Medicare Coverage

When Does Medicare Start? A Guide for Older Adults

Medicare coverage begins based on your birthday, not a fixed calendar date. Understanding exactly when your coverage starts, and what to do to avoid late penalties, can save you significant money and stress. Here is what you need to know.

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Eligibility

Medicare starts at 65 for most people.

For most Americans, Medicare eligibility begins on the first day of the month you turn 65. If your birthday falls on the first of the month, your coverage begins on the first of the previous month.

You are automatically enrolled in Medicare Part A and Part B if you are already receiving Social Security benefits. If you are not receiving Social Security, you need to actively enroll. According to the Centers for Medicare and Medicaid Services, your Initial Enrollment Period is a 7-month window: the 3 months before your 65th birthday month, your birthday month itself, and the 3 months after.

Enrollment windows

Do not miss your Initial Enrollment Period.

Missing your Initial Enrollment Period can result in a permanent late enrollment penalty on your Part B premium (an extra 10% for each 12-month period you were eligible but did not enroll). The only exception is if you have coverage through an employer or union plan that qualifies as creditable coverage.

After your Initial Enrollment Period, you can enroll during the General Enrollment Period (January 1 to March 31 each year), with coverage beginning July 1. Special Enrollment Periods are available if you lost employer coverage.

What Medicare covers

Mental health therapy is covered under Part B.

Medicare Part B covers outpatient mental health services, including individual therapy, group therapy, psychiatric evaluation, and telehealth sessions from home. After meeting your annual deductible, Medicare pays 80% of the approved amount. Most Medicare Advantage and Medigap supplement plans cover the remaining 20%.

This means that for most older adults with supplemental coverage, therapy through Total Life costs $0 out of pocket. Learn more about finding a therapist that accepts Medicare.

Medicare Advantage

Part C: an alternative way to get your Medicare benefits.

Medicare Advantage (Part C) plans are offered by private insurers and must cover everything Original Medicare covers, plus they often include additional benefits such as dental, vision, and enhanced mental health benefits. If you are approaching 65 and considering a Medicare Advantage plan, compare plans during your Initial Enrollment Period or during the Annual Open Enrollment Period (October 15 to December 7).

Most Total Life patients pay $0 out of pocket.

Covered by Medicare. Licensed therapists who specialize in adults 65+. Matched within 48 hours.

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Common questions

Frequently asked questions

When exactly does Medicare start on your birthday? +

For most people, Medicare begins on the first day of the month you turn 65. If your birthday is on the first of the month, Medicare starts on the first of the previous month.

What happens if I miss my Medicare enrollment window? +

Missing your Initial Enrollment Period typically results in a permanent late enrollment penalty added to your Part B premium. You can still enroll during the General Enrollment Period (January 1 to March 31), with coverage starting July 1.

Does Medicare cover mental health therapy? +

Yes. Medicare Part B covers outpatient mental health services including individual therapy, group therapy, and telehealth sessions from home. Most patients with supplemental insurance pay $0 per session.

Can I get Medicare before 65? +

Yes. You may qualify for Medicare before 65 if you have received Social Security Disability Insurance for 24 months, or if you have ALS (amyotrophic lateral sclerosis) or end-stage renal disease.

What is the difference between Medicare Part A and Part B? +

Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health care. Medicare Part B covers outpatient medical services, including doctor visits, preventive care, and mental health therapy.

Total Life is a Medicare provider. We are not affiliated with, endorsed by, or part of Medicare or any government agency.

Sources: Medicare.gov | Centers for Medicare and Medicaid Services