Most people get Medicare Part A automatically at 65
If you are a U.S. citizen or permanent resident and you have worked and paid Medicare taxes for at least 10 years (40 quarters), Medicare Part A is sent to you automatically three months before your 65th birthday. You do not need to do anything. Social Security will enroll you unless you tell them not to.
The enrollment happens through Social Security, not through Medicare directly. If you are already receiving Social Security benefits when you turn 65, the process is automatic. If you are not yet receiving Social Security, Social Security will contact you by mail about two months before your birthday to confirm your information.
Your Medicare card will arrive in the mail about two weeks before your coverage starts on the first day of the month you turn 65. Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services.
Key Takeaways
- If you have worked 10 years in jobs where you paid Medicare taxes, Part A enrollment happens automatically three months before you turn 65.
- Social Security handles the enrollment process, and you will receive your Medicare card by mail before your coverage begins.
- If you are not yet receiving Social Security at 65, you must contact Social Security to start your benefits and complete Part A enrollment.
- If you delay enrolling after 65 without a valid reason, you may face a permanent penalty on your Part A premiums.
- Railroad workers and some federal employees have different enrollment rules and should contact their own retirement systems.
What happens if you are not automatically enrolled
You are not automatically enrolled if you have not yet started receiving Social Security benefits by age 65. In this case, you must contact Social Security yourself to enroll in Medicare Part A. You can do this online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office.
You should enroll during the three-month window before your 65th birthday to avoid a gap in coverage. If you miss this window, you can still enroll, but your coverage will start on the first day of the month after you complete enrollment, which may delay your protection.
Some people choose to delay Part A enrollment if they are still working and covered by a group health plan. If this applies to you, you can enroll later without penalty, but you must have had continuous coverage through your employer or spouse's employer.
How to enroll if you are not yet on Social Security
Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Have your Social Security number, birth certificate, proof of citizenship or permanent residency, and bank account information ready. Social Security will ask you to confirm your work history to verify you have the required 10 years of Medicare-taxed employment.
You can also visit your local Social Security office in person. Find the office nearest you at ssa.gov/locator. Bring the same documents listed above. Processing takes about two weeks by phone or mail, or the same day if you visit in person.
If you are explore online at ssa.gov, you can create an account and begin the process yourself. Online applications may take longer to process than in-person visits, so plan ahead if your 65th birthday is soon.
What if you have not worked 10 years in Medicare-taxed jobs
If you have fewer than 10 years of work history under your own Social Security number, you may still be able to get Part A based on your spouse's or ex-spouse's work record. You must be at least 62 years old and married (or divorced for at least two years). Contact Social Security to explore this option.
If you do not meet the 10-year requirement through your own work or a spouse's record, you can still purchase Part A. The monthly premium varies depending on how many years of Medicare-taxed work you have. In 2024, the premium ranges from about $278 to $506 per month, but this amount changes yearly. Contact Social Security for the current premium that applies to you.
Some people who are not yet 65 but have been on disability for two years, or who have end-stage renal disease or ALS, may be able to get Medicare earlier. Ask Social Security whether you meet these conditions.
Timing and your coverage start date
Medicare Part A coverage begins on the first day of the month you turn 65, as long as you enroll during the correct window. If you enroll before your birthday, your coverage starts automatically on that date. If you enroll after your birthday, coverage starts on the first day of the month after you complete enrollment.
Your Medicare card will show your Part A coverage start date. Keep this card with you and show it to hospitals and other providers. You can also view your Medicare information online at Medicare.gov by creating an account with your Social Security number.
If you are still working at 65 and covered by your employer's health plan, you can delay Part A without penalty as long as you have continuous employer coverage. When you leave that job or lose that coverage, you have eight months to enroll in Part A without facing a late-enrollment penalty.
Late enrollment penalties and what they mean
If you do not enroll in Part A when you first become may be able to access and you do not have a valid reason for the delay, you will pay a permanent 10 percent increase on your Part A premium for twice the number of years you delayed. For example, if you delay for two years, you pay 20 percent more for life.
Valid reasons for delay include continuous coverage through an employer or spouse's employer, or coverage through a group health plan. If you had one of these, you can enroll later without penalty. You must tell Social Security about your employer coverage when you enroll.
If you believe you have a valid reason for late enrollment, explain it when you contact Social Security. They will review your situation and let you know whether the penalty applies.
Special situations: Railroad workers and federal employees
If you worked for a railroad company, you are covered by the Railroad Retirement Board, not Social Security. Contact the Railroad Retirement Board at 1-877-772-5772 or visit rrb.gov to enroll in Medicare Part A. The process is similar, but the Railroad Retirement Board handles your enrollment instead of Social Security.
Some federal employees hired before 1984 are covered by the Civil Service Retirement System (CSRS) and do not pay Medicare taxes. These employees are not may be able to access for Part A based on their federal work. If you have other work history that qualifies, you can use that instead. Contact the Office of Personnel Management at 1-888-767-6738 if you are unsure about your status.
Federal employees hired in 1984 or later pay Medicare taxes and are may be able to access for Part A like other workers. Enroll through Social Security using the same process described above.
Frequently Asked Questions
Do I have to enroll in Part B or Part D when I get Part A?
No. Part A is separate from Part B (doctor visits and outpatient care) and Part D (prescription drugs). You can have Part A alone, though most people also choose Part B. If you do not enroll in Part B when you first become may be able to access, you may face a late-enrollment penalty later, so consider your options carefully.
What if I am still working at 65 and have health insurance through my job?
You can delay Part A enrollment without penalty as long as you have continuous coverage through your employer or your spouse's employer. When you leave that job or lose that coverage, you have eight months to enroll in Part A without a penalty. Tell Social Security about your employer coverage when you do enroll.
Can I enroll in Part A online?
You can start the enrollment process online at ssa.gov if you are not yet receiving Social Security. However, you will likely need to complete the process by phone or in person. Calling Social Security at 1-800-772-1213 is usually faster if your birthday is coming up soon.
What documents do I need to enroll?
Have your Social Security number, birth certificate, proof of citizenship or permanent residency, and bank account information ready. If you are enrolling based on a spouse's work record, bring their Social Security number and birth certificate as well.
What if my name or information has changed since I last worked?
Tell Social Security about any name changes, address changes, or other updates when you enroll. Bring documents that show the change, such as a marriage certificate or divorce decree. Social Security will update your record before processing your Medicare enrollment.