The Age You Need to Be for Medicare Coverage

You must be 65 to get Medicare, with rare exceptions

Medicare may be able to access starts the month you turn 65. You do not have to wait until your birthday — coverage begins on the first day of the month in which you turn 65. If you turn 65 on any day in March, your Medicare coverage starts March 1.

There are three narrow exceptions to the age 65 rule. You can get Medicare before 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, if you have end-stage renal disease (ESRD) requiring dialysis or a transplant, or if you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease. ALS coverage begins the month you are approved for Social Security disability, with no waiting period.

If you are not yet 65 and do not fall into one of these categories, you will need to find coverage through your employer, the individual market, Medicaid, or a combination of these until you reach 65.

Key Takeaways

Medicare begins the first day of the month you turn 65, not on your birthday itself.
You can get Medicare before 65 only if you have been on SSDI for 24 months, have end-stage renal disease, or have ALS.
You should sign up for Medicare during your Initial Enrollment Period, which runs three months before and three months after the month you turn 65.
If you miss your Initial Enrollment Period and do not have a may have access to reason, you may pay a permanent penalty on your premiums.
Working past 65 does not delay Medicare — you can be covered and still employed.

When your Initial Enrollment Period starts and ends

Your Initial Enrollment Period (IEP) is a seven-month window centered on the month you turn 65. It begins three months before that month and ends three months after. If you turn 65 in June, your IEP runs from March through September.

You should sign up during this window, even if you plan to delay taking benefits. Signing up on time protects you from late-enrollment penalties that can add to your premiums permanently. The penalty is 10 percent of your Part B premium for each full year you delayed, and it stays with you for life.

If you are still working at 65 and covered by your employer's health plan, you may have a different enrollment window. Talk to your employer's benefits office or call Social Security at 1-800-772-1213 to confirm your dates.

How to sign up for Medicare at 65

You can sign up 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. Online is usually fastest — the process takes 10 to 15 minutes if you have your Social Security number and birth certificate information ready.

You will need to provide your name, date of birth, Social Security number, and citizenship or legal residency status. If you are signing up by phone or in person, bring your Social Security card and a photo ID. Have your bank account information ready if you want direct deposit for any benefits.

Social Security will mail you a Medicare card within two weeks of approval. You can also view your card online through your Medicare.gov account. Do not wait for the physical card to arrive before your coverage starts — your coverage is active on the first day of the month you turn 65, whether or not you have received the card.

What happens if you miss your enrollment window

If you do not sign up during your Initial Enrollment Period and you do not have a may have access to reason for the delay, you will face a permanent late-enrollment penalty. This penalty applies to Part B (doctor and outpatient care) and Part D (prescription drugs) if you delay those parts.

The Part B penalty is 10 percent of the standard premium for each full 12-month period you were may be able to access but not enrolled. If the standard Part B premium is $165 per month and you delayed for two years, your penalty would be 20 percent — an extra $33 per month for life. The Part D penalty works the same way and is calculated based on the national average drug plan premium.

You can avoid this penalty if you have a may have access to reason for late enrollment, such as employer coverage that ended, loss of Medicaid, or moving out of your plan's service area. You will need to show proof of the may have access to event. Contact Medicare to discuss your situation.

Continuing to work after 65 does not affect Medicare

You can work full-time, part-time, or not at all after you turn 65 — it does not change your Medicare coverage or when you can get it. Your age is what matters, not your employment status.

If you are still working and covered by your employer's health plan, you may want to delay enrolling in Medicare Part B. Your employer coverage will be primary (it pays first), and Medicare will be secondary. You can sign up for Part B later without penalty as long as you enroll within eight months of losing your employer coverage or retiring, whichever comes first. This is called a Special Enrollment Period.

You should still enroll in Part A (hospital insurance) when you turn 65, even if you have employer coverage. Part A is usually free if you or your spouse paid Medicare taxes for at least 10 years, and it does not conflict with employer plans.

Medicare at 65 if you are not yet receiving Social Security

You do not have to be receiving Social Security benefits to get Medicare at 65. You can sign up for Medicare alone and delay Social Security to a later age if you want a higher benefit amount.

If you have not yet claimed Social Security, you will need to sign up for Medicare separately. You can do this online at Medicare.gov, by phone, or at a Social Security office. Signing up for Medicare does not automatically start your Social Security checks — you choose when to claim those separately.

Delaying Social Security past 65 increases your monthly benefit by about 8 percent per year until age 70. Many people sign up for Medicare at 65 but wait until 70 to start Social Security payments. This is a common strategy to maximize lifetime benefits.

Frequently Asked Questions

Can I get Medicare before I turn 65 if I am still working?

No, unless you have SSDI for 24 months, end-stage renal disease, or ALS. Working does not change the age requirement. If you have employer coverage, you can usually keep it and delay Medicare Part B without penalty as long as you enroll within eight months of losing that coverage.

What if I turn 65 in the middle of the month?

Your Medicare coverage starts on the first day of the month you turn 65, regardless of the date of your birthday. If you turn 65 on March 15, your coverage begins March 1. You should sign up during your seven-month enrollment window, which runs from three months before to three months after the month you turn 65.

Do I have to sign up for Medicare at 65 if I have VA benefits?

No, you are not required to sign up. However, Medicare and VA benefits work differently and cover different services. Many veterans sign up for Medicare Part A (which is usually free) while keeping VA coverage. Talk to your VA benefits counselor about how the two programs coordinate before you decide.

What if I was not a U.S. citizen for 10 years — can I still get Medicare at 65?

You must be a U.S. citizen or permanent legal resident and have lived in the United States for at least five consecutive years to get Medicare. If you do not meet these requirements, you will not be able to enroll. Contact Social Security to discuss your specific situation.

Can I delay Medicare past 65 without penalty?

You can delay Part B and Part D without penalty if you have employer coverage or other may have access to reasons. You must enroll within eight months of losing that coverage. Part A has no penalty for delay if it is free to you, but you should still sign up at 65 to avoid gaps in coverage.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.