The Age You Need to Qualify for Medicare

You must be 65 years old to get Medicare

Medicare starts the month you turn 65, not the day after. If your birthday is on the 15th of any month, your coverage begins on the 1st of that month. You do not have to wait until the end of the month or the end of the year — the program recognizes your age as soon as the calendar month in which you turn 65 arrives.

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 disability, with no waiting period. For SSDI and ESRD, the 24-month clock starts from the month you first received the disability payment or started dialysis.

If you are not yet 65 and do not fall into one of these three categories, you cannot get Medicare. You would need to look at other coverage options, such as marketplace insurance through the Affordable Care Act or coverage through an employer or spouse.

Key Takeaways

Medicare coverage begins the month you turn 65, regardless of the specific date of your birthday within that month.
You can get Medicare before 65 only if you have been on SSDI for 24 months, have end-stage renal disease, or have been diagnosed with ALS.
You do not have to do anything on your birthday — Social Security automatically enrolls you in Medicare Part A and Part B if you are already receiving benefits.
If you are still working at 65, you can delay enrollment in Part B without penalty, but you must enroll in Part A.

What happens automatically when you turn 65

If you are already receiving Social Security retirement or disability benefits when you turn 65, Medicare enrollment happens without you taking any action. Social Security sends your information to Medicare, and you are automatically enrolled in Part A (hospital insurance) and Part B (medical insurance) starting the month you turn 65. You will receive a Medicare card in the mail about two weeks before your coverage begins.

If you have not yet claimed Social Security by age 65, you need to contact Social Security to enroll in Medicare. You can do this online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. Even if you do not want to claim retirement benefits yet, you should still enroll in Medicare at 65 to avoid paying a penalty later.

Penalties for signing up late

If you do not enroll in Part B when you first become may be able to access at 65, you will pay a late enrollment penalty for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each 12-month period you could have had coverage but did not. If you wait three years to enroll, for example, you pay 30 percent more than the standard premium for the rest of your life.

The main exception is if you are still working and covered by your employer's health plan. If your employer has 20 or more employees, you can delay Part B enrollment without penalty as long as you are actively employed and covered. Once you leave that job or lose the coverage, you have eight months to enroll in Part B without penalty. You will need to show proof of your employer coverage when you enroll.

Part A (hospital insurance) does not have a late enrollment penalty, so you can enroll in Part A at any time. However, it is still wise to enroll at 65 even if you do not enroll in Part B, because Part A is free for most people and covers hospital stays.

Turning 65 while still working

You can work past 65 and still get Medicare. Your age, not your employment status, determines when you are may be able to access. If you are still working and your employer offers health insurance, you can choose to keep that coverage instead of Medicare, or you can have both. Many people keep employer coverage as their primary insurance and use Medicare as secondary coverage.

If you choose to delay Part B because you have employer coverage, make sure your employer plan is considered "creditable coverage" — meaning it is at least as good as Medicare Part B. Your employer's benefits office can tell you whether your plan qualifies. If it does, you will not face a late enrollment penalty when you eventually switch to Medicare.

Medicare for people under 65 with disabilities

If you receive SSDI and have been on the program for 24 months, you become may be able to access for Medicare at any age. The 24 months do not have to be consecutive — they are counted from the first month you received a disability payment. Once you hit 24 months, Medicare begins automatically the following month.

If you have end-stage renal disease and need dialysis or a kidney transplant, you can get Medicare regardless of age. Coverage typically begins the month you start dialysis or the month of your transplant, depending on your situation. If you have ALS, you are may be able to access for Medicare the month you are approved for SSDI, with no waiting period.

People under 65 with these conditions are enrolled in the same Medicare program as people 65 and older. You will have the same coverage options and pay the same premiums as anyone else on Medicare, though your specific costs may vary based on your income.

What to do if you are turning 65 soon

About three months before you turn 65, contact Social Security to confirm your enrollment. If you are already receiving benefits, Social Security will handle Medicare enrollment automatically, but it is worth checking to make sure everything is in order. You can call 1-800-772-1213 or visit ssa.gov.

If you are not yet receiving Social Security, you will need to explore for Medicare separately. You can do this online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Have your Social Security number and proof of citizenship or legal residency ready.

If you are still working and covered by an employer plan, gather documentation of that coverage. You will need it if you delay Part B enrollment or if you have questions about coordination between your employer plan and Medicare later.

Frequently Asked Questions

Can I get Medicare before I turn 65?

Only if you have been on SSDI for 24 months, have end-stage renal disease, or have ALS. Otherwise, you must wait until 65. If you are under 65 and uninsured, you can look into marketplace plans through healthcare.gov or your state's health insurance marketplace.

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

Your Medicare coverage begins on the first day of the month in which you turn 65, regardless of which day your birthday falls on. So if you turn 65 on June 15th, your coverage starts June 1st.

Do I have to enroll in Medicare if I am still working?

You should enroll in Part A at 65 because it is usually free and covers hospital care. You can delay Part B if you have employer coverage with 20 or more employees, but you must enroll within eight months of leaving that job to avoid a penalty.

What happens if I miss the enrollment important date?

You will pay a late enrollment penalty on Part B for as long as you have Medicare — 10 percent of the standard premium for each year you could have enrolled but did not. The penalty is permanent unless you had employer coverage that may have access to as creditable coverage.

How do I know if my employer plan is creditable coverage?

Ask your employer's benefits office or human resources department directly. They can tell you whether your plan meets Medicare's standards for creditable coverage. If it does, you can delay Medicare Part B without penalty.

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.