The Age You Need to Be for Medicare Coverage

You must be 65 years old to get Medicare, with very few exceptions

Medicare may be able to access starts the month you turn 65. You do not have to wait until your birthday passes — you can sign up starting three months before you turn 65, and coverage can begin as early as the first day of the month you turn 65.

There are exceptions for people under 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare regardless of age. If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — you can get Medicare at any age. If you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you become may be able to access for Medicare when ready without waiting for SSDI payments.

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 Affordable Care Act marketplace, Medicaid, or another source until you reach 65.

Key Takeaways

Medicare begins at age 65 for most people, and you can sign up three months before your 65th birthday.
People under 65 who have received SSDI for 24 months become may be able to access for Medicare automatically.
People with end-stage renal disease or ALS can get Medicare at any age, regardless of work history.
If you do not sign up during your initial enrollment window around your 65th birthday, you may face late enrollment penalties when you do sign up.

When your Medicare coverage actually starts

Your Medicare coverage begins on the first day of the month you turn 65. If your birthday is on the first of the month, coverage starts that day. If your birthday is any other day of the month, coverage still starts on the first day of that month.

You can sign up for Medicare as early as three months before you turn 65. The Social Security Administration recommends signing up during this window so there is no gap between your current coverage and Medicare. If you sign up after the month you turn 65, there may be a delay before your coverage begins, and you could face a late enrollment penalty.

What happens if you miss the sign-up window

Your initial enrollment period lasts seven months — it starts three months before the month you turn 65 and ends three months after. If you do not sign up during this window, you can still sign up later, but you will likely pay a permanent penalty.

The Part B late enrollment penalty is 10 percent of the standard monthly 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 two years and did not sign up, your penalty would be 20 percent added to your premium for the rest of your life. The Part D (prescription drug) late enrollment penalty works similarly — you pay 1 percent of the national average premium for each month you were may be able to access but did not sign up.

There are exceptions to late enrollment penalties. If you had coverage through an employer or union while you or your spouse were still working, you may not face a penalty. If you were covered by Medicaid, you may not face a Part B penalty. You will need to show proof of this coverage when you sign up.

Signing up before you turn 65

You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need your Social Security number and information about your current health coverage.

If you are already receiving Social Security benefits, Medicare will be set up automatically when you turn 65. You do not need to do anything — your coverage will start, and you will receive your Medicare card in the mail. If you are not yet receiving Social Security, you will need to sign up for Medicare separately.

The best time to sign up is during your initial enrollment period, which gives you the most time to choose your coverage options and avoid penalties. Even if you plan to delay Part B because you have employer coverage, you should still sign up for Part A (hospital insurance) during this window to avoid penalties later.

Medicare for people under 65 with disabilities

If you are under 65 and receiving SSDI, you become may be able to access for Medicare after you have been on SSDI for 24 months. The 24-month period starts from the month your SSDI payments began, not from the month you applied. Medicare coverage begins the 25th month of your SSDI may be able to access.

If you have end-stage renal disease, you can get Medicare when ready. You do not need to have worked or paid Medicare taxes. You will need documentation from your doctor or dialysis center showing your diagnosis. If you have ALS, you become may be able to access for Medicare right away as well, without waiting for SSDI approval or any other condition.

If you are under 65 and may be able to access for Medicare through one of these pathways, you should still sign up during your initial enrollment period to avoid late penalties. Contact Social Security or Medicare directly to confirm your may be able to access and begin the sign-up process.

How age affects your Medicare choices

Your age at the time you sign up does not change what Medicare covers, but it may affect when you can delay coverage without penalty. If you are still working at 65 and have health insurance through your employer, you can delay signing up for Part B without penalty as long as your employer has 20 or more employees. Once you leave that job or lose that coverage, you have eight months to sign up for Part B without penalty.

If you are 65 or older and not working, or working for an employer with fewer than 20 employees, you should sign up for Part B during your initial enrollment period. Delaying Part B in these situations will result in a permanent penalty.

Frequently Asked Questions

Can I get Medicare before I turn 65?

Only if you have received SSDI for 24 months, have end-stage renal disease, or have ALS. Otherwise, you must wait until you turn 65. If you need coverage before then, you can look into Medicaid, the Affordable Care Act marketplace, or employer coverage.

What if I am still working at 65?

You can still get Medicare at 65 even if you are working. If your employer has 20 or more employees and offers health insurance, you can delay Part B without penalty. You should still sign up for Part A (hospital insurance) to avoid penalties later.

Do I have to sign up for Medicare the month I turn 65?

No, but you should. You can sign up three months before you turn 65, and your coverage can start the first day of the month you turn 65. If you sign up after that window, there may be a delay in your coverage and you could face late enrollment penalties.

What is the penalty for signing up late?

For Part B, you pay 10 percent of the standard premium for each full year you were may be able to access but did not sign up. For Part D (prescription drugs), you pay 1 percent of the national average premium for each month you were may be able to access but did not sign up. These penalties are permanent.

Will I automatically get Medicare when I turn 65?

If you are already receiving Social Security benefits, Medicare will be set up automatically. If you are not receiving Social Security, you will need to sign up for Medicare yourself through Medicare.gov, by phone, or at your local Social Security office.

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.