Turning 65 in South Carolina: Your Medicare Enrollment Timeline

When you turn 65, you get a 7-month Initial Enrollment Period to sign up for Medicare. It starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. If you sign up before your birthday month, your coverage starts the month you turn 65. Sign up during your birthday month or later, and it starts the following month.

Sign up early, and you can line up your Medicare start date with the end of your current coverage so there's no gap and no overlap.

If you're already getting Social Security retirement benefits at least four months before you turn 65, you'll usually be enrolled in Part A and Part B automatically. Your Medicare card arrives in the mail about three months before your birthday month.

If you're not drawing Social Security yet, which is common for people still working or waiting to claim, you need to apply through the Social Security Administration. You can apply online at ssa.gov, by phone or at a local Social Security office.

This sample timeline is for someone in Irmo whose 65th birthday is July 20, 2027.

One quirk: Social Security treats you as reaching 65 the day before your birthday. If your birthday falls on the 1st of the month, your enrollment window and your earliest start date both move one month earlier.

If you or your spouse are still working and covered by an employer group health plan based on that current job, you may be able to delay Part B without a penalty. Talk with your employer's benefits office about how their plan works with Medicare.

When the job or the coverage ends, whichever comes first, you get an 8-month Special Enrollment Period to sign up for Part B.

This exception is for job-based coverage. An individual Marketplace plan is not employer coverage, so it doesn't let you delay Part B without risking a penalty. More on that below.

Most people pay no premium for Part A because they or a spouse worked and paid Medicare taxes long enough. For people who didn't, CMS set the 2026 Part A premium at $311 a month with at least 30 quarters of work and $565 with fewer.

The standard Part B premium for 2026 is $202.90 a month, with a $283 annual deductible. The 2026 Medicare Trustees Report projects about $209.50 a month for 2027; CMS usually announces the final figures in November, and we'll update this page when it does. Higher-income members pay more for Part B and Part D.

Original Medicare (Parts A and B) leaves you with deductibles, 20% coinsurance on most Part B services and no yearly cap. It also doesn't include most drug coverage. There are two common ways to fill those gaps.

Original Medicare + Medigap + Part D

A Medigap (Medicare Supplement) policy pays some or all of what Original Medicare leaves behind, and you can see any provider that accepts Medicare. You add a stand-alone Part D plan for drugs. CMS lists 8 stand-alone Part D plans in South Carolina for 2027.

Your Medigap Open Enrollment Period is the key date here. It's the 6-month period that starts the first month you're 65 or older and enrolled in Part B. During it, an insurer can't turn you down or charge you more because of your health. After it ends, insurers can generally ask health questions. If Medigap appeals to you, buy it in this window. Our Plan G guide covers costs.

Medicare Advantage

A Medicare Advantage plan combines your hospital, medical and usually drug coverage, with a network and a yearly out-of-pocket limit. The 2027 federal in-network limit is $9,850. CMS reports 97 Medicare Advantage plans in South Carolina for 2027, and a MoneyGeek analysis of CMS data found 89% of the state's standard Medicare Advantage plans charge a $0 premium.

In the Midlands, check whether your doctors at Prisma Health, Lexington Medical Center or MUSC Health are in a plan's network. Our Medicare Advantage vs. Medigap comparison lays out the trade-offs side by side.

Whichever path you pick, the 2027 Part D out-of-pocket cap is $2,400. See our 2027 Part D guide.

If you have a HealthCare.gov plan, two rules matter:

1. Your Marketplace plan doesn't end on its own. You have to update your application and end it. You can report a Medicare start date up to 3 months ahead, and HealthCare.gov will end your plan the day before Medicare starts.
2. Your savings stop once you're eligible for premium-free Part A. You can't keep using premium tax credits after that point. If you keep the plan, you pay full price, and credits used after Medicare starts may have to be paid back at tax time.

You can't backdate the end date, so set it up before Medicare starts. We cover this in detail in Moving From a Marketplace Plan to Medicare, and in One Spouse Turning 65, One Not.

• Part B: 10% added to your premium for each full 12-month period you could have had Part B but didn't. You generally pay it as long as you have Part B.
• Part D: 1% of the national base beneficiary premium ($41.33 in 2027) for each month you went without creditable drug coverage, if the gap is 63 days or more.
• Part A (if you pay a premium): up to 10% higher, for twice the number of years you didn't sign up.

If you miss your window and have no Special Enrollment Period, you can sign up during the General Enrollment Period, January 1 to March 31.