Turning 65 in Southern California: Your Medicare Checklist

I'm Matt Rolph, an independent Medicare broker based in Los Angeles. This is the checklist I walk through with people who are about to turn 65.

Your timeline at a glance

When	What to do
About 6 months before your birthday month	List your doctors, prescriptions and pharmacy. Find out whether you or your spouse will still have employer coverage at 65.
3 months before (your window opens)	Sign up for Part A and Part B through Social Security, or decide to delay Part B because you are still working.
1 to 3 months before	Choose your path (Step 2) and apply, so everything starts on the same day as your Part B.
Your birthday month	If you signed up earlier, coverage starts on the 1st of this month. If your birthday is on the 1st, Medicare treats you as turning 65 the month before, so your coverage and your whole seven-month window move one month earlier.
Your birthday month or the 3 months after	You can still sign up, but Part B starts the month after you do, which can leave a gap.

Step 1: Sign up for Part A and Part B, or decide to wait

If you already receive Social Security. If your benefits started at least four months before you turn 65, you are enrolled in Part A and Part B automatically, and your Medicare card is mailed about three months before your coverage starts.

If you don't. You sign up yourself: online at ssa.gov/medicare, by phone at 1-800-772-1213, or at a local Social Security office. A broker cannot file that application for you. My step-by-step guide to signing up at 65 covers the application.

What it costs. Most people pay no premium for Part A. The standard Part B premium is $202.90 a month in 2026; the 2027 amount had not been announced when this page was last reviewed. See what Medicare costs and how higher incomes change the premium.

If you are still working. If you or your spouse have group coverage from a current employer with 20 or more employees, you can usually delay Part B without a penalty, then sign up within eight months after the job or the coverage ends, whichever comes first. With a smaller employer, you generally need Part A and Part B at 65. COBRA and retiree coverage do not count as coverage from current employment and do not extend those eight months. Delaying Part B without current-employer coverage adds a penalty of 10% for each full 12 months you waited, in most cases for as long as you have Part B. More in working past 65 in California, which also covers Health Savings Accounts, and Medicare vs. COBRA.

Step 2: Choose how you get your coverage

There are two main paths, and neither is right for everyone.

• Original Medicare, a Medigap policy, and a Part D plan. You can see any doctor or hospital in the country that accepts Medicare. You pay a monthly premium for the Medigap policy, which pays some or most of the costs Original Medicare leaves to you, and a separate premium for drug coverage.
• A Medicare Advantage plan. A private plan provides your Part A and Part B benefits, usually with drug coverage included. You generally use the plan's network, pay copays as you use care, and have a yearly limit on out-of-pocket costs. Many plans in Southern California have a $0 monthly plan premium. You still pay your Part B premium.

Either way, don't go without drug coverage by accident. If you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period ends, a late enrollment penalty is added to your premium when you do join, generally for as long as you have Part D.

For more, see Medicare Advantage vs. Medicare Supplement and how to compare Medicare Advantage plans.

What is different in Southern California

Your doctor's medical group matters as much as the plan. With most HMO plans here, your primary doctor belongs to a medical group or IPA, and that group generally handles your referrals to specialists and hospitals. Before you choose a plan, ask your doctor's office which Medicare plans and medical groups they accept. My health-system guides for Los Angeles, Orange County, and San Diego explain how this works locally.

Plans change by county. Medicare Advantage plans are offered county by county, so the choices in Los Angeles County are not the same as in Ventura, Riverside, or San Diego County. Stand-alone Part D drug plans are offered statewide. Medicare's Plan Finder at Medicare.gov lists every plan offered in your ZIP code. A broker can show you only the plans they represent. For local detail, start with Medicare help near you.

If you have a Covered California plan. It does not end by itself at 65. Covered California says your plan won't be automatically canceled when you become eligible for Medicare, and that you must cancel at least 14 days before you want it to end. Time it so that coverage ends when your Medicare begins, and if family members are staying on the plan, ask how to remove only yourself. People who are eligible for Medicare generally can't receive Covered California's financial help, and if you keep receiving it you may have to pay it back. Having a Covered California plan is not a reason to delay Part B.

If you have Medi-Cal. The rules change at 65: Medi-Cal looks at assets as well as income. The Department of Health Care Services lists the asset limit as $130,000 for one person through June 30, 2027, and $21,000 starting July 1, 2027; the home you live in and one vehicle don't count. Ask your county Medi-Cal office what will change for you.

Medigap protections to know in California. Two are federal and one is a California rule:

• Medigap Open Enrollment Period. For six months, starting the first month you have Part B and are 65 or older, an insurer can't use your health history to turn you down. After that, it generally can.
• A trial right. If you join a Medicare Advantage plan when you are first eligible at 65 and change your mind within the first 12 months, you can return to Original Medicare and buy a Medigap policy without health questions. You must apply no later than 63 days after your Medicare Advantage coverage ends. See switching from Medicare Advantage to Medigap in California.
• The California Birthday Rule. If you already have a Medigap policy, you have 60 days beginning on your birthday each year to switch to a policy with equal or lesser benefits without medical underwriting. It does not get you into Medigap for the first time. See my Birthday Rule guide and when you can change a Medigap plan in California.

If you turn 65 during Annual Enrollment

Your seven-month window is your own. You don't have to wait for the Annual Enrollment Period (AEP), October 15 to December 7, and you are not held to its December 7 deadline. If your Medicare starts in 2026, you choose a 2026 plan now and can use Annual Enrollment, by December 7, to make a change for January 1. If it starts in 2027, you are choosing among 2027 plans; see what changes for Medicare in California in 2027.

Every fall after that, you can change plans during the AEP. People already in a Medicare Advantage plan can also switch plans or return to Original Medicare during the Medicare Advantage Open Enrollment Period (MA-OEP), January 1 to March 31.

Where to get help in Southern California

• Social Security (ssa.gov/medicare or 1-800-772-1213) for Part A and Part B enrollment.
• Medicare.gov or 1-800-MEDICARE to see every plan offered in your ZIP code.
• HICAP, California's State Health Insurance Assistance Program (SHIP), at 1-800-434-0222 for free, confidential one-on-one Medicare counseling.
• An independent broker. That's what I do. Insurance carriers pay brokers a commission when someone enrolls through them, and your premium is the same either way. I currently represent 12 insurance companies, which is not every plan in your area. We can talk by phone, by video, or in person. How working with me works.

Common questions about turning 65 in Southern California

How far ahead of my 65th birthday should I sign up for Medicare?

You can sign up starting three months before the month you turn 65. Sign up in those first three months and coverage starts the month you turn 65. If you wait until your birthday month or later, your Part B starts the month after you sign up.

Do I need to contact Social Security when I turn 65?

If your Social Security benefits started at least four months before you turn 65, Part A and Part B start automatically, and you only need to act if you want to delay Part B. Otherwise, you sign up through Social Security yourself.

I have Covered California. What happens when I turn 65?

Your plan is not canceled automatically. Sign up for Medicare, then contact Covered California at least 14 days before the date you want your coverage there to end, timed to when your Medicare begins. If family members are staying on the plan, ask how to remove only yourself. Once you are eligible for Medicare, you generally can't keep Covered California's financial help.

If I start with Medicare Advantage, can I get a Medigap policy later?

In the first 12 months, usually yes: people who joined Medicare Advantage when first eligible at 65 have a trial right, and must apply for the Medigap policy within 63 days after the Medicare Advantage coverage ends. After that, a Medigap insurer in California can generally review your health before accepting you, unless you have another guaranteed-issue right.