You can enroll in Part A alone if you have enough work credits and meet age or disability requirements

Medicare Part A covers hospital stays, skilled nursing care, hospice, and home health services. You do not have to take Part B (doctor visits and outpatient care) at the same time. Most people over 65 who worked long enough automatically receive Part A without paying a monthly premium, but you still need to formally enroll unless you are already receiving Social Security or Railroad Retirement Board benefits.

The enrollment process differs depending on your age, work history, and whether you are already collecting retirement income. Some people enroll automatically; others must contact Social Security directly. The key is understanding which path applies to you and acting before your coverage window closes, because late enrollment penalties can add to your costs.

Key Takeaways

  • If you are 65 or older and have 40 work credits (roughly 10 years of work), you can enroll in Part A with no monthly premium.
  • Most people who receive Social Security at 65 are enrolled in Part A automatically, but you should verify this by checking your Social Security account or calling Social Security.
  • If you do not receive Social Security, you must contact Social Security directly to enroll in Part A during your initial enrollment period, which begins three months before the month you turn 65.
  • You can enroll online through your Social Security account, by phone at 1-800-772-1213, or in person at your local Social Security office.
  • If you miss your initial enrollment period, you can still enroll during the General Enrollment Period (January 1 through March 31 each year), but you may face a late enrollment penalty.

Who gets Part A automatically and who must enroll

If you are receiving Social Security retirement benefits when you turn 65, you are enrolled in Part A automatically. Social Security will send you a Medicare card in the mail about two months before your 65th birthday. You do not need to do anything. However, you should still verify that Part A appears on your card and that your name and Social Security number are correct.

If you are not yet receiving Social Security but you have 40 work credits, you are not automatically enrolled. You must contact Social Security to enroll in Part A. This includes people who are still working past 65, people who delayed Social Security to earn a higher benefit, and people who worked for a railroad instead of under Social Security. The same rule applies if you are under 65 and disabled or have end-stage renal disease — you must enroll yourself.

If you worked for a railroad, contact the Railroad Retirement Board instead of Social Security. Their phone number is 1-877-772-5772.

Your enrollment window and when to act

Your initial enrollment period is seven months long: it starts three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, your window opens in March and closes in September. You can enroll at any point during this window, and coverage begins the first day of the month you turn 65 (or the first day of the month you enroll, whichever is later).

If you miss this window, you can still enroll during the General Enrollment Period, which runs January 1 through March 31 each year. However, coverage does not begin until July 1 of that year, and you may owe a late enrollment penalty. The penalty is 10 percent of the Part A premium for each full year you were may be able to access but did not enroll. Since most people do not pay a Part A premium, this penalty typically does not explore — but it is worth confirming with Social Security before you delay.

If you are under 65 and disabled or have end-stage renal disease, your initial enrollment period works differently. Contact Social Security to learn the exact dates for your situation.

How to enroll online, by phone, or in person

The fastest way to enroll is through your Social Security account at ssa.gov. Create an account if you do not have one, sign in, and look for the Medicare enrollment option. You can complete the process in about 10 minutes. Social Security will confirm your enrollment and tell you when your coverage begins.

If you prefer to speak with someone, call Social Security at 1-800-772-1213. Have your Social Security number, date of birth, and citizenship status ready. Representatives are available Monday through Friday, 7 a.m. to 7 p.m. Eastern time. Wait times are usually shorter early in the week and early in the day.

You can also visit your local Social Security office in person. Find the nearest office at ssa.gov/locator. Bring your Social Security card, proof of citizenship (passport, birth certificate, or naturalization papers), and proof of age. No appointment is required, but you may wait longer during peak hours.

Documents and information you will need

To enroll in Part A, have the following ready: your Social Security number, your date of birth, your citizenship status, and your current mailing address. If you are explore by phone or in person, bring a photo ID.

If you are under 65 and disabled, you will also need to confirm that you have been receiving Social Security disability benefits for at least 24 months. If you have end-stage renal disease, you will need documentation from your doctor or dialysis center. Social Security will guide you through what they need.

If you worked for a railroad, have your railroad retirement account number ready when you contact the Railroad Retirement Board.

What happens after you enroll

Once you enroll, Social Security processes your request and mails you a Medicare card. This usually takes two to four weeks. Your card will show your Medicare number, the date your coverage begins, and which parts of Medicare you are enrolled in (in your case, Part A only).

Keep your Medicare card in a safe place. You will need it when you check into a hospital or skilled nursing facility. If your card is lost or damaged, you can request a replacement through your Social Security account or by calling 1-800-MEDICARE (1-800-633-4227).

After you receive your card, review it carefully. Check that your name, Social Security number, and coverage dates are correct. If anything is wrong, contact Social Security when ready to request a correction.

What Part A covers and what you will pay

Part A covers inpatient hospital care, skilled nursing facility care (after a hospital stay), home health services, and hospice care. You do not pay a monthly premium for Part A if you have 40 work credits, but you do pay a deductible when you use hospital services. The deductible amount changes each year; in 2024 it is $1,632 per hospital stay. After you meet the deductible, Medicare covers most of your hospital costs for up to 60 days.

If your hospital stay extends beyond 60 days, you pay a daily coinsurance amount. For days 61 through 90, you pay a set amount per day (in 2024, $408 per day). If you stay longer than 90 days, costs rise further. Skilled nursing facility care and home health services have their own cost-sharing rules.

These amounts are updated each January. You can find the current amounts on medicare.gov.

Frequently Asked Questions

What if I am still working at 65 and do not want to enroll in Part A yet?

You can delay enrollment, but you must still enroll during your initial enrollment period (seven months centered on your 65th birthday) to avoid a late penalty. Even if you are working and do not plan to use Part A right away, enrolling during this window protects you from future penalties. You can enroll and straightforward not use it until you retire.

Can I enroll in Part A without enrolling in Part B?

Yes. Part A and Part B are separate. You can enroll in Part A only and decline Part B. If you later decide you want Part B, you can add it during the General Enrollment Period (January 1 through March 31) each year, though you may owe a late enrollment penalty if you wait.

What if I am not a U.S. citizen?

You must be a U.S. citizen or a lawful permanent resident (green card holder) to enroll in Part A. If you are a lawful permanent resident, you must have lived in the United States for at least five consecutive years. Contact Social Security to discuss your specific situation.

How long does it take to get my Medicare card after I enroll?

Social Security typically mails your Medicare card within two to four weeks of your enrollment. If you need coverage sooner, you can ask Social Security for a temporary proof of coverage letter, which you can show to hospitals or doctors while you wait for your card.

What if Social Security says I do not have enough work credits for Part A?

If you do not have 40 work credits, you may still be able to enroll in Part A by paying a monthly premium. The premium amount depends on how many credits you do have. Contact Social Security to learn whether you are may be able to access to buy in and what the cost would be.