Turning 65? Your Complete Florida Medicare Checklist

Section 1

Know Your Initial Enrollment Period

For most people who become eligible for Medicare at age 65, the Initial Enrollment Period lasts seven months:

• Three months before the month you turn 65
• The month you turn 65
• Three months after the month you turn 65

Starting early gives you time to understand your options and avoid rushing into a decision.

If your birthday is on the first day of a month, Medicare generally treats you as reaching age 65 during the previous month for enrollment and effective-date purposes.

Coverage start dates can depend on when you enroll. Confirm your specific effective date through Social Security or Medicare before ending any other health coverage.

Section 2

Determine Whether You Need to Enroll Yourself

Some people are enrolled automatically, while others must actively apply.

People who are already receiving Social Security or Railroad Retirement Board benefits before age 65 may be enrolled automatically in Medicare Part A and Part B. Those who are not receiving those benefits usually need to apply.

Watch for your Medicare card and enrollment information. Do not assume enrollment is automatic in every situation.

Section 3

Decide Whether to Enroll in Part B Right Away

You may be able to delay Part B without a penalty when you have qualifying employer group health coverage based on your own current employment or your spouse's current employment.

Before delaying Part B:

• Ask the employer benefits administrator how the plan coordinates with Medicare
• Confirm that the coverage is based on current employment
• Ask whether Medicare would pay first or second
• Compare the employer premium and benefits with Medicare options
• Keep documentation showing when employment and coverage begin and end
• Review HSA contribution rules before enrolling in any part of Medicare

COBRA, retiree coverage, Marketplace coverage, and coverage that is not based on current employment may follow different rules. Do not assume they allow you to delay Part B safely.

If current employment or the related group coverage ends, a person may qualify for a Part B Special Enrollment Period. The timing rules should be confirmed before employment or coverage ends.

Section 4

Understand the Main Parts of Medicare

Section 5

Choose How You Want to Receive Medicare Benefits

Neither path is automatically best for everyone.

Section 6

Review Your Doctors and Healthcare Facilities

Create a list of:

• Primary care physician
• Specialists
• Preferred hospital
• Outpatient facilities
• Therapy providers
• Durable medical equipment suppliers

For Medicare Advantage, verify participation directly with both the provider and the plan when possible.

Do not rely only on an old directory or assume that a provider who accepts one plan from an insurance company accepts every plan from that company.

Section 7

Review Your Prescription Medications

List every medication, including:

• Exact drug name
• Dosage
• Quantity
• Frequency
• Preferred pharmacy

Then check:

• Whether each drug is on the formulary
• Its tier
• Estimated cost
• Whether prior authorization applies
• Whether step therapy applies
• Whether quantity limits apply
• Which pharmacies offer preferred cost sharing

The lowest monthly premium does not always produce the lowest total prescription cost.

Section 8

Compare Total Expected Costs

Do not compare plans based only on the premium.

Consider:

• Part B premium
• Additional plan or policy premium
• Deductibles
• Copayments
• Coinsurance
• Prescription costs
• Maximum out-of-pocket exposure under Medicare Advantage
• Expected use of specialists, hospitals, therapy, and medical equipment
• Travel needs

The best fit is based on the overall combination of access, protection, predictability, and cost.

Section 9

Understand Medigap Enrollment Timing

Under federal rules, the Medigap Open Enrollment Period generally lasts six months and begins the first month a person is both age 65 or older and enrolled in Medicare Part B.

During this period, a person generally has stronger federal protections when purchasing a Medigap policy.

Outside that period, eligibility, pricing, and medical underwriting may depend on applicable federal protections, Florida law, and the insurance company's rules.

Section 10

Documents and Information to Gather

• Social Security information
• Medicare card, if received
• Current health insurance information
• Employer benefits contact information
• Prescription list
• Preferred pharmacy
• Doctors and specialists
• Preferred hospitals
• HSA information, if applicable
• VA, TRICARE, retiree, Medicaid, or other coverage information
• Expected retirement or employer-coverage end date

Section 11

Common Medicare Mistakes to Avoid

• Missing an enrollment deadline
• Assuming all employer coverage allows Part B to be delayed
• Treating COBRA as active-employment coverage
• Canceling existing coverage before confirming Medicare's effective date
• Choosing a plan before checking doctors and prescriptions
• Selecting coverage based only on premium or advertised extra benefits
• Ignoring Part D because no medications are currently taken
• Assuming a Medigap policy can always be purchased later without underwriting
• Failing to review coverage annually
• Making HSA contributions after Medicare eligibility without reviewing the tax rules

Section 13

Questions to Ask Before Choosing Coverage

• Are my doctors and specialists available?
• Is my preferred hospital available?
• How are my prescriptions covered?
• What could I pay during a high-use healthcare year?
• Will the coverage work when I travel?
• Are referrals or prior authorizations required?
• What happens if my health needs change?
• Am I comfortable with the provider network?
• Could I qualify for Medigap later if I change my mind?
• When will the new coverage begin?