Medicare Supplement

Medicare Timing at 65: First Steps for Charlotte Residents

If you're approaching 65 in Charlotte, your Medicare clock is already ticking. The good news: the rules are the same everywhere, and once you understand the timing, the decisions get much easier.

Charlotte, N.C. — Your 65th birthday brings a big decision window

Your first stop is the Initial Enrollment Period (IEP) — a seven-month window built around your 65th birthday. It starts three months before the month you turn 65, includes your birthday month, and ends three months after. Missing it can mean late penalties and gaps in coverage, so mark your calendar early.

Step 1: Know your seven-month window

The IEP has three parts, and the timing inside it matters:

• The three months before your birthday month: If you sign up here, your coverage can start the first day of your birthday month.
• Your birthday month: Coverage starts the following month.
• The three months after: Coverage starts the month after you enroll.

If you're already receiving Social Security benefits before 65, you'll usually be enrolled in Part A and Part B automatically. If not, you need to sign up yourself at SSA.gov or by calling Social Security.

Step 2: Understand the parts of Medicare

Before you pick anything, it helps to know what the letters mean:

• Part A covers hospital stays, skilled nursing, and some home health. Most people pay no premium.
• Part B covers doctor visits, outpatient care, and preventive services. It has a monthly premium.
• Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare, offered by private insurers approved by CMS.
• Part D covers prescription drugs, either as a standalone plan or bundled inside a Medicare Advantage plan.

Some people also add a Medigap (Medicare Supplement) policy to Original Medicare to help with out-of-pocket costs. You cannot have Medigap and Medicare Advantage at the same time.

Step 3: Still working? Check with your employer first

If you or your spouse has coverage through a current job, talk to the benefits office before you enroll. Depending on the employer's size and how their plan coordinates with Medicare, delaying Part B may be fine — or it may cost you a lifelong late penalty. Get the answer in writing when you can.

Step 4: Know what's changing in 2026

A few program-level facts you should have in mind as you compare drug coverage:

• The Part D out-of-pocket cap is $2,100 for 2026. Once your covered drug spending reaches that amount, you pay $0 for covered drugs the rest of the year.
• The Part D deductible can be no more than $615 in 2026 (plans can set it lower).
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments, at no extra charge. It's optional.
• IRMAA — the income-related surcharge on Part B and Part D — kicks in above $109,000 in income for a single filer in 2026 (based on your 2024 tax return).

Step 5: Look at what's available in Mecklenburg County

Medicare Advantage and Part D plan availability is set at the county level, not the city level. Charlotte is in Mecklenburg County, so when you use Medicare's Plan Finder, you'll be shown the plans available to Mecklenburg County residents. If you live just over the line in Union, Cabarrus, Gaston, or Iredell County, your options may look different — even if your ZIP code says Charlotte.

You can compare every plan in your county at Medicare.gov/plan-compare using your list of medications and your preferred pharmacies. Star Ratings — the 1-to-5 scores CMS publishes each fall — are one of several tools to help you judge plan quality and customer service.

Step 6: Mark the enrollment periods that come after IEP

Once you're in Medicare, two more windows matter each year:

• Annual Enrollment Period (AEP): Oct. 15 – Dec. 7. This is when anyone can join, switch, or drop a Medicare Advantage or Part D plan for the next year.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance to switch to another MA plan or drop back to Original Medicare.