Turning 65 in Florida: 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 and When should I sign up if I'm turning 65 in Florida?

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 split the year between Florida and another state, decide which home is your permanent residence: Medicare Advantage and Part D plans are tied to it.
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. If your income is limited, apply for a Medicare Savings Program through ACCESS Florida at the same time.
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. State Group Insurance retirees: decide whether to stay in the State plan or move to one of the State's group Medicare Advantage plans.
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.
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. Florida has no birthday rule or yearly switching right, so this is your main guaranteed chance at 65 or older to buy a 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.

About 88.5% of Florida's state and local government workers were covered by Social Security on their jobs in 2023 (Congressional Research Service), so most Florida teachers and public employees qualify for premium-free Part A and follow the same rules as private-sector workers. If you retired early and already claimed Social Security, expect your card in the mail. If you're waiting to claim, you must sign up yourself.

How do I sign up?

Social Security handles Medicare sign-up. No Florida agency does. You can:

• Apply online at ssa.gov/medicare/sign-up (the online application is in English only).
• Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Press 7 for Spanish.
• Visit a Social Security office. Find the nearest with Social Security's office locator.

If you're a lawful permanent resident, see Can I get Medicare as a permanent resident in Florida?

State Group Insurance retirees turning 65

If you retired from the State of Florida and kept coverage through the State Group Insurance Program (run by the Department of Management Services, with enrollment through People First), turning 65 changes how your plan works:

• Your State plan becomes secondary. The State says its health plan pays after Medicare "even if you fail to enroll in Part B." Without Part B, you'd pay the share Medicare Part B would have paid, about 80% of Part B-covered costs. The State says it's in your financial interest to enroll in Part B.
• Two paths. Stay in a State Group Insurance PPO or HMO plan that pays after Medicare and includes drug coverage, or join one of the State's group Medicare Advantage and prescription drug (MA-PD) plans. MA-PD enrollment is optional and open year-round, and the State says you will never be called to enroll.
• To join an MA-PD, People First must receive your Medicare card showing Part A and Part B. Requests received after the 20th of a month take effect the first day of the second month after. For family coverage, everyone on the policy must have Medicare.
• No separate Part D needed if you keep the State's secondary plan: the State says its drug coverage is creditable.
• Don't drop it lightly. A retiree who cancels State coverage or lets it lapse can't re-enroll later.

Call People First at 866-663-4735 (TTY 866-221-0268). Florida Retirement System retirees may also qualify for the Health Insurance Subsidy (HIS), a monthly payment based on years of service that helps with health insurance costs; you certify your coverage with the FRS. Retirees of counties, cities and school districts can by law stay in their former employer's group plan, often paying the premium; ask that employer how its plan works with Medicare. See Florida state retirees and Medicare.

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. When your group coverage ends, Florida also gives you 2 months to buy Medigap without health questions. 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. During it, companies selling Medigap in Florida must sell you a policy without health questions. After it ends, Florida has no birthday rule and no annual right to switch, so a company can usually review your health and decline you, unless a guaranteed-issue right applies.

Florida law (Florida Statutes, Chapter 627, Part VIII) adds protections:

• 2-month group-coverage window: if your group health coverage ends while you're in Part B, you have 2 months to buy a Medigap policy without health questions (s. 627.6741).
• No attained-age pricing: Florida doesn't allow Medigap premiums that rise automatically as you age (s. 627.410). Premiums can still go up for everyone in a plan, and the Office of Insurance Regulation must approve rate increases first.
• 30-day free look: you can return a new policy within 30 days for a full refund (s. 627.674).
• Pre-existing conditions: a policy can't exclude a pre-existing condition for more than 6 months, and the wait is shortened or waived if you had prior creditable coverage (s. 627.6741).

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. To see sample Medigap rates filed in Florida, the Office of Insurance Regulation has a CHOICES rate comparison tool. See Medigap in Florida and Medigap vs. Medicare Advantage in Florida.

How many plans can I choose from?

It depends heavily on your county. For 2027, CMS lists 297 Medicare Advantage plans open to everyone in Florida from 22 companies. A resident of Miami-Dade County can choose from {{fl:plans.counties.Miami-Dade.ma:n}} of them and a resident of Sumter County, home to most of The Villages, from 48, while Monroe County has 7. Florida is its own Part D region, with 11 standalone Part D plans from 6 companies. Check your county on the county pages, and see Medicare Advantage in Florida and Part D in Florida.

Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.

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, State Group Insurance, the VA, TRICARE or an Indian health program. Otherwise you may pay a late enrollment penalty for as long as you have Part D.

Splitting the year between Florida and another state?

Original Medicare and Medigap work with any doctor or hospital that takes Medicare anywhere in the U.S. Medicare Advantage and Part D plans are tied to your permanent residence: a plan can ask for proof such as your driver's license, voter registration, tax records or utility bills. A Medicare Advantage plan must disenroll you if you're away from its service area more than 6 months (up to 12 if it offers a visitor or traveler program), and a Part D plan after more than 12 months. Emergency and urgent care are covered nationwide in Medicare Advantage. If Florida is becoming your permanent home, see moving to Florida with Medicare and snowbirds and Medicare.

Can I get help paying costs?

Veterans and military retirees

If you have TRICARE, you need Part A and Part B to keep TRICARE For Life once you're eligible for Medicare. VA health care and Medicare are separate; you can have both, and many veterans keep Part B so they can see providers outside the VA. See military, veterans and TRICARE in Florida.

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, People First for State Group Insurance, your former local government employer, the VA or TRICARE.
4. Settle your permanent address. If you live in two states, choose the one that's your permanent residence before picking a plan.
5. Choose your coverage. Original Medicare with Medigap and Part D, or Medicare Advantage, or your State Group Insurance option.
6. Check for help paying. See if you qualify for a Medicare Savings Program or Extra Help.
7. Keep your papers together. Your Medicare card, letters, creditable coverage notices and any People First 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 — Sign up for Medicare
• Social Security — Sign up for Medicare
• Social Security — Inscríbase en Medicare (Spanish; online application in English only)
• Social Security — Office locator
• Medicare.gov — Avoid late enrollment penalties
• CMS — Choosing a Medigap Policy (March 2026)
• Florida Statutes — s. 627.6741, Medigap open enrollment and group-coverage window
• Florida Statutes — s. 627.410, rating practices (attained-age pricing)
• Florida Statutes — s. 627.674, 30-day free look
• Florida Office of Insurance Regulation — CHOICES rate comparison
• Florida Division of State Group Insurance — Retirees
• Florida Division of State Group Insurance — Retiree FAQ
• Florida Division of State Group Insurance — Medicare Advantage and Prescription Drug plans
• Florida Statutes — s. 112.363, FRS Health Insurance Subsidy
• Florida Statutes — s. 112.0801, local government retirees' group coverage
• CMS — MA and Part D Enrollment and Disenrollment Guidance, CY2027 (permanent residence, time away)
• Florida Department of Children and Families — Public assistance (ACCESS Florida)
• Florida DCF — Appendix A-9.1, Medicare Savings Programs and LIS financial standards (April 2026)
• Florida DCF — ESS Policy Manual, Chapter 2000 (MEDS-AD, QMB, SLMB, QI-1)
• KFF — Status of State Medicaid Expansion Decisions
• Congressional Research Service — Social Security Coverage of State and Local Government Employees (R46961)
• TRICARE — TRICARE For Life
• CMS — CY2027 Medicare Advantage and Part D Landscape files

Frequently asked questions

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