When and where to sign up for Medicare

You can sign up for Medicare starting three months before the month you turn 65. The easiest way is online at Medicare.gov — go to the "Sign Up" section and follow the steps. You can also call 1-800-MEDICARE (1-800-633-4227) to sign up by phone, or visit your local Social Security office in person.

If you are already getting Social Security benefits when you turn 65, Medicare will enroll you automatically. You do not need to do anything — your coverage starts the first day of the month you turn 65. If you are not yet receiving Social Security, you will need to sign up for Medicare yourself.

The important date to sign up without a penalty is the end of the month you turn 65. If you miss this window, you may pay more for coverage later, so it is worth marking your calendar three months ahead.

Key Takeaways

  • You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office starting three months before you turn 65.
  • If you already receive Social Security, Medicare will enroll you automatically when you turn 65 — you do not need to take any action.
  • You will need your Social Security number, birth date, citizenship or immigration status, and information about any current health coverage.
  • Sign up by the end of the month you turn 65 to avoid paying higher premiums later.
  • Part A (hospital insurance) is usually free if you or your spouse paid Medicare taxes for at least 10 years; Part B (medical insurance) has a monthly premium.

What documents and information to have ready

Before you start, gather your Social Security number, birth date, and citizenship or immigration status. You will also need information about any health insurance you currently have — the name of your plan, your policy number, and the group number if it is through an employer.

If you are signing up online, you can save your progress and come back later, so you do not have to complete it all at once. If you are calling or visiting an office, having these details in front of you will make the conversation faster.

Understanding Part A and Part B

Part A covers hospital stays, skilled nursing care, hospice, and some home health services. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working for at least 10 years. If you do not meet that requirement, you can still enroll, but you will pay a premium.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium that varies based on your income. In 2024, the standard premium is higher than in previous years, but the exact amount depends on what you reported to the IRS two years earlier. When you sign up, Medicare will tell you what your premium will be.

You must enroll in Part A and Part B separately, though most people do both at the same time. Part A is automatic if you are already on Social Security, but Part B requires you to say yes — do not skip it by accident.

Choosing between Original Medicare and Medicare Advantage

When you sign up, you will choose between Original Medicare (Part A and Part B) and a Medicare Advantage plan (Part C). You cannot have both at the same time.

Original Medicare lets you see any doctor or hospital that accepts Medicare. You pay a deductible and coinsurance for each service. Many people add Medigap (supplemental insurance) or Part D (prescription drug coverage) to fill gaps in what Original Medicare covers.

Medicare Advantage plans are offered by private insurance companies and usually include prescription drug coverage. They often have lower premiums than Original Medicare plus Medigap, but they typically require you to use doctors and hospitals in their network. If you have a chronic condition or see specialists regularly, check whether your doctors are in the plan's network before you choose.

Adding prescription drug coverage

If you choose Original Medicare, you can add Part D (prescription drug coverage) when you sign up. You do not have to add it right away, but if you wait and do not have other drug coverage, you may pay a penalty when you eventually enroll.

Part D plans are offered by private insurance companies and vary in cost and which drugs they cover. You can compare plans on Medicare.gov. If you take medications regularly, look up your drugs in each plan's formulary (the list of covered medications) to see which plan costs you the least.

If you choose a Medicare Advantage plan, prescription drug coverage is usually included, so you do not need to add Part D separately.

What happens after you sign up

After you submit your information, Medicare will send you a confirmation. If you signed up online or by phone, you should receive your Medicare card in the mail within two to four weeks. If you need coverage to start sooner, you can print a temporary notice from your Medicare.gov account.

Your coverage starts on the first day of the month you turn 65, or the first day of the month after you sign up, whichever is later. Before your coverage begins, you may want to schedule a preventive visit with your doctor — Medicare covers an annual wellness visit at no cost once your coverage is active.

Keep your Medicare card with you when you see a doctor or go to the hospital. If you lose it, you can request a replacement through Medicare.gov or by calling 1-800-MEDICARE.

Signing up if you are still working

If you are still working at 65 and have health insurance through your employer, you may not need to sign up for Medicare right away. However, the rules depend on the size of your employer and whether you are the employee or the spouse of an employee.

If your employer has 20 or more employees, you can delay enrolling in Part B without penalty as long as you have coverage through your job. You will need to enroll in Part A, though, because it covers hospital care that employer plans may not.

If your employer has fewer than 20 employees, you should enroll in both Part A and Part B when you turn 65. When you do leave your job, you can switch to Medicare Advantage or add Medigap without waiting.

Talk to your employer's benefits office or call 1-800-MEDICARE to confirm the rules for your situation before you turn 65.

Frequently Asked Questions

Can I sign up for Medicare before I turn 65?

You can start the sign-up process three months before the month you turn 65, but your coverage will not begin until the first day of the month you turn 65 or later. If you are already on Social Security, you do not need to do anything — you will be enrolled automatically.

What if I miss the sign-up important date?

If you sign up after the end of the month you turn 65, you may pay a higher premium for Part B and Part D for as long as you have Medicare. The penalty is usually 10 percent per year for Part B and 1 percent per month for Part D. You can still sign up at any time, but the sooner you do, the sooner the penalty stops growing.

Do I have to choose a plan right away, or can I change my mind later?

You can change your plan during the annual enrollment period, which runs from October 15 to December 7 each year. Your new coverage starts January 1. If you have a major life change — like losing employer coverage or moving to a new state — you may be able to change plans outside this window.

What if I do not know which plan is right for me?

Medicare.gov has a plan comparison tool where you can enter your doctors and medications to see which plans cover them and what you would pay. You can also call 1-800-MEDICARE to speak with someone who can walk you through your options, or visit your local Area Agency on Aging for free counseling.

Will I have to pay anything when I sign up?

Signing up is free. You may have to pay a premium for Part B or a Medicare Advantage plan starting the month your coverage begins, but there is no fee to enroll.