When You Can Sign Up for Medicare: Age and Other Starting Points

The standard age to start Medicare is 65

You become may be able to access for Medicare at age 65, regardless of whether you are still working. This is the main entry point for most people. You do not have to retire to sign up, and your may be able to access does not depend on your income or health history.

Medicare may be able to access at 65 applies whether you were born in the United States or are a lawful permanent resident (green card holder) who has lived in the country for at least five years. If you are already receiving Social Security benefits when you turn 65, you will be enrolled automatically. If you are not yet taking Social Security, you will need to sign up for Medicare separately.

Key Takeaways

You become may be able to access for Medicare at age 65, and enrollment is automatic if you are already receiving Social Security benefits.
If you are not yet taking Social Security at 65, you must sign up for Medicare yourself during your initial enrollment period, which runs three months before and three months after your 65th birthday.
Some people under 65 can sign up for Medicare if they receive Social Security Disability Insurance (SSDI) for at least 24 months, or if they have end-stage renal disease or ALS.
Signing up late without a valid reason can result in a permanent penalty added to your Part B and Part D premiums for as long as you have Medicare.
Your initial enrollment period is the best time to sign up because waiting can cost you more money in the long run.

Who can start Medicare before age 65

Three groups of people under 65 can sign up for Medicare. The first group is people who have been receiving Social Security Disability Insurance (SSDI) for at least 24 months. Once you have been on SSDI for two years, you automatically become may be able to access for Medicare, even if you are in your 20s or 30s. You do not need to do anything — Medicare enrollment happens automatically.

The second group is people with end-stage renal disease (ESRD), which means permanent kidney failure requiring dialysis or a transplant. People with ESRD can sign up for Medicare regardless of age. The third group is people with amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease. People diagnosed with ALS become may be able to access for Medicare when ready, without waiting for SSDI approval or any other condition.

If you are under 65 and fall into one of these categories, you will need to contact Social Security or Medicare directly to confirm your may be able to access and complete the enrollment process, unless you are already on SSDI (in which case it happens automatically).

Your initial enrollment period and why it matters

Your initial enrollment period (IEP) is a seven-month window that runs three months before your 65th birthday, through your birth month, and three months after. For example, if you turn 65 in June, your IEP runs from March through September. This is your chance to sign up without penalty.

If you miss your IEP and do not have a valid reason, you will face a permanent penalty on your Part B premium (the part that covers doctor visits and outpatient care). The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but not enrolled. This penalty stays with you for life, even after you eventually sign up. The same penalty applies to Part D (prescription drug coverage) if you go without it during your IEP.

The only way to avoid this penalty is to have a valid reason for missing your important date, called a may have access to life event. These include losing employer health coverage, moving out of your plan's service area, or having a family member lose coverage. You must report the event to Medicare and sign up within a set timeframe after it happens.

How to sign up during your initial enrollment period

If you are already receiving Social Security benefits when you turn 65, Medicare Part A and Part B are automatic — you do not need to do anything. You will receive a Medicare card in the mail about three months before your 65th birthday.

If you are not yet taking Social Security at 65, you must sign up for Medicare yourself. 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. You will need your Social Security number, proof of citizenship or lawful permanent residency, and information about any current health coverage you have.

When you sign up, you will choose between Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C). You will also decide whether to add prescription drug coverage (Part D). These choices affect your costs and which doctors and pharmacies you can use, so review your options before you enroll.

What happens if you miss your enrollment important date

If you turn 65 and do not sign up during your IEP, you can still enroll later, but you will face consequences. The General Enrollment Period runs from January 1 through March 31 each year, and coverage begins July 1 if you sign up during this window. However, you will owe the permanent penalty on Part B and Part D premiums mentioned above.

The only exception is if you had a may have access to life event — such as losing employer coverage or moving — and you sign up within 63 days of that event. You must report the event to Medicare and provide documentation. Without a valid reason, the penalty applies and cannot be removed.

If you are still working at 65 and have health coverage through your employer, you may be able to delay Medicare without penalty. This is called creditable coverage. You can work past 65 and keep your employer plan, then sign up for Medicare later without the late penalty. However, you must sign up within eight months of losing the employer coverage, and you need to confirm with your employer that the plan qualifies.

Special situations: working past 65 and other exceptions

If you are still working and have health insurance through your job, you do not have to sign up for Medicare at 65. You can delay enrollment as long as your employer coverage continues, provided your employer has 20 or more employees. When you eventually leave that job or lose the coverage, you have eight months to sign up for Medicare without penalty.

If your employer has fewer than 20 employees, Medicare becomes your primary insurance at 65, even if you are still working. In this case, you should sign up for Medicare to avoid penalties, even though you will keep your employer plan as secondary coverage.

If you are a federal employee, railroad retiree, or covered under TRICARE (military health coverage), different rules may explore. Contact your specific plan administrator to understand how your coverage interacts with Medicare may be able to access at 65.

Frequently Asked Questions

What if I turn 65 while still working?

You become may be able to access for Medicare at 65 regardless of employment status. If your employer has 20 or more employees and you have health coverage through them, you can delay Medicare without penalty. Once you leave that job, you have eight months to sign up. If your employer has fewer than 20 employees, you should sign up for Medicare at 65 even though you keep your work coverage.

Do I have to take Social Security when I turn 65 to get Medicare?

No. Medicare and Social Security are separate programs. You can sign up for Medicare at 65 without claiming Social Security benefits. However, if you are already receiving Social Security, you will be enrolled in Medicare automatically. If you are not on Social Security, you must sign up for Medicare yourself during your initial enrollment period.

Can my spouse sign up for Medicare based on my age?

No. Each person signs up for Medicare based on their own age or disability status. Your spouse becomes may be able to access at their own 65th birthday or if they meet the under-65 may be able to access criteria (SSDI for 24 months, ESRD, or ALS). You cannot transfer your may be able to access to them.

What is the penalty for signing up late, and how long does it last?

The Part B penalty is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. The Part D penalty is similar. These penalties are permanent — they stay with you for life, even after you sign up. For example, if you wait five years to sign up, you will pay a 50 percent penalty on top of your regular premium forever.

If I have SSDI, do I need to do anything to get Medicare at 65?

No. If you have been on SSDI for at least 24 months, you are automatically enrolled in Medicare when you turn 65. You will receive your Medicare card in the mail. You do not need to take any action unless you want to make changes to your coverage, such as adding prescription drug coverage or switching to a Medicare Advantage plan.

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.