When and how to sign up for Medicare

You become may be able to access for Medicare the month you turn 65, regardless of whether you are still working. You do not have to wait until you retire. The Social Security Administration handles Medicare enrollment, and you can sign up in three ways: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office.

The easiest route for most people is online. Go to Medicare.gov, select "Sign up for Medicare," and follow the steps. You will need your Social Security number, birth date, and citizenship or legal residency information. The process takes about 15 minutes. If you prefer to talk to someone, call 1-800-MEDICARE and a representative will walk you through it over the phone. Both options are free.

Your coverage can start as early as the first day of the month you turn 65, but only if you sign up before that month begins. If you turn 65 on March 15, for example, you can have coverage starting March 1 if you enroll by the end of February. If you miss that window, your coverage will start the month after you enroll.

Key Takeaways

  • You can sign up for Medicare online at Medicare.gov, by phone at 1-800-MEDICARE, or at your local Social Security office starting three months before you turn 65.
  • If you sign up before the month you turn 65, your coverage can start on the first day of that month; otherwise it starts the month after you enroll.
  • You will need your Social Security number, birth date, and proof of citizenship or legal residency to complete enrollment.
  • If you are still working and have health insurance through your job, you may be able to delay enrollment without penalty, but you should contact Medicare to confirm your situation.
  • After you enroll, Medicare will mail you a Medicare card within two weeks; you can also view and print it online when ready.

The three-month window before your 65th birthday

Medicare has a Initial Enrollment Period that runs for seven months total: three months before the month you turn 65, the month you turn 65, and three months after. You can enroll anytime during this window without penalty, but the timing affects when your coverage starts.

The best time to sign up is during the three months before you turn 65. This gives you the most control over your start date and ensures there is no gap between your current coverage and Medicare. If you wait until the month you turn 65 or later, your coverage will not start until the following month, which can leave you uninsured in the meantime.

If you miss this seven-month window entirely, you can still enroll, but you may face a late enrollment penalty. This penalty increases your Medicare Part B and Part D premiums permanently. The penalty is small in the first year but grows the longer you wait, so it is important to enroll as soon as you realize you missed the important date.

What happens if you are still working

If you are 65 or older and still working, you may not need to enroll in Medicare right away if your employer has 20 or more employees and you are covered by their health plan. This is called creditable coverage. You can delay Medicare enrollment without penalty as long as you are actively employed and covered.

However, you must enroll in Medicare Part A (hospital insurance) within eight months of leaving your job or losing your employer coverage, or you will face a late enrollment penalty on Part B. Part A rarely has a penalty, but Part B does. To be safe, contact Medicare or your Social Security office before you turn 65 to discuss your specific situation. They can tell you whether your employer plan qualifies and what your important date is.

If you are self-employed or work part-time for a small employer without health coverage, you should enroll in Medicare during your Initial Enrollment Period like anyone else.

Choosing between Original Medicare and Medicare Advantage

When you enroll, you will choose between Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C). This choice is made during enrollment and affects your coverage for the coming year.

Original Medicare is run by the federal government and covers hospital stays (Part A) and doctor visits and outpatient care (Part B). You can see any doctor or hospital that accepts Medicare. Most people also buy a separate Medigap policy to cover costs that Medicare does not pay, such as copayments and deductibles.

Medicare Advantage is offered by private insurance companies and includes all of Part A and Part B coverage plus usually prescription drug coverage (Part D). The trade-off is that you typically must use doctors and hospitals in the plan's network, and you may need prior approval for certain services. Medicare Advantage plans often have lower monthly premiums than Original Medicare plus Medigap, but your out-of-pocket costs can be higher if you use a lot of care.

You do not have to decide right now. You have until December 7 each year to change your choice during the Annual Enrollment Period, which runs from October 15 to December 7. If you enroll before your 65th birthday, your choice takes effect when your coverage starts.

Your Medicare card and first steps after enrollment

After you enroll, Medicare will mail you a physical Medicare card within two weeks. Your card shows your Medicare number, which you will need for doctor visits and prescriptions. You can also view and print your card when ready from your Medicare.gov account without waiting for the mail.

Once you have your Medicare number, give it to your doctors, pharmacies, and any other healthcare providers. They will use it to bill Medicare for your care. If you chose Original Medicare, you will also need to decide whether to buy a Medigap policy and whether to enroll in a separate Part D prescription drug plan. If you chose Medicare Advantage, your plan will handle prescription coverage and you do not need to do anything else.

Review your Medicare Summary Notice when it arrives in the mail. This document shows what Medicare paid for your care and what you owe. Check it for errors and contact Medicare if something looks wrong.

What to do if you missed the enrollment important date

If you did not enroll during your Initial Enrollment Period and you are no longer working or have lost your employer coverage, you can still enroll, but you will likely face a late enrollment penalty. The penalty for Part B is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. This penalty is permanent and added to your monthly premium for as long as you have Part B.

You can enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. Coverage starts July 1 of that year. This is much slower than enrolling during your Initial Enrollment Period, so if you are approaching 65, it is worth signing up before your birthday to avoid the wait and the penalty.

If you have a good reason for missing the important date—such as a serious illness or a mistake by Social Security—you may be able to request a Special Enrollment Period, which allows you to enroll outside the normal windows without penalty. Contact Social Security or Medicare to explain your situation and ask whether you may have access to.

Questions to ask your doctor and Medicare

Before your coverage starts, call your current doctor's office and ask whether they accept Medicare. Not all doctors do, and some may be accepting new Medicare patients only on a limited basis. If your doctor does not accept Medicare, ask for a referral to someone who does in your area.

Ask your doctor which hospitals and specialists they work with, so you know where you can go for care. If you are considering a Medicare Advantage plan, check whether your preferred doctors and hospitals are in the plan's network.

Call Medicare at 1-800-MEDICARE if you have questions about your enrollment, your coverage options, or whether you need to enroll at all. They can also tell you whether you may have access to for help paying your premiums if your income is low.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

Yes. You can start the enrollment process three months before the month you turn 65. Your coverage will not start until the first day of the month you turn 65 or later, depending on when you enroll, but you can complete the paperwork early. This is the best time to enroll because it gives you the most control over your start date.

What if I do not want Medicare and want to keep my employer coverage instead?

If your employer has 20 or more employees and you are actively working, you can decline Medicare and stay on your employer plan. You must enroll in Part A within eight months of leaving your job or losing coverage, or you will face a penalty. Contact Medicare before you turn 65 to document that you declined coverage due to active employment.

Do I have to choose a Medigap plan when I enroll in Medicare?

No. If you choose Original Medicare, you can buy a Medigap policy anytime, but the best time is within six months of turning 65. During this window, insurance companies cannot deny you or charge you more based on your health. After six months, they can. You do not need Medigap if you choose Medicare Advantage, because that plan includes prescription coverage.

How much does Medicare cost?

Medicare Part A (hospital insurance) is free for most people who paid Medicare taxes while working. Part B (doctor visits) costs a monthly premium that varies by income; in 2024 it ranges from about $175 to $560 per month depending on your income. Part D (prescription drugs) costs vary by plan. If you choose Medicare Advantage, you pay a monthly premium to the insurance company instead.

What if I move to a different state after I enroll?

Your Medicare coverage works in all 50 states and U.S. territories. You do not need to re-enroll or notify Medicare when you move. However, if you have a Medicare Advantage plan, you may need to switch plans because not all plans operate in all areas. Contact your plan or Medicare to confirm your coverage in your new location.