Turning 65 in Nebraska: A Month-by-Month Medicare Checklist

Turning 65 comes with a lot of mail and a few deadlines that actually matter. Miss the wrong one and you can pay a penalty for life or lose your easiest shot at a Medicare Supplement. Here's the timeline I walk people through, month by month, with the Nebraska details that apply.

When is your Initial Enrollment Period?

Your Initial Enrollment Period is the 7-month window to sign up for Part A and Part B: the 3 months before the month you turn 65, your birthday month, and the 3 months after. When your coverage starts depends on when in that window you sign up.

Here's an example for someone with a May 20, 2027 birthday:

That "month after you sign up" rule has applied since January 1, 2023. Before then, signing up late in the window could leave you waiting up to 3 months.

If your birthday is on the 1st, everything shifts a month earlier. The window starts 4 months before your birthday month and ends 2 months after, and early sign-ups start coverage the first day of the month before your birthday month. Plug your own birthday into my Medicare enrollment calculator, or read more about the Initial Enrollment Period.

Will you be enrolled automatically?

You will if you're already getting Social Security or Railroad Retirement benefits. Part A and Part B start the first day of the month you turn 65, and your Medicare card arrives about 3 months before your birthday. If you don't want Part B, maybe because you're still working, you have to tell Social Security before the start date on the card.

If you're not drawing Social Security yet, nothing happens automatically. You sign up through Social Security at SSA.gov or at a local Social Security office. Most people get Part A without a premium because they or a spouse worked and paid Medicare taxes long enough.

Not drawing Social Security also means your Part B premium isn't taken out of a check. You'll get a bill from Medicare, typically every 3 months. That first bill surprises people, because it covers three months at once and says "amount due." You can pay it online through your Medicare account, by mail, or set up automatic payments with Medicare Easy Pay.

What should you do each month before and after you turn 65?

Here's the checklist, using your birthday month as the anchor:

Can you delay Part B if you're still working?

Often, yes, if your coverage comes from current work at a big enough employer. The rule turns on the employer's size:

• 20 or more employees: the group plan pays first and Medicare pays second. You can usually delay Part B without a penalty. Many people still take Part A because most pay no premium for it, but read the HSA section below first.
• Fewer than 20 employees: Medicare pays first. If you skip Part B, your employer plan may pay very little, so sign up on time.

When the job or the coverage ends, whichever happens first, you get an 8-month Special Enrollment Period to sign up for Part B without a penalty. If you sign up while still covered, you can ask to delay your Part B start for up to 3 months.

Three types of coverage don't count as current employment coverage for this rule: COBRA, retiree coverage and VA coverage. The 8 months start when work ends, even if you take COBRA. And once you're 65 and eligible for Medicare, COBRA pays second. See COBRA vs Medicare, employer coverage vs Medicare and my full page on working past 65.

If you're retiring from a large Lincoln employer like the State of Nebraska, Lincoln Public Schools or the University of Nebraska-Lincoln, ask your benefits office in writing how any retiree coverage works once you have Medicare.

What about your HSA?

You can't contribute to a health savings account once you have Medicare, and that includes Part A. If you sign up for Part A after 65, it's usually retroactive up to 6 months, so stop contributions 6 months before you apply. Details are on HSAs and Medicare.

What will Medicare cost you at 65?

Here are the 2026 figures. CMS usually announces the 2027 amounts in November.

Higher income adds to your Part B and Part D premiums through IRMAA, based on your tax return from two years earlier. For 2027, that's your 2025 income, and the surcharge starts above $111,000 for single filers and $222,000 for married couples filing jointly. If your income dropped because you retired, you can ask Social Security to use the lower number. My IRMAA page explains how.

On top of that comes whatever you choose to fill the gaps: a Medicare Supplement plus a Part D plan, or a Medicare Advantage plan.

Should you pick a Medigap or Medicare Advantage at 65?

The timing makes 65 different from any other year. Your Medigap Open Enrollment Period is the one time Nebraska companies must sell you any Medigap plan they offer without health questions. Nebraska has no birthday rule to give you another shot later.

If you'd rather try Medicare Advantage first, you have a trial right. Join a Medicare Advantage plan when you're first eligible at 65, and you can leave within the first 12 months and buy a Medigap policy without health questions. My page on Medigap vs Medicare Advantage compares them, and Medigap open enrollment in Nebraska covers the rules.

What happens if you miss your enrollment window?

The penalties are permanent, so this is worth getting right:

• Part B: 10% for each full 12-month period you could have had Part B but didn't. Wait 2 full years and your premium is 20% higher for as long as you have Part B. You'd sign up during the General Enrollment Period, January 1 to March 31, with coverage starting the month after.
• Part D: if you go 63 days or more without creditable drug coverage, you'll pay 1% of the national base premium ($41.33 in 2027) for each month you went without.
• No Part B penalty if you qualified for a Special Enrollment Period, or if you enroll in a Medicare Savings Program.

My Part B penalty calculator shows what a delay would cost, and late enrollment penalties has worked examples.

Retiring before 65?

If you want to stop working at 62, health insurance is usually the hardest piece, especially the medications your employer plan was helping pay for. COBRA, the ACA Marketplace and a spouse's plan are the usual bridges. See health insurance if you retire before 65 and ACA Marketplace vs COBRA.

Where can you get help turning 65 in Nebraska?

You have good options, and you can use more than one:

• Social Security handles signing up for Part A and Part B, online at SSA.gov.
• Medicare.gov and 1-800-MEDICARE (1-800-633-4227) answer coverage questions 24 hours a day, 7 days a week (TTY 1-877-486-2048).
• Nebraska SHIP (formerly SHIIP) offers unbiased counseling at 1-800-234-7119.
• Aging Partners in Lincoln has benefits counselors who are certified SHIP counselors and help people 60 and older, at 402-441-7070.

My local pages for Lincoln, Omaha and Grand Island cover local details. When you'd like to sit down and build your own timeline, talk to me. My help costs you nothing.