Turning 65 in Alabama: What to Do First

If you are turning 65 in Alabama, your Medicare window opens three months before your birthday month and closes three months after it. Your first moves are simple: confirm your Part A is premium-free, pick one of the two coverage paths, and protect your one-time 6-month Medigap window. This guide walks through each step with the 2026 numbers.

Your 7-Month Initial Enrollment Period

Medicare gives you a 7-month Initial Enrollment Period built around your 65th birthday. It includes the 3 months before your birthday month, your birthday month itself, and the 3 months after.

Enrolling early in that window matters. Sign up during the 3 months before your birthday month and coverage generally starts the first day of the month you turn 65. Wait until later in the window and your start date slides back.

Miss the window entirely and things get expensive. The Part B late enrollment penalty adds 10% to your premium for each full 12-month period you were eligible but not enrolled, and it usually lasts as long as you have Part B. Our Medicare enrollment checklist lays out every deadline in one place.

Check Whether Your Part A Is Premium-Free

Most people never pay a Part A premium. If you or your spouse worked and paid Medicare taxes for 40 or more quarters, which is about 10 years, Part A costs you nothing each month. Roughly 99% of beneficiaries fall into this group.

If you have 30 to 39 quarters, Part A costs $311 per month in 2026. Under 30 quarters, it runs $565 per month. You can confirm your quarters through your Social Security account before you enroll.

What Medicare Costs in 2026

Here are the core numbers for 2026:

Item	2026 amount
Part B standard monthly premium	$202.90
Part B annual deductible	$283
Part A inpatient hospital deductible (per benefit period)	$1,736
Part A premium (40+ quarters of work)	$0

The Part B premium comes out of your Social Security check if you are drawing benefits. Higher-income households pay more through IRMAA surcharges, which are based on your tax return from two years earlier.

The Two Coverage Paths

Every new Alabama beneficiary faces the same fork in the road, and it shapes everything that follows.

Path one: Original Medicare plus a Medigap plan and a standalone Part D drug plan. You can see any provider in the country that accepts Medicare, with no networks and no referrals. The Medigap policy fills most of the gaps Original Medicare leaves behind.

Path two: a Medicare Advantage plan. A private plan bundles your hospital, medical, and usually drug coverage, often with a low or $0 premium. In exchange, you use the plan’s provider network and follow its rules.

Neither path is right for everyone. Our Medicare Advantage vs. Medigap comparison breaks down the tradeoffs, and Medicare 101 covers the basics if you are starting from zero.

The 6-Month Medigap Window Matters More in Alabama

When your Part B starts at 65, a clock starts too. For 6 months, insurers must sell you any Medigap plan they offer at the best available rate, no health questions asked. This is called your Medigap open enrollment period.

After those 6 months, Alabama insurers can medically underwrite you. That means they can review your health history, charge you more, or turn you down completely.

Some states have a “birthday rule” that gives residents a fresh window to change Medigap plans each year. Alabama does not. Outside of limited federal guaranteed-issue situations, this 6-month window is the one clean shot Alabama residents get. If you think a Medigap plan might ever be right for you, take the decision seriously now rather than assuming you can switch in later.

Free Help: Alabama SHIP

Alabama has a free, unbiased counseling resource called SHIP, the State Health Insurance Assistance Program. It is run by the Alabama Department of Senior Services through local Area Agencies on Aging.

SHIP counselors do not sell insurance and are not tied to any carrier. You can reach them at 1-800-243-5463. They are a good check on anything you hear from any agent, including us.

Your First-90-Days Checklist

Use this checklist as your roadmap from about 90 days before your 65th birthday:

• Confirm your work quarters with Social Security so you know your Part A is premium-free
• Mark your 7-month Initial Enrollment Period dates on a calendar
• If you have employer coverage, ask the benefits office in writing whether it is creditable for Medicare purposes
• Enroll in Parts A and B through Social Security, ideally in the 3 months before your birthday month
• Decide between the two coverage paths before your Part B start date
• If you choose Medigap, apply during your 6-month open enrollment window
• Add drug coverage, either a standalone Part D plan or a Medicare Advantage plan that includes drugs
• List your doctors and prescriptions, and confirm each one works with the plan you pick
• Save the Alabama SHIP number, 1-800-243-5463, for free unbiased answers

Our Alabama Medicare page covers how these choices play out across the state.

Frequently Asked Questions

Do I have to enroll at 65 if I am still working?

Not always. If you have health coverage through your own or your spouse’s current employer, you may qualify for a Special Enrollment Period later and can often delay Part B without penalty. Get written confirmation from the benefits office that your coverage counts, because guessing wrong triggers a lifetime penalty.

When does my coverage actually start?

If you enroll during the 3 months before your birthday month, coverage generally begins the first day of the month you turn 65. Enroll during your birthday month or the 3 months after, and coverage starts later. Earlier is almost always better.

What happens if I miss my Initial Enrollment Period?

You can use the General Enrollment Period, which runs January 1 through March 31 each year, and coverage begins the month after you enroll. You may also owe the Part B late enrollment penalty, which is 10% of the standard premium for each full 12-month period you went without coverage.

Is Alabama different from other states for Medigap?

The plans themselves are standardized by the federal government, but the rules around switching are state-specific. Alabama has no birthday rule and no extra state guaranteed-issue windows, so your 6-month Medigap open enrollment period carries more weight here than it does in some other states.

Do I need drug coverage if I take no medications?

You should still get it, or confirm you have other creditable drug coverage. Going 63 or more days without creditable coverage after your enrollment period triggers a Part D late penalty that grows for every month you wait and stays with you for as long as you have Part D.