You can sign up for Medicare starting three months before you turn 65

Medicare enrollment opens on the first day of the month you turn 65, but you can actually start the process three months earlier. The Social Security Administration handles most Medicare signups automatically if you are already receiving Social Security benefits — you do not have to do anything. If you are not yet taking Social Security, you will need to contact Medicare yourself during your enrollment window.

Your enrollment window lasts seven months total: three months before the month you turn 65, the month itself, and three months after. If you miss this window and do not have coverage through an employer, you may face a permanent penalty on your premiums. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but not enrolled.

The easiest way to enroll is online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

Key Takeaways

  • You can begin the signup process three months before you turn 65, and you have until three months after your birthday to enroll without penalty.
  • If you already receive Social Security, Medicare will enroll you automatically — you do not need to take action unless you want to change your coverage choices.
  • You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE, or at your local Social Security office.
  • Missing your enrollment window can result in a permanent 10 percent increase to your Part B premium if you do not have employer coverage.
  • You will need your Social Security number, proof of citizenship or legal residency, and details about any current health insurance.

What happens if you are still working at 65

If you are covered by health insurance through your current employer, you may not need to enroll in Medicare right away. The rules depend on how many employees your company has. If your employer has 20 or more employees, your employer coverage is considered primary, meaning it pays first, and you can delay Medicare enrollment without penalty. You should still contact Medicare to let them know you have employer coverage.

If your employer has fewer than 20 employees, Medicare becomes primary when you turn 65, even if you are still working. In this case, you should enroll in Medicare on time to avoid the permanent premium penalty. Your employer coverage will coordinate with Medicare rather than replace it.

Once you leave your job or lose employer coverage, you have eight months to enroll in Medicare without penalty. This is called a Special Enrollment Period. You will need to show proof that you had employer coverage and the date it ended.

Choosing between Original Medicare and Medicare Advantage

When you enroll, you will decide whether to use Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C). Original Medicare is run by the federal government and covers hospital stays, doctor visits, and some preventive care. You can see any doctor or hospital that accepts Medicare. If you choose Original Medicare, you will also need to decide whether to buy a Medigap policy to cover costs that Medicare does not pay.

Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans bundle hospital, doctor, and usually prescription drug coverage into one plan. Most Advantage plans have lower monthly premiums than Original Medicare plus Medigap, but they typically require you to use doctors and hospitals in their network. Some plans charge copays or coinsurance for each visit.

You do not have to choose right now. If you enroll in Original Medicare, you can switch to a Medicare Advantage plan during the annual open enrollment period (October 15 to December 7 each year). If you enroll in a Medicare Advantage plan, you can switch back to Original Medicare during the same window, though you may not be able to buy a Medigap policy without medical underwriting if you wait.

Signing up for prescription drug coverage

Part D prescription drug coverage is separate from hospital and doctor coverage. You can enroll in a Part D plan when you first sign up for Medicare, or during the annual open enrollment period. If you go without Part D coverage when you are first may be able to access, you may pay a permanent penalty — 1 percent of the national average Part D premium for each month you were not enrolled.

You have the same seven-month enrollment window for Part D as you do for the rest of Medicare. If you are already taking prescription medications, compare plans based on which drugs they cover and what you will pay out of pocket, not just the monthly premium. The coverage and cost of the same drug can vary significantly between plans.

If you have coverage through an employer or union that includes prescription drugs, you may not need Part D right away. You should check whether that coverage is considered creditable (as good as Medicare Part D). If it is not, you should enroll in Part D to avoid the penalty.

Documents and information you will need to have ready

Before you contact Medicare, gather the following items. You will need your Social Security number, date of birth, and citizenship or legal residency documentation. Have your current health insurance information available — the name of your plan, your policy number, and the group number if you have employer coverage.

If you are enrolling by mail, you will also need to complete Form CMS-40B (process for Enrollment in Part B) or Form CMS-L564 (process for Enrollment in Part A). Both forms are available on Medicare.gov. If you are enrolling online or by phone, the representative will ask you these questions directly and you will not need to print anything.

Have a list of your current doctors and hospitals if you are considering a Medicare Advantage plan, so you can check whether they are in the plan's network. If you are taking prescription medications, have a list of those as well, including the dosage and how often you take them.

What to expect after you enroll

Once you enroll, Medicare will mail you a Medicare card within two to three weeks. Your coverage will start on the first day of the month you turn 65, even if your card arrives later. You can view your coverage details online at Medicare.gov using your username and password before your card arrives.

If you enrolled in Original Medicare, you will receive a separate bill for your Part B premium each month, unless you set up automatic payments from your bank account. Your Part A premium is usually deducted from your Social Security check if you are receiving benefits. If you enrolled in a Medicare Advantage plan or Part D, your insurance company will send you information about how to pay your premium and how to use your coverage.

Your coverage choices are not permanent. You can make changes during the annual open enrollment period each fall, or if you experience a may have access to life event such as moving to a new state, losing employer coverage, or getting married.

Questions to ask your doctor or Medicare before you enroll

Before you make your final choices, contact your current doctors to find out whether they accept Medicare and whether they are in any Medicare Advantage plans you are considering. Ask whether they have any restrictions on new Medicare patients. If you take prescription medications regularly, ask your pharmacy which Medicare Part D plans cover those drugs and what your out-of-pocket cost would be under each plan.

Contact Medicare directly if you are unsure whether you need to enroll now or can delay, or if you have questions about the penalty for late enrollment. The representatives at 1-800-MEDICARE can also help you compare specific plans based on your doctors, medications, and budget. They do not recommend one plan over another, but they can explain how each plan works.

Frequently Asked Questions

What if I am still working and my employer offers retiree health coverage?

You can delay Medicare enrollment if your employer coverage is considered creditable — meaning it is as good as Medicare. Your employer should tell you in writing whether your coverage is creditable. If it is, you can wait to enroll in Medicare until you retire or lose that coverage, without facing a penalty.

Can I enroll in Medicare before I turn 65?

You can start the enrollment process three months before your 65th birthday, but your coverage will not start until the first day of the month you turn 65. If you enroll early, your Medicare card will arrive before your coverage begins.

What if I miss my enrollment important date?

If you miss your seven-month enrollment window and do not have employer coverage, you can still enroll, but you may face a permanent penalty on your Part B and Part D premiums. The penalty is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. Contact Medicare to enroll as soon as possible to limit the penalty.

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

You can change your coverage choices during the annual open enrollment period from October 15 to December 7 each year. Changes take effect January 1. If you experience a may have access to life event such as moving, losing coverage, or getting married, you may be able to make changes outside the annual window.

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

Use the Medicare Plan Finder tool at Medicare.gov, which shows you plans available in your area based on your doctors and medications. You can also call 1-800-MEDICARE to speak with a representative who can walk you through your options. Some states also have State Health Insurance information Programs (SHIP) that offer free, one-on-one counseling about Medicare choices.