What Age You Need to Be to Start Medicare

You can enroll in Medicare when you turn 65

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. You do not have to be retired to sign up — you can still be working and earning income.

There are a few exceptions where you can start Medicare before 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you can enroll at any age. If you have end-stage renal disease (permanent kidney failure) or ALS (amyotrophic lateral sclerosis), you may be able to start right away without waiting.

Your 65th birthday month is when your coverage can begin. You do not have to wait until the exact day — Medicare typically starts on the first day of your birthday month. If you turn 65 on any day in March, for example, your coverage can start March 1st.

Key Takeaways

Medicare starts at age 65 for most people, and you can enroll even if you are still working.
You can start before 65 if you have been on SSDI for 24 months, or if you have end-stage renal disease or ALS.
You should enroll during your initial enrollment period, which is the three months before your 65th birthday, your birthday month, and the three months after.
If you miss your initial enrollment period and do not have employer coverage, you may pay a permanent penalty on your premiums.
You enroll through Medicare.gov, by phone at 1-800-MEDICARE, or at your local Social Security office.

Your initial enrollment period and why it matters

You have a seven-month window to enroll without penalty: the three months before you turn 65, the month you turn 65, and the three months after. This is called your initial enrollment period. If you enroll during this window, your coverage starts on the first day of your birthday month.

If you miss this window and you do not have health coverage through an employer (yours or a spouse's), you will owe a late enrollment penalty. This penalty is added to your Part B and Part D premiums for as long as you have Medicare. The penalty amount increases the longer you wait, so enrolling on time saves you money over your lifetime.

If you are still covered by an employer health plan when you turn 65, you may be able to delay enrollment without penalty. This is called creditable coverage. You should ask your employer's benefits office whether your plan qualifies before you decide to wait.

How to enroll when you turn 65

You have three main ways to enroll in Medicare. The easiest is online at Medicare.gov — you can create an account, review your options, and submit your enrollment from home. You will need your Social Security number and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. A representative can answer questions about your options and help you sign up. The line is open 24 hours a day, seven days a week.

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 Social Security at 1-800-772-1213. Bring your Social Security card and a photo ID.

What happens if you delay enrollment

If you do not enroll during your initial enrollment period and you do not have employer coverage, you will face a late enrollment penalty. For Part B, the penalty is 10 percent of the standard premium for each full year you were not enrolled. For Part D (prescription drug coverage), the penalty is 1 percent of the national average premium for each month you were not enrolled.

These penalties stay with you for life. If you wait two years past your initial enrollment period and then enroll, you will pay the higher premiums forever — even after you switch plans or move to a different state.

The only way to avoid the penalty is to have had creditable coverage (through an employer or union) during the time you were not enrolled in Medicare. You will need to provide proof of that coverage when you enroll.

Special situations: Starting Medicare before 65

If you are receiving Social Security Disability Insurance, you automatically become may be able to access for Medicare after you have been on SSDI for 24 consecutive months. You do not have to wait until 65. Social Security will contact you about three months before your 24-month mark to let you know you can enroll.

If you have end-stage renal disease (permanent kidney failure requiring dialysis or a transplant), you can enroll in Medicare as soon as your condition is diagnosed, regardless of age. The same applies if you have ALS. You will need medical documentation from your doctor to prove your diagnosis.

If you are under 65 and have neither SSDI, end-stage renal disease, nor ALS, you cannot enroll in Medicare. You will need to find coverage through the health insurance marketplace, your employer, or Medicaid until you turn 65.

Medicare Parts and what you need to know at enrollment

Medicare has four parts, and understanding them helps you choose what to enroll in. Part A covers hospital stays, skilled nursing care, and hospice — most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. Part B covers doctor visits and outpatient care and costs a monthly premium based on your income.

Part D is prescription drug coverage and requires a separate enrollment. Part C, also called Medicare Advantage, is an alternative to Parts A and B offered by private insurance companies. When you turn 65, you will choose whether to enroll in Original Medicare (Parts A and B) or a Medicare Advantage plan.

You should also decide whether you want Part D coverage for prescriptions. If you do not enroll in Part D during your initial enrollment period and you do not have other creditable drug coverage, you will pay a penalty when you eventually enroll.

Questions to ask your doctor before you turn 65

Before your 65th birthday, talk to your primary care doctor about your upcoming Medicare enrollment. Ask whether your current medications are covered under typical Medicare Part D plans in your area. Ask which hospitals and specialists accept Medicare in your region, especially if you have a chronic condition that requires ongoing specialist care.

If you see doctors outside your state or travel frequently, ask whether they accept Medicare and whether you need supplemental coverage (called Medigap) to cover costs Medicare does not pay. If you have had recent surgeries or ongoing treatments, ask your doctor's office whether they have seen issues with Medicare coverage for those services.

When to contact Medicare directly

Contact Medicare if you turn 65 and have questions about your coverage options, if you missed your initial enrollment period and want to understand your penalty, or if you need help choosing between Original Medicare and Medicare Advantage plans. Call 1-800-MEDICARE or visit Medicare.gov.

Contact Social Security if you are on SSDI and approaching your 24-month mark, or if you are unsure whether you have paid enough Medicare taxes to may have access to for Part A without a premium. You can reach Social Security at 1-800-772-1213 or visit ssa.gov.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65 if I am still working?

Yes. You can enroll at 65 even if you are still employed and earning income. However, if you are covered by your employer's health plan, you may want to delay Part B enrollment without penalty — ask your employer's benefits office whether your plan qualifies as creditable coverage.

What if I was born outside the United States — do I still become may be able to access at 65?

You can enroll in Medicare at 65 if you are a U.S. citizen or a permanent resident who has lived in the United States for at least five years. If you do not meet these requirements, contact Social Security to discuss your situation.

Do I have to enroll in Part D when I turn 65?

You do not have to enroll in Part D, but if you do not and you do not have other creditable drug coverage, you will pay a penalty when you eventually enroll. The penalty is 1 percent of the national average premium for each month you were not enrolled.

What happens to my employer health insurance when I turn 65?

Your employer coverage does not automatically stop when you turn 65. You can keep it if you are still working and your employer still offers it. However, Medicare becomes your primary payer once you enroll, so your employer plan becomes secondary. Talk to your benefits office about how the two plans will work together.

Can I change my mind after I enroll in Medicare?

Yes. You have a seven-month initial enrollment period, and you can make changes during that time. After that, you can change your coverage during the annual open enrollment period (October 15 to December 7 each year) or if you have a may have access to life event like moving to a new state.

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.