You may not need to sign up for Part A at all

If you are already receiving Social Security or Railroad Retirement Board benefits when you turn 65, Medicare Part A is enrolled automatically. You do not have to do anything. Medicare sends you a card in the mail about three months before your 65th birthday.

If you are not yet receiving Social Security or Railroad Retirement benefits, you will need to take action. The process depends on whether you are still working and whether you have employer health insurance.

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Many people sign up for Part A only because they have employer coverage for doctor visits and outpatient care, or because they want to delay Part B to avoid a higher premium later.

Key Takeaways

  • If you receive Social Security or Railroad Retirement benefits at 65, Part A enrollment happens automatically and you receive a Medicare card by mail.
  • If you do not receive Social Security benefits, you must contact Social Security yourself to sign up for Part A during your Initial Enrollment Period, which runs three months before to three months after your 65th birthday.
  • You can sign up by phone, online at ssa.gov, or in person at a Social Security office, and the process takes about 15 minutes.
  • If you miss your Initial Enrollment Period and do not have a may have access to reason, you may face a permanent 10 percent premium increase on Part A when you eventually sign up.

When your Initial Enrollment Period starts and ends

Your Initial Enrollment Period is a seven-month window: three months before the month you turn 65, the month you turn 65, and three months after. For example, if you turn 65 in June, your period runs from March through September.

You can sign up anytime during this window. There is no penalty for signing up early or late within the period, as long as you sign up before the period closes. If you sign up in the first three months (before your birthday month), your coverage starts the month you turn 65. If you sign up in your birthday month or after, your coverage typically starts the first day of the following month.

If you are still working and have employer health insurance, you may be able to delay Part B without penalty, but Part A rules are different. Even if you delay Part B, you should still sign up for Part A during your Initial Enrollment Period to avoid a permanent premium penalty.

How to sign up through Social Security

Contact Social Security to sign up for Part A. You have three options: online, by phone, or in person.

Online: Go to ssa.gov and look for the "explore for Medicare" option. You can start an process and return to finish it later. The online process takes about 15 minutes if you have your information ready. You will need your Social Security number, date of birth, and citizenship or immigration status.

By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Wait times are usually shorter early in the week and early in the day. Have your Social Security number and date of birth ready. The call typically takes 10 to 15 minutes.

In person: Visit your local Social Security office. You can find the nearest office at ssa.gov/locator. Bring your Social Security card, birth certificate, and proof of citizenship or legal residency (passport, naturalization papers, or green card). In-person appointments often have shorter wait times if you call ahead to schedule one.

Documents you will need to have ready

Before you contact Social Security, gather these documents:

  • Your Social Security number
  • Your date of birth
  • Proof of U.S. citizenship or legal residency (passport, birth certificate, naturalization certificate, or green card)
  • Your current mailing address

If you are explore in person, bring originals or certified copies. If you are explore online or by phone, you will answer questions about this information rather than uploading documents. Social Security may ask you to send documents later if they need to verify anything.

If you were born outside the United States, have your immigration documents ready. Social Security will ask about your status, and you may need to provide additional paperwork.

What happens after you sign up

After you submit your process, Social Security processes it within two to four weeks. You will receive a Medicare card by mail showing your Medicare number and coverage dates. Keep this card in a safe place — you will need it when you see a doctor or go to the hospital.

Your Part A coverage begins on the date shown on your card. You do not pay a monthly premium for Part A if you or your spouse paid Medicare taxes for at least 10 years while working. If you do not meet this requirement, you will have a monthly premium, which varies by how many quarters of work history you have.

Once you have Part A, you are responsible for the deductible and coinsurance when you use hospital services. Part A does not cover doctor visits, outpatient care, or prescription drugs — that is what Part B and Part D cover.

If you miss your Initial Enrollment Period

If you do not sign up during your seven-month Initial Enrollment Period and you do not have a may have access to reason for the delay, you face a permanent 10 percent premium increase on Part A. This increase stays with you for as long as you have Medicare.

may have access to reasons include losing employer coverage, moving out of your employer's service area, or your employer ending their health plan. If you have one of these reasons, you may have an eight-month Special Enrollment Period to sign up without penalty. You will need to prove the reason when you explore.

If you missed your period and do not have a may have access to reason, you can still sign up during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage would start July 1 of that year, and the 10 percent penalty would explore.

Part A costs and what it covers

Part A has no monthly premium for most people, but you pay out-of-pocket costs when you use it. In 2024, the Part A deductible for a hospital stay is $1,632 for the first 60 days. After 60 days, you pay coinsurance. These amounts change each year.

Part A covers inpatient hospital care, skilled nursing facility care (after a hospital stay), hospice services, and some home health services. It does not cover outpatient doctor visits, lab work, imaging, or prescription drugs. If you need those services, you would sign up for Part B and Part D separately.

Many people who sign up for Part A only are using employer coverage or a Medigap plan to cover what Part A does not. Make sure you understand what your other coverage includes before you decide to take Part A alone.

Frequently Asked Questions

Do I have to sign up for Part B if I sign up for Part A?

No. Part A and Part B are separate. You can sign up for Part A only and delay Part B if you have employer coverage. However, if you delay Part B without a may have access to reason, you will pay a 12 percent premium increase when you eventually sign up. Part A and Part B have different enrollment periods and different rules about delays.

What if I am still working at 65?

You can still sign up for Part A during your Initial Enrollment Period. Part A covers hospital care, which you might need regardless of whether you are working. If you have employer health insurance through your job, you can keep that coverage and use Part A as backup. You may be able to delay Part B without penalty as long as your employer plan is active.

Can I sign up for Part A after I turn 65?

Yes, but only during your Initial Enrollment Period, which ends three months after your birthday month. If you sign up after that period ends without a may have access to reason, you will face a permanent 10 percent premium increase. You can still sign up during the General Enrollment Period (January 1 through March 31), but coverage would not start until July 1.

Will I get a bill for Part A?

Most people do not pay a monthly premium for Part A because they paid Medicare taxes while working. If you do owe a premium, Social Security will tell you the amount when you sign up. You will receive a bill or the premium will be deducted from your Social Security check if you receive benefits.

What if Social Security says I do not may have access to for Part A?

This is rare. Most U.S. citizens and legal residents who are 65 or older may have access to for Part A. If Social Security says you do not may have access to, ask them to explain why and what documents they need. You may need to provide proof of work history, citizenship, or legal residency. If you disagree with their decision, you can request a reconsideration.