Turning 65 in Washington State: your Medicare starter guide

Turning 65 comes with a stack of Medicare mail and a few decisions that matter for the rest of your life. Here is the plain-English version — what to do, when, and which deadlines you really don’t want to miss — with the Washington twists that most guides leave out. When you are ready, we walk through your specific options at no cost.

1. Your enrollment window: the 7-month Initial Enrollment Period

Your Initial Enrollment Period (IEP) is seven months long: the three months before the month you turn 65, your birthday month, and the three months after. Signing up in the three months before your birthday means coverage starts the first of your birthday month. You enroll through Social Security (online at ssa.gov, by phone, or at an office); if you already draw Social Security you are enrolled in A and B automatically.

• Part A (hospital) is premium-free for most people, so most enroll when first eligible.
• Part B (medical) carries the $202.90 standard monthly premium in 2026 — and a timing decision if you are still working (see below).

2. The parts of Medicare, briefly

• Part A — inpatient hospital, skilled nursing, hospice.
• Part B — doctors, outpatient care, preventive services.
• Part C (Medicare Advantage) — a private all-in-one alternative that bundles A, B and usually drug coverage, sold by county.
• Part D — prescription drug coverage.
• Medigap — a supplement that pairs with A and B and works anywhere in the country.

3. Your big decision: two paths

Where you live, and which system your doctors belong to, tilts the answer. In King, Pierce, Snohomish, Spokane and Clark counties the Advantage menu is deep, and the question is whether UW Medicine, Providence Swedish, MultiCare, Virginia Mason Franciscan or Kaiser Permanente Washington is inside the plan you like. East of the Cascades, on the Olympic Peninsula and along the coast, the menu is short and the nearest specialist may be a long drive, and a Medigap policy’s any-provider access is often the practical choice. Military retirees with TRICARE For Life are a third case; see Veterans.

If you lean toward a supplement, the second deadline is easy to miss: your Medigap open enrollment is its own six-month window, separate from the seven-month one above. Washington’s year-round switching rule means you will never be trapped in the wrong Medigap plan once you have one — but getting in without health questions still depends on using this window or a guaranteed-issue event. Our research site sets the two windows side by side: turning 65 in Washington.

4. Deadlines that carry lifelong penalties

5. Still working at 65?

If you (or your spouse) have qualifying employer coverage, you may be able to delay Part B without penalty and get a Special Enrollment Period when that coverage ends. The rules depend on employer size (20 or more employees is the usual line) and whether the drug coverage is creditable. Washington’s big employers — Boeing, Microsoft, Amazon, the state and its universities, the school districts, the health systems, the ports and the utilities — generally qualify; a small business, a retiree plan, or COBRA may not. It is worth a quick conversation before you decide, and a form (CMS-L564) from your employer when you do enroll. State, school and higher-education retirees with PEBB coverage have their own Medicare enrollment rules; ask us before you assume the employer rules apply.

6. A simple checklist

• Mark your 7-month IEP on the calendar (it starts 3 months before your birthday month).
• Decide on Part B based on whether you have other creditable coverage.
• Find out how deep the Advantage menu is in your county, and which hospital systems each plan includes for 2026.
• Choose your path: Original Medicare + Medigap + Part D, or Medicare Advantage.
• Check that your doctors and prescriptions are covered before you enroll — especially if UW Medicine, Fred Hutch or a specific system is your care.
• If you are a veteran, see how TRICARE or VA benefits coordinate; if you have Apple Health, see the Medicare Savings Programs; if you already hold a Medigap policy, read the switching rule.
• Estimate your costs on our 2026 costs & IRMAA page.

None of this has to be done alone. We help Washingtonians sort through it every day — clearly, patiently, and at no cost to you. Washington SHIBA (800-562-6900), the Office of the Insurance Commissioner’s volunteer counseling program, offers free, unbiased state counseling as well.