What Age You Need to Be for Medicare Coverage

The Basic Age Requirement for Medicare

You become may be able to access for Medicare when you turn 65, regardless of your work history or income. This is the standard entry point for most people. If you are already receiving Social Security retirement benefits when you turn 65, Medicare enrollment happens automatically — you do not need to do anything. If you have not yet claimed Social Security, you will receive information about Medicare in the mail a few months before your 65th birthday.

The month you turn 65 matters for when your coverage starts. Medicare coverage begins on the first day of the month in which you turn 65. So if your birthday is January 15, your coverage starts January 1. If your birthday is January 1, your coverage also starts January 1 of that year.

Key Takeaways

You are may be able to access for Medicare at age 65, and coverage begins the first day of the month you turn 65.
If you are already getting Social Security at 65, Medicare enrollment is automatic and requires no action on your part.
You can sign up for Medicare during your Initial Enrollment Period, which runs three months before, during, and three months after the month you turn 65.
Missing your Initial Enrollment Period can result in permanent late enrollment penalties on your premiums unless you have may have access to coverage like employer insurance.
Some people under 65 may be may be able to access for Medicare if they receive Social Security Disability Insurance (SSDI) or have end-stage renal disease or ALS.

When to Sign Up for Medicare at 65

Your Initial Enrollment Period is a seven-month window: three months before you turn 65, the month you turn 65, and three months after. During this time, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance) without penalty. This is the easiest time to enroll because you have flexibility in when you submit your information.

If you miss this window, you can still sign up during the General Enrollment Period, which runs January 1 through March 31 each year. However, coverage does not start until July 1 of that year, and you will likely face a permanent penalty on your Part B premium. The penalty is 10 percent for each full year you were may be able to access but did not sign up. That penalty stays with you for life.

The exception is if you had may have access to health coverage through an employer or union when you turned 65. If you were covered under a group health plan based on current employment — either your own or your spouse's — you can sign up without penalty during an eight-month period after that coverage ends or your employment ends, whichever comes first.

Medicare Before Age 65

Most people cannot get Medicare until 65, but three groups can may have access to earlier. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare at any age. The 24 months starts from when your disability benefits began, not from when you applied. You will be notified by Social Security when you become may be able to access.

If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you can get Medicare regardless of age. You must have worked long enough to be insured under Social Security, or be the spouse or dependent child of someone who has. Coverage typically begins the first day of the month you start dialysis or the month of your transplant.

If you have ALS (amyotrophic lateral sclerosis), you become may be able to access for Medicare when ready upon approval of your Social Security Disability Insurance claim, without waiting the usual 24 months. This is a recent change that took effect in 2023.

How to Sign Up for Medicare at 65

If you are already receiving Social Security retirement or disability benefits, you do not need to do anything. Social Security will automatically enroll you in Medicare Part A and Part B and send you your Medicare card about two weeks before your coverage starts.

If you are not yet receiving Social Security benefits, you have three ways to sign up. You can visit Medicare.gov and use the online enrollment tool. You can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to sign up by phone. Or you can visit your local Social Security office in person. All three routes take you through the same process and produce the same result.

When you sign up, have your Social Security number and information about any current health coverage ready. If you are still working and have employer coverage, tell them that during enrollment — it affects which parts of Medicare you need right away.

What Happens If You Miss the Enrollment important date

If you do not sign up during your Initial Enrollment Period and you do not have may have access to coverage, you will face a permanent late enrollment penalty. For Part B, this penalty is 10 percent of the standard premium for each full year you were may be able to access but did not sign up. If you were may be able to access for three years and did not enroll, your penalty is 30 percent, and you pay it for the rest of your life.

Part D (prescription drug coverage) also has a late enrollment penalty. If you go 63 days or more without Part D coverage and you do not have other creditable prescription drug coverage, you pay a penalty of about 1 percent of the national average Part D premium for each month you were without coverage. Like Part B, this penalty is permanent.

The only way to avoid these penalties is to have had may have access to coverage — employer insurance, TRICARE, or certain other plans — when you turned 65. If you did, you have an eight-month window after that coverage ends to sign up without penalty.

Special Situations: Working Past 65

If you are still working at 65 and have health insurance through your employer, you may not need to sign up for Medicare right away. If your employer has 20 or more employees, your employer coverage is primary, meaning it pays first. You can delay Medicare enrollment without penalty as long as you are covered under the group health plan based on current employment.

However, you should still sign up for Medicare Part A (hospital insurance) even if you delay Part B. Part A has no premium if you or your spouse paid Medicare taxes for 10 years, and it covers hospital stays. Delaying Part A can create gaps in coverage and cause problems later.

When you do leave your job or lose your employer coverage, you have eight months to sign up for the parts of Medicare you need. This is called your Special Enrollment Period, and it protects you from late enrollment penalties.

Frequently Asked Questions

Do I have to sign up for Medicare at 65 if I am still working?

You do not have to sign up for Part B if you have employer coverage and your employer has 20 or more employees. However, you should sign up for Part A because it has no premium and protects you in case of hospitalization. When your employment ends, you have eight months to sign up for Part B without penalty.

What if I turn 65 in another country?

You can still sign up for Medicare while living abroad. Contact Social Security or visit Medicare.gov to enroll. Your Medicare card will be mailed to a U.S. address you provide. Some Medicare coverage works outside the U.S., but coverage is limited — check the specific rules for the country where you live.

Can my spouse sign me up for Medicare if I cannot do it myself?

Yes. A spouse, family member, or caregiver can call Social Security or visit Medicare.gov on your behalf to start the enrollment process. They will need your Social Security number and information about your current coverage. You may need to sign documents, so discuss this with the person helping you.

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

You need to have worked and paid Medicare taxes for at least 10 years (40 quarters) to get Part A without a premium. If you have not, you may still be able to buy Part A. Citizenship or permanent residency requirements vary by situation. Contact Social Security to discuss your specific work history.

Do I lose Medicare if I move to another state?

No. Medicare coverage follows you anywhere in the United States. You keep the same Medicare number and coverage. If you move, update your address with Social Security and Medicare so they can reach you about changes to your coverage or benefits.

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.