Your 7-month window
| When you sign up | When coverage starts |
|---|---|
| 3, 2 or 1 month before your birthday month | First day of your birthday month |
| Your birthday month | First day of the next month |
| 1, 2 or 3 months after your birthday month | First day of the month after you sign up |
| After your window, with no special enrollment period | General Enrollment Period, January 1 to March 31; coverage starts the next month, and a penalty may apply |
If you already get Social Security benefits at least 4 months before you turn 65, you'll be enrolled automatically and your card arrives about 3 months ahead. Otherwise, apply online at ssa.gov/medicare/sign-up, by calling 1-800-772-1213 (TTY 1-800-325-0778), or at a Social Security office.
What's different in North Carolina?
- State Health Plan retirees: if you're already retired with State Health Plan coverage, the Plan assigns you to its group Medicare Advantage Base Plan about 90 days before your Medicare becomes primary. You can choose another Medicare option between 90 and 31 days before; 30 days before, your choice is locked. Parts A and B must be in effect, or you're placed on the 70/30 Plan. See State Health Plan retirees and Medicare.
- Medigap timing: North Carolina has no birthday rule, so plan your Medigap decision for the 6 months after your Part B starts.
- Help paying: if your income is limited, apply for NC's Medicare Savings Programs (MQB) through ePASS or your county Department of Social Services at the same time; see Medicare Savings Programs in North Carolina.
When waiting is OK
If you or your spouse have group coverage from current work at an employer with 20 or more employees, you can usually delay Part B and sign up within 8 months after that job or coverage ends. COBRA and retiree coverage don't count. If you're still working for the State at 65, the State Health Plan suggests taking Part A and delaying Part B while its active-employee plan pays first. See working past 65.
For the full timeline, use the turning 65 in North Carolina guide. To compare coverage before your Medicare starts, you can request a call from a licensed insurance agent to go over plans from the companies they work with.
Related questions
How do I sign up for Medicare in North Carolina?
Online, by phone or in person.
What if I miss my enrollment period?
Penalties and the General Enrollment Period.
What are the Medicare deadlines for 2027?
Every date in one place.
Sources
- Medicare.gov — When does Medicare coverage start?
- Social Security — Sign up for Medicare
- State Health Plan — Retiree presentation (turning 65, Base Plan assignment, Parts A and B)
- North Carolina General Assembly — G.S. Chapter 58, Article 54, Medicare supplement insurance
- NC Medicaid — How to apply
More questions in this guide
- Can I get Medicare before 65 in North Carolina?
- Do I need Medicare Part B if I'm still working at 65 in North Carolina?
- How do I sign up for Medicare in North Carolina?
- What are the Medicare deadlines in North Carolina for 2027?
- What happens if I miss my Medicare enrollment period in North Carolina?
Part of the guide: Medicare enrollment periods in North Carolina · All questions
Frequently asked questions
What if I sign up during my birthday month?
Your coverage starts the first day of the next month. Signing up in any of the 3 months after your birthday month also starts coverage the month after you sign up, so waiting means a short gap if you have no other coverage.
My birthday is on the 1st. Does that change anything?
Yes. Social Security treats you as turning 65 the day before, so your window and coverage start a month earlier: your coverage can begin the first day of the month before your birthday month.
Does my Medigap clock start when I sign up?
It starts when your Part B starts, as long as you're 65. North Carolina's 6-month Medigap open enrollment period is your one guaranteed chance at 65 or older to buy any policy, since the state has no birthday rule. Delaying Part B because of job coverage delays this window too.
Medicare in your North Carolina county
Plans, local agents and help, county by county: Wake · Mecklenburg · Guilford · Forsyth · Durham · Cumberland · Buncombe · Union · Johnston · Cabarrus · New Hanover · Gaston · Onslow · Iredell · Alamance · Pitt · Davidson · Brunswick · Catawba · Rowan · All 100 counties →
