Turning 65 - Medicare Enrollment

Get expert guidance on Medicare enrollment as you approach 65. We'll help you understand your options and make the right choice.

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⭐Plan Comparison

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Full Name *

Phone Number *

Email Address *

Date of Birth *

State *

ZIP Code *

Month Turning 65 *

Year Turning 65 *

Are you currently working? *

YesNo

Do you have employer coverage? *

YesNo

What plan are you interested in? *

By checking this box, I acknowledge that before meeting, Medicare requires Licensed Sales Representatives to use this form to ensure our discussion focuses only on the products I am interested in. I agree to meet with a Licensed Sales Representative to discuss Medicare-related products, including Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Plans. The Licensed Sales Representative is either employed or contracted by a Medicare plan and may be paid based on my enrollment but does NOT work directly for the federal government. Signing this form does NOT affect my current or future Medicare enrollment, enroll me in a plan, or obligate me in any way. All information provided is confidential. I also consent to receive automated and personalized marketing text messages (e.g., appointment reminders) at the number I provided. Messages may be sent manually or by automation. Consent is not a condition of purchase. Msg & data rates may apply. We will NEVER sell your data. Reply STOP to opt out anytime.

I agree to the terms above. *

Digital Signature (Type your full name) *

Important Information for Those Turning 65

Turning 65 is a major milestone for Medicare. Understanding your enrollment window and options is crucial to avoid penalties and gaps in coverage.

Your Initial Enrollment Period begins 3 months before you turn 65
Working past 65? Special rules may apply
Choose from Original Medicare or Medicare Advantage
Consider prescription drug coverage (Part D)