Understanding Medicare’s New “Turning 65” Enrollment Rules and Applying with Spousal Benefits

Toni,

My issue regarding how to enroll in Medicare is different from any problem that I have read in the Toni Says Medicare column. I heard from a friend who received an email from Medicare.gov last year that there are new “turning 65” enrollment rules.

I have rheumatoid arthritis and will turn 65 on February 20. I need my Medicare to begin by May 1 because my husband is retiring and losing his company benefits, effective May 1.

I don’t work due to my health issues and do not have enough work quarters to receive Medicare on my own. I do not know how to apply using my husband’s Medicare benefits. What do I do?

Heather from Nashville, TN

Hi Heather,

To ensure you enroll in Medicare correctly, it’s important to understand the eligibility requirements, especially if you haven’t accumulated the necessary 40 quarters of work and tax payments under your own Social Security number. In this case, you’ll need to qualify for Medicare under your husband’s Social Security number if he meets the eligibility criteria. Here’s what to do:

To get started with the Medicare enrollment process, reach out to your local Social Security office or contact Social Security directly at 1-800-772-1213. They will guide you on how to arrange an appointment, either over the phone or at a nearby Social Security office. During this appointment, you can inquire about applying under your husband’s work record. Remember to bring your “original” certified marriage license as proof of your current marital status when meeting with Social Security. They will provide you with all the necessary information and requirements to ensure a smooth enrollment process.

Prior to talking with a Social Security representative, set up a www.ssa.gov account. Social Security may want you to enroll in Medicare online when talking with the representative who is guiding you through this process.

What Are the “New Turning 65” Rules?

The changes that your friend mentioned regarding the “new turning 65” rule began on January 1, 2023, and refers to your Initial Enrollment Period (IEP). Medicare’s IEP is the time you’re first eligible to sign up. This is the 3 months before you turn 65, the month you turn 65, and the 3 months after turning 65 (Chapter 1 of my Medicare Survival Guide Advanced edition explains in more detail).

The big thing to know is that coverage will now be effective the first of the month after the month of enrollment for individuals who enroll in the last three months of their Initial Enrollment Period. This change is designed to provide more flexibility when it comes to enrolling in Medicare and ensuring you have the necessary coverage without any significant delays (or, more commonly referred to as coverage gaps).

Let’s use Heather’s situation to further explain how your Initial Enrollment Period works:

Remember, she’s turning 65 on February 20.

• If you enroll 3 months before turning 65, then your Medicare coverage begins the first day of the month of your birthday. Heather can enroll in November, December, or January, and her coverage will begin February 1.
• If you enroll the month you turn 65, then your Medicare coverage will begin the first day of the following month. Heather can enroll in February, and her coverage will begin March 1.
• If you enroll one month after you turn 65, then your Medicare coverage will begin the first day of the following month. Heather can enroll in March, and her coverage will begin April 1.
• If you enroll two months after you turn 65, then your Medicare coverage will begin the first day of the following month. Heather can enroll in April, and her coverage will begin May 1.
• If you enroll three months after you turn 65, then your Medicare coverage will begin the first day of the following month. Heather can enroll in May, and her coverage will begin June 1.

Heather, you want your Medicare to begin May 1, so the first of April is when you would want to schedule your appointment with your local Social Security office. Explain your enrollment situation of not having enough quarters and enroll in Medicare during that meeting. I would advise you to bring your Social Security card, driver’s license, and especially your original marriage license. Your husband should attend the meeting as well, since you will be using his Social Security information.

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