Turning 65 in Minnesota: a Medicare checklist

Coverage always starts on the first of a month. Part A, which is premium-free for most people because they or a spouse worked at least 10 years in jobs that paid Medicare taxes, starts the month you turn 65. Part B depends on when you sign up:

If you have been getting Social Security or Railroad Retirement benefits for at least four months before you turn 65, you are enrolled in Part A and Part B automatically, and your Medicare card arrives about three months before your coverage starts. If you are keeping coverage from a current job and do not want Part B yet, follow the instructions that come with the card and send it back; keep the card and you keep Part B, premium and all. The next section is about when waiting is safe.

If you have not started Social Security, nothing happens on its own. You sign up with Social Security: online at SSA.gov, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or at a local office. If you or your spouse worked for a railroad, you sign up with the Railroad Retirement Board instead. Your card comes about two weeks after you sign up.

Whether you can wait on Part B depends on the employer whose plan covers you, yours or your spouse’s, and on whether you or your spouse still work there. If that employer has 20 or more employees, you can take premium-free Part A at 65 and put off Part B. (If you are still putting money into an HSA, you put off Part A as well; see the next section.) You can sign up any time while you or your spouse still work there, and for up to eight months after the job or the coverage ends, whichever comes first, with no penalty. If it has fewer than 20 employees, the job’s plan might not pay for your care unless you have both Part A and Part B, so ask the employer before you turn 65.

Three things do not count as coverage from a current job: COBRA, retiree coverage, and a MNsure or other individual plan. If one of those is what you will have at 65, sign up during your seven months. COBRA does not stretch the eight months either: they are counted from when the job or its coverage ends, not from when COBRA runs out.

When you retire, sign up for Part B the month before the job’s coverage ends, so the two meet without a gap. If you already have Part A, you can sign up online and have the employer fill out form CMS-L564, which shows you had job-based coverage. The plan also has to tell you, before your seven months and again before each fall’s Annual Enrollment, whether its drug coverage counts as creditable. Keep that notice: it is what protects you from the Part D penalty later.

One more reason not to take Part B early while you are on a good employer plan: your Supplement window starts the month Part B does, even while you still have the job’s coverage, and it can run out before you need a Supplement. Minnesota does give you a new six months if you drop Part B to go back on a job’s plan and sign up for it again later.

HSA contributions stop the first month you are enrolled in any part of Medicare, and that includes Part A you did not ask for: start Social Security at 65 or later and Part A comes with it. If you sign up for Medicare or Social Security after 65, premium-free Part A is backdated up to six months, though never earlier than the month you turned 65, and contributions made in those backdated months are excess contributions, which carry a tax penalty. So if you are working past 65 with an HSA, you and your employer should stop contributing six months before you apply for either one.

In the year Medicare starts, your limit is cut to the months before it. For 2027 the limits are $4,500 for self-only coverage and $9,000 for family coverage, plus $1,000 from age 55. If your Medicare starts July 1, 2027, you have six eligible months: up to $2,750 on self-only coverage ($4,500 plus $1,000, times 6 of 12).

The account stays yours. You can spend it tax-free on Medicare premiums and on deductibles, copays and other medical costs, but not on a Medicare Supplement’s premium, which the IRS leaves out.

With Part A and Part B in place, there are two ways to fill the gaps, and you can have one or the other, not both. A Medicare Supplement keeps Original Medicare paying first and picks up much of what it leaves, with any doctor in the country who takes Medicare and a separate Part D plan for drugs. A Medicare Advantage plan is a private plan you get your Medicare through instead: most have a network, every one has a yearly limit on what you pay for covered services, and most include drug coverage. Our Supplement vs. Advantage guide lays them side by side; what belongs here is the timing.

In Minnesota, Supplements are the state’s own Basic and Extended Basic plans rather than the lettered plans sold elsewhere, and premiums are not set by your age. The time to buy one is the six months starting the first month you have Part B. In that window a company cannot turn you down, charge you more, or leave out a condition because of your health, and Minnesota law protects an application made before Part B starts, too.

After those six months, a company can usually ask health questions and say no, with a few exceptions. Two are worth knowing now. If you join an Advantage plan when you first get Medicare at 65 and leave it within the first year, you can buy a Supplement with no health questions, as long as you apply no later than 63 days after the Advantage coverage ends. And since August 1, 2026, Minnesota gives people aged 65 to 70 one more chance, once, during Medicare’s open enrollment periods, which for most people means Annual Enrollment in the fall. That chance costs more: the premium is 15% higher for someone who uses it in the 2026 open enrollment period, rising five points a year to 35% from 2030, and the increase stays for as long as you keep the policy, on top of the company’s usual rate changes. The six months after Part B starts are still the window to plan around: no health questions and no surcharge.

If you choose Advantage, timing matters there too. Ask to join before your Part A and Part B start, and the plan starts the same day they do. And someone who joins an Advantage plan during their seven months can switch plans, or go back to Original Medicare, within the first three months they have Part A and Part B.

Supplements sold since 2006 do not include drug coverage, so the Supplement route means adding a separate Part D plan; most Advantage plans include it. Join during your seven months unless you have other drug coverage that counts as creditable, such as a current job’s plan. Go 63 days or more without creditable drug coverage after that, and a penalty is added to your Part D premium for as long as you have Medicare drug coverage: 1% of a national base premium for each month you went without.

For 2027, the most anyone pays out of pocket for covered Part D drugs is $2,400 for the year, and no plan can charge a deductible above $700 (in 2026, $2,100 and $615). Plans differ in which drugs they cover and what they charge for each, so the right plan is the one that fits your prescriptions. Bring the list, and we check it against the drug lists of the plans we compare.

Above certain incomes, Part B and Part D premiums carry an extra charge, the income-related monthly adjustment amount, or IRMAA. Social Security sets it from the most recent tax return the IRS gives it, which is generally the one from two years earlier: 2026 premiums generally used 2024 income, from returns filed in 2025. That can catch people who have just retired, because the return being used still shows a full salary. If your income has dropped because you or your spouse stopped working or cut back, you can ask Social Security to use the lower figure, with form SSA-44. Marriage, divorce and a spouse’s death count too.

If a MNsure plan is carrying you to 65, line the dates up so neither side lapses. Your MNsure tax credit ends once you are eligible for premium-free Part A, and a marketplace plan does not end on its own when Medicare starts: tell MNsure to end yours the day before Medicare begins. A younger spouse can stay on the MNsure plan. Our Medicare vs. MNsure guide goes through the household side.

In your first 12 months with Part B, Medicare covers a one-time “Welcome to Medicare” preventive visit: not a full physical, but a review of your history, screenings and vaccines, and you pay nothing if your provider accepts assignment. And every fall, Medicare Annual Enrollment runs October 15 to December 7. Plans can change their drug lists, networks and premiums from one year to the next, so the plan you pick at 65 is worth a second look each October.

In the order it comes up:

Pat and Spencer are licensed Minnesota insurance agents who work Medicare Advantage, Medicare Supplement and Part D plans. We go through your dates, your doctors and your prescriptions, compare the plans we offer, and enroll you when you are ready. There is no charge for the review. We are happy to meet at a coffee shop, at your house or at the office by appointment, or to do it by phone.

For free, unbiased help from the state, Minnesota’s State Health Insurance Assistance Program is the Senior LinkAge Line, 1-800-333-2433. Medicare itself is at Medicare.gov and 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), 24 hours a day, 7 days a week.