may seem crazy that you've gotten to this point, you may now join Medicare – and many people are shocked at how great Medicare can be! Let NJ Life and Health guide you through what to expect when you reach 65.
When Do I Start Medicare?
Despite what you may have read, in many cases you do not have to make Medicare your primary insurance at 65. And if you have a little bit of help and direction, avoiding the dreaded Medicare penalties is easy!
There are many variables to consider when turning 65. Do you have work insurance? Does your spouse? Are you on insurance from the marketplace with a subsidy? Do you have retiree coverage from your employer?
We're confident the best way to decide if you should go onto Medicare is to sit with one of our brokers and get a full Medicare education. Once you get that education, we will go over all your options based on your unique situation. We will compare your monthly premiums, deductibles, drug costs, and most importantly your Maximum Out-of-Pocket costs with each option available to see which is best for you.
Do I Have to Take Medicare When I Turn 65?
It depends! If you have creditable employer coverage through you or your spouse's current employment, you may not have to join Medicare when you turn 65. In general, “creditable” employer insurance is offered by an employer that has more than 20 employees. When you have creditable employer insurance, you can typically keep that insurance until you are ready to retire without accruing any Medicare penalty. Many insurance agents and brokers incorrectly discuss Medicare penalties to scare people into taking Medicare earlier than needed. The truth is, you won't accrue Medicare penalties if you have creditable employer coverage and sign up correctly in the future.
While you don't have to join Medicare at 65 if you have creditable employer coverage, we highly recommend considering it. Many people love Original Medicare or Medicare Advantage and find it has better coverage or is more cost effective than their current work insurance.
If you are not offered credible employer-based insurance, you will likely need to join Medicare at 65. Situations in which you must join Medicare at 65 to avoid penalties include:
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You don't have creditable employer coverage at 65 (your employer offering you insurance has less than 20 employees)
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You are on a Marketplace health plan from Healthcare.gov or Get Covered NJ
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You are self-employed or purchased your own private insurance
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You are losing Medicaid
How To Sign Up For Medicare
Social Security manages Medicare. You can sign up for Medicare in many ways, but we recommend doing so through the www.ssa.gov online portal. You also can schedule an appointment with Social Security over the phone or in person, but those options often take longer than the online application. If you elected to take Social Security before age 65, you will automatically be signed up for Medicare.
We have helped hundreds of people sign up for Medicare correctly each year and are happy to help you do the same! Please schedule an appointment with one of our trusted brokers today to guide you through the process and make it as easy as possible. Or call our Toms River office at 848-226-6897.
Medicare Secondary Plan Options
While Original Medicare is great, the vast majority of Medicare enrollees get additional Medicare secondary plans to get extra coverage and benefits.
Which option you choose is a big decision that you should consider in depth before joining Medicare because not all options may be available to you after turning 65.
We highly recommend working with our team of licensed brokers who specialize in Medicare secondary plans. Please schedule an appointment with one of our team members today to guide you through the process and assess all of your options. Or call our Toms River office at 848-226-6897.
To learn more about the different secondary plans available to you, read some of our articles below:
Medicare Supplements (or Medigap) plans help eliminate your Out-of-Pocket Hospital and Medical costs under Original Medicare for a reasonable monthly premium.
Medicare Prescription Drug Plans offer prescription coverage, which Original Medicare does not cover.
Medicare Advantage plans bundle coverage for hospitals, medical care, prescriptions, and more. These plans often also provide dental, vision, gym memberships, and other benefits not covered by Original Medicare.
Medicare Disability at 65
If you are on Medicare Disability, you have already enrolled in Medicare prior to turning 65. You are in luck because you now get another Initial Enrollment period to assess your Medicare options!
If you would like to take a Medicare Supplement for the first time or would like to switch Medicare Supplements, you can do so without having to answer any health questions. You will also have some new Medicare supplement plan options available to you.
Call our team at 848-226-6897 to make the transition from Medicare Disability to Medicare at 65 as easy as possible.
For more information, click the link to our article: Medicare Disability
Medicare & Medicaid at 65
When you turn 65 and are on Medicaid, you may become "Dual Eligible." Dual Eligibility is for people who are eligible for both Medicare and Medicaid. You can enroll in dual-eligible plans that may include extra benefits that Medicare and Medicaid, individually, do not cover.
When you turn 65, the standards for keeping Medicaid may rise. Be sure to check your Medicaid enrollment status to see if you can continue receiving it.
Many people, especially those in New Jersey, are no longer eligible for Medicaid upon becoming eligible for Medicare. You can lose Medicaid eligibility at 65 or earlier upon enrolling in Medicare Disability.
Call our team at 848-226-6897 or schedule your appointment to see if you will be able to maintain Medicaid status at 65. We can also help you look around for dual-eligible plans!
For more information, click on the link to our article: Medicaid
About the Author
John O'Hara is the President of NJ Life and Health. He has personally helped hundreds of people with their Medicare needs across several states. He also has given dozens of Medicare Seminars across the state of New Jersey!