Turning 65 in Ohio: your Medicare checklist

When is my Initial Enrollment Period?

Your Initial Enrollment Period (IEP) is 7 months long: the 3 months before the month you turn 65, your birthday month, and the 3 months after. When your coverage starts depends on when you sign up:

• In the 3 months before your birthday month: coverage starts the first day of your birthday month.
• In your birthday month or the 3 months after: coverage starts the first day of the month after you sign up.

If you miss your IEP and don't have job-based coverage from current work, you may have to wait for the General Enrollment Period (January 1 to March 31) and pay a Part B late penalty of 10% for each full 12 months you could have had Part B, for as long as you have it. See Medicare enrollment periods.

What should I do month by month?

1. 12 to 6 months before: gather your information. List your doctors, prescriptions and pharmacy. Create a my Social Security account at ssa.gov/myaccount and check your work record. If you'll retire from an Ohio public job, watch for mail from your retirement system; OPERS, for example, says its Medicare Connector vendor starts writing 12 months before your 65th birthday and OPERS sends its own letter 5 months before.
2. 4 months before: decide on Part B timing. If you or your spouse are still working with job-based coverage, ask the employer's benefits office whether that plan pays first and whether you should delay Part B. See working past 65.
3. 3 months before: sign up. Your IEP opens. Sign up for Part A and Part B with Social Security, unless you're enrolled automatically or are delaying Part B because of coverage from current work.
4. 2 to 1 months before: choose your coverage. Decide between Original Medicare with a Medigap policy and a Part D plan, or a Medicare Advantage plan sold in your county. If your retirement system offers or requires its own Medicare plan, follow its steps. Apply so coverage starts with your Medicare.
5. Your birthday month: coverage starts. If you signed up early, Medicare starts the first of the month. Your 6-month Medigap open enrollment period starts when your Part B does. Send your retirement system a copy of your Medicare card if it asks.
6. 3 months after: your IEP ends. This is the last month to sign up without waiting, and your first chance to join a Part D or Medicare Advantage plan ends, unless you have other creditable coverage.
7. 6 months after Part B starts: your Medigap window closes. Ohio has no birthday rule or yearly switching right, so this is your one guaranteed chance to buy any Medigap policy without health questions.

What if I already get Social Security?

If you get Social Security or Railroad Retirement benefits at least 4 months before you turn 65, you're enrolled in Part A and Part B automatically, and your Medicare card arrives about 3 months before your coverage starts. The Part B premium ($202.90 a month for most people in 2026) is usually taken out of your benefit. If you have job-based coverage from current work and want to delay Part B, follow the instructions that come with the card.

How do I sign up in Ohio?

Social Security handles Medicare sign-up. You can:

• Apply online at ssa.gov/medicare/sign-up.
• Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
• Visit a Social Security office. Ohio has offices in every region of the state; find the nearest with Social Security's office locator.

Ohio public retirees: OPERS, STRS Ohio, SERS, OP&F and HPRS

Ohio's public employees generally don't pay into Social Security on their public jobs, so many aren't enrolled in Medicare automatically. Those hired after March 31, 1986 paid the Medicare tax, which usually earns premium-free Part A. Each system has its own rules:

• OPERS: Medicare-eligible benefit recipients must enroll in Parts A and B, then choose an individual Medigap or Medicare Advantage plan through the OPERS Medicare Connector to receive monthly HRA deposits. If you don't qualify for premium-free Part A, OPERS requires you to buy it and reimburses the premium. See OPERS and Medicare.
• STRS Ohio: medical plan enrollees must enroll in Part B, and in Part A if it's premium-free, when first eligible; declining ends STRS Ohio medical coverage (OAC 3307:1-11-03). See STRS Ohio and Medicare.
• SERS: everyone joining SERS's Medicare coverage must enroll in Part B and send SERS proof of it; coverage starts the month after SERS receives it. See SERS and Medicare.
• OP&F and HPRS: see OP&F and Medicare and HPRS and Medicare.

Retirement-system benefit amounts change every year; each system publishes its current amounts in its own guide. Compare them on OPERS vs. STRS vs. SERS retiree coverage.

What if I'm still working at 65?

If you or your spouse are still working and have health coverage from that job, the employer's size decides who pays first. With 20 or more employees, the job-based plan pays first and you can usually delay Part B without a penalty; you get 8 months to sign up after the job or the coverage ends. With fewer than 20, Medicare usually pays first. COBRA and retiree coverage don't count as coverage from current work. See working past 65.

When should I buy Medigap?

Your best chance is your Medigap open enrollment period: the 6 months starting the first month you're both 65 and enrolled in Part B (OAC 3901-8-08). During it, any company selling Medigap in Ohio must sell you any policy it offers, without health questions. After it ends, Ohio has no birthday rule and no annual right to switch, so a company can usually review your health and decline you, unless a federal guaranteed-issue right applies (for example, your Medicare Advantage plan leaves your area). A bill to add an Ohio birthday rule has been proposed; it is not law.

That's why the Medigap-or-Medicare-Advantage choice at 65 matters more in Ohio than in birthday-rule states. If you choose Medicare Advantage first, you have a 12-month trial right to switch back to Original Medicare and buy Medigap with a guarantee. You also get a 30-day free look on any new Medigap policy to return it for a refund. See Medigap in Ohio and Medigap vs. Medicare Advantage in Ohio.

Do I need Part D now?

If you choose Original Medicare, join a standalone Part D plan during your IEP unless you have other creditable drug coverage, such as from a current employer, VA or TRICARE. Otherwise you may pay a late enrollment penalty for as long as you have Part D. Ohio is its own Part D region, and CMS lists 9 standalone Part D plans from 5 companies in Ohio for 2027. Most Medicare Advantage plans include drug coverage. See Part D in Ohio.

Can I get help paying costs?

Veterans and military retirees

VA health care and Medicare generally don't pay for the same service: the VA pays for care at VA facilities, and Medicare pays for Medicare-covered care elsewhere. Many veterans keep Part B so they can also see providers outside the VA. If you have TRICARE, you generally need Part A and Part B to keep TRICARE For Life once you're eligible for Medicare. See veterans, TRICARE and military retirees in Ohio.

Your turning-65 checklist

1. Mark your IEP dates. Put the first and last months on your calendar, plus the end of your 6-month Medigap window.
2. Sign up for Part A and Part B. Apply with Social Security, or confirm you're enrolled automatically.
3. Check your other coverage. Call your employer, your Ohio retirement system, the VA or TRICARE.
4. Choose your coverage. Original Medicare with Medigap and Part D, or Medicare Advantage.
5. Check for help paying. See if you qualify for a Medicare Premium Assistance Program or Extra Help.
6. Keep your papers together. Your Medicare card, letters, creditable coverage notices and your retirement system's confirmations.

When you're ready to look at coverage, see plans for your ZIP code, or you can request a call from a licensed insurance agent to go over plans from the companies they work with. See also Medicare eligibility and Medicare basics.

Sources

• Medicare.gov — When does Medicare coverage start?
• Medicare.gov — How do I sign up for Medicare?
• Social Security — Sign up for Medicare
• Social Security — Office locator
• Social Security — Mandatory Medicare coverage for state and local government employees
• Medicare.gov — Avoid late enrollment penalties
• Medicare.gov — When can I buy Medigap?
• Ohio Administrative Code 3901-8-08 — Medicare supplement (open enrollment, guaranteed issue, free look)
• Ohio Legislature — House Bill 24 (136th General Assembly), status
• OPERS — 2026 Health Care Program Guide (Medicare enrollment timeline)
• Ohio Administrative Code 3307:1-11-03 — STRS Ohio medical plan
• SERS — 2027 Member Healthcare Guide
• Ohio Administrative Code 5160:1-3-02.1 — Medicare premium assistance programs
• TRICARE — TRICARE For Life

Frequently asked questions

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