Turning 65 — Your Step-by-Step Guide to Medicare in New Jersey, New York, and Pennsylvania

Turning 65 is an important milestone. It is also when most Americans become eligible for Medicare. For many people in New Jersey, New York, and Pennsylvania, the process can feel confusing, especially with deadlines, coverage choices, and enrollment rules.

This guide explains what to expect and what steps to take so you can make informed decisions about your coverage.

Step One — Understand When Your Coverage Begins

Most people become eligible for Medicare on the first day of the month they turn 65. If your birthday falls on the first of the month, your eligibility begins on the first day of the previous month.

Your Initial Enrollment Period is a seven-month window:

• Three months before your birthday month

• Your birthday month

• Three months after your birthday month

This is the best time to enroll because it allows your coverage to begin on time and helps you avoid late enrollment penalties.

Starting early gives you more time to review your options carefully.

Step Two — Understand the Different Parts of Medicare

Medicare is made up of several parts. Each covers different services.

Part A — Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people do not pay a monthly premium for Part A if they worked and paid Medicare taxes for at least ten years.

Part B — Medical Insurance
Covers doctor visits, outpatient care, preventive services, and medical equipment. Part B has a monthly premium. In 2025, the standard premium is $185 per month, though some people pay more based on income.

Part C — Medicare Advantage
Offered by private insurance companies approved by Medicare. These plans combine Part A and Part B and often include prescription drug coverage and additional benefits.

Part D — Prescription Drug Coverage
Helps cover the cost of prescription medications. This can be added to Original Medicare or included in many Medicare Advantage plans.

Step Three — Decide Between Original Medicare and Medicare Advantage

When you first enroll, you will choose between two main paths.

Original Medicare (Part A and Part B)

• Allows you to visit most doctors and hospitals that accept Medicare nationwide

• Does not include prescription drug coverage automatically

• Does not have a yearly limit on out-of-pocket costs unless you add additional coverage

Medicare Advantage (Part C)

• Offered by private insurance companies approved by Medicare

• Often includes prescription drug coverage

• May include additional benefits such as dental, vision, or hearing

• Typically uses provider networks

Both options are valid. The right choice depends on your healthcare needs, budget, and preferences.

Step Four — If You Are Still Working at Age 65

If you are still working and have employer health insurance, you may be able to delay enrolling in Part B without penalty. This depends on the size of your employer and whether your coverage is considered creditable.

It is important to review your situation carefully before delaying enrollment, as missing the proper enrollment window can result in permanent penalties.

Step Five — How to Enroll

You can enroll in Medicare through the Social Security Administration in three ways:

• Online at ssa.gov

• By calling 1-800-772-1213

• By visiting your local Social Security office

If you are already receiving Social Security benefits before turning 65, you may be enrolled automatically. Your Medicare card will usually arrive by mail before your coverage begins.

Take Time to Understand Your Options

The decisions you make when you turn 65 can affect your healthcare coverage and costs for years to come. Understanding your choices helps you select coverage that fits your needs.

At Aegis Sage, we help Medicare beneficiaries in New Jersey, New York, and Pennsylvania understand their coverage, review their options, and prepare for enrollment.

Call (929) 888-7348 or visit aegissage.com to schedule a consultation.

Not affiliated with or endorsed by the government or Federal Medicare program. We do not offer every plan available in your area. Currently we represent multiple organizations which offer multiple products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Program (SHIP) to get information on all your options.