The age requirement for Medicare

You become may be able to access for Medicare at age 65, regardless of your work history or income. This is the standard age set by federal law. If you are already receiving Social Security retirement benefits when you turn 65, Medicare enrollment happens automatically. If you have not yet claimed Social Security, you will need to sign up for Medicare separately.

There are narrow exceptions to the age 65 rule. You may may have access to for Medicare before 65 if you have been receiving Social Security Disability Insurance (SSDI) for at least 24 months, or if you have end-stage renal disease (permanent kidney failure requiring dialysis or transplant) or ALS (amyotrophic lateral sclerosis). These are the only medical conditions that override the age requirement.

Key Takeaways

  • Medicare begins at age 65 for most people, and you should sign up during your Initial Enrollment Period, which starts three months before the month you turn 65.
  • If you delay signing up past your Initial Enrollment Period without may have access to for an exception, you will pay a permanent penalty on your Part B and Part D premiums.
  • You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • If you are still working and have health insurance through your employer at 65, you may be able to delay Part B enrollment without penalty if your employer has 20 or more employees.

When to sign up for Medicare

Your Initial Enrollment Period is a seven-month window that starts three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, your enrollment period runs from March through September. You should sign up during this window to avoid late penalties.

If you miss your Initial Enrollment Period, you can still sign up 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 will owe a permanent 10 percent increase to your Part B premium for each full year you delayed. This penalty stays with you for life, so signing up on time matters.

The one exception is if you have employer health insurance when you turn 65. If your employer has 20 or more employees, you can delay Part B without penalty as long as you are actively working and covered by that plan. You must sign up within eight months of losing that coverage to avoid the penalty.

How to sign up

You have three ways to sign up for Medicare. The easiest is online at Medicare.gov, where you can complete the entire process from home. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to speak with someone who can walk you through the process. The line is open 24 hours a day, seven days a week. Have your Social Security number and current insurance information ready when you call.

A third option is to visit your local Social Security office in person. You can find the nearest office at ssa.gov or by calling 1-800-772-1213. Bring your Social Security card, proof of citizenship or legal residency, and proof of age (such as a birth certificate or passport).

What happens if you turn 65 while still working

Turning 65 does not mean you have to stop working or retire. You can continue your job and delay claiming Social Security retirement benefits if you wish. However, Medicare enrollment and Social Security retirement are separate decisions.

If you are still working and covered by your employer's health insurance, you have options. If your employer has 20 or more employees, you can delay enrolling in Part B (medical insurance) without penalty. You must still enroll in Part A (hospital insurance) at 65, but Part A has no premium for most people. When you eventually leave your job or lose employer coverage, you have eight months to sign up for Part B without penalty.

If your employer has fewer than 20 employees, Medicare becomes your primary insurance at 65, and your employer coverage becomes secondary. In this case, you should sign up for Medicare during your Initial Enrollment Period to avoid penalties.

Special situations: may have access to before age 65

If you have been receiving SSDI for 24 consecutive months, you automatically become may be able to access for Medicare at any age. Your coverage begins in the 25th month of receiving SSDI. You do not need to do anything — Medicare enrollment happens automatically.

If you have end-stage renal disease, you may may have access to for Medicare regardless of age. You become may be able to access either when you start dialysis treatment or when you receive a kidney transplant, whichever comes first. You will need to sign up yourself; this does not happen automatically. Contact Medicare at 1-800-MEDICARE to begin the process.

If you have ALS, you become may be able to access for Medicare when ready upon diagnosis. Like end-stage renal disease, you must sign up yourself. Bring documentation of your diagnosis from your doctor when you explore.

Understanding the penalty for late enrollment

If you do not sign up for Part B during your Initial Enrollment Period and do not have a may have access to reason to delay, you will pay a permanent penalty. The penalty is 10 percent of the standard Part B premium for each full 12-month period you were may be able to access but not enrolled. This penalty is added to your monthly premium for as long as you have Medicare.

The same penalty applies to Part D (prescription drug coverage) if you go without creditable drug coverage for more than 63 days. The penalty is one percent of the national average Part D premium for each month you were without coverage. Unlike Part B, the Part D penalty can change year to year, but it stays on your record permanently.

These penalties exist to encourage people to sign up on time. The best way to avoid them is to enroll during your Initial Enrollment Period, even if you do not plan to use Medicare right away.

What to ask your doctor before turning 65

Before your 65th birthday, talk with your primary care doctor about your Medicare options. Ask whether your current medications are covered under standard Medicare Part D plans, and whether your doctor accepts Medicare. If your doctor does not accept Medicare, ask for a referral to someone who does, or plan to switch providers.

Ask your doctor whether you have any chronic conditions that might affect which Medicare plan is right for you. If you have diabetes, heart disease, or other ongoing conditions, your doctor can help you think through whether Original Medicare (Parts A and B) or a Medicare Advantage plan (Part C) might work better for your care.

If you are still working and unsure whether to delay Part B, ask your doctor whether there are any reasons you should enroll right away. Some people with certain conditions benefit from enrolling when ready, even if they have employer coverage.

Frequently Asked Questions

Can I sign up for Medicare before I turn 65?

You can sign up during your Initial Enrollment Period, which begins three months before the month you turn 65. You cannot sign up earlier than that unless you may have access to for one of the exceptions (SSDI for 24 months, end-stage renal disease, or ALS). If you try to sign up before your Initial Enrollment Period opens, your process will be rejected.

What if I am still working at 65 and do not want Medicare yet?

You still need to sign up for Part A (hospital insurance) at 65, even if you are working, because it has no premium for most people and covers hospital stays. You may be able to delay Part B if your employer has 20 or more employees and you are actively working. However, you must sign up for Part B within eight months of leaving your job to avoid a permanent penalty.

Do I lose Medicare if I go back to work after 65?

No. Once you are enrolled in Medicare, you keep it for life. Working does not affect your Medicare coverage. Your employer health insurance, if you have it, will work alongside Medicare as secondary coverage.

What if I miss my Initial Enrollment Period?

You can sign up during the General Enrollment Period (January 1 through March 31), but your coverage will not start until July 1, and you will owe a permanent 10 percent penalty on your Part B premium. The only way to avoid this penalty is if you had may have access to employer coverage when you turned 65 — in that case, you have eight months after losing that coverage to sign up without penalty.

How do I know if my employer health insurance counts as creditable coverage?

Creditable coverage means your employer plan is at least as good as Medicare coverage. Your employer should send you a notice each year stating whether your coverage is creditable. If you are unsure, call your employer's benefits department or ask your HR representative. This matters for Part D (prescription drug coverage) — if you go without creditable drug coverage for more than 63 days, you will owe a permanent penalty.