You can enroll in Medicare when you turn 65, regardless of your employment status or health history

Medicare may be able to access begins the month you turn 65. You do not have to be retired, and you do not have to wait for a specific date within that month — your coverage can start as early as the first day of the month in which you turn 65. The federal government runs Medicare, and the rules are the same in every state.

If you are already receiving Social Security benefits when you turn 65, you will be enrolled in Medicare Parts A and B automatically. If you are not yet taking Social Security, you will need to sign up for Medicare yourself during your enrollment window, or you may face a penalty on your premiums later.

There are limited exceptions to the age 65 rule. Some people under 65 can enroll if they have received Social Security Disability Insurance (SSDI) for at least 24 months, or if they have end-stage renal disease or ALS (amyotrophic lateral sclerosis). Those situations are rare and have their own enrollment rules.

Key Takeaways

  • You become may be able to access for Medicare the month you turn 65, and you can enroll starting three months before your birthday.
  • If you are receiving Social Security when you turn 65, Medicare enrollment happens automatically — you do not need to do anything.
  • If you are not on Social Security, you must sign up during your Initial Enrollment Period or face a permanent increase to your premiums.
  • Your Initial Enrollment Period lasts seven months: three months before the month you turn 65, the month itself, and three months after.
  • You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

Your Initial Enrollment Period: When to Sign Up

Your Initial Enrollment Period is a seven-month window centered on the month you turn 65. It runs from three months before your birthday month through three months after. For example, if you turn 65 in June, your enrollment period runs from March through September.

You should sign up as soon as your enrollment period opens, even if you do not plan to retire right away. Waiting until the last month of your window leaves no room for processing delays. If you miss your Initial Enrollment Period and do not have a valid reason, you will pay a permanent surcharge on your Part B premium for as long as you have Medicare.

The surcharge is 10 percent of the standard Part B premium for each full year you were may be able to access but not enrolled. If you wait two years past your important date, you will pay 20 percent more than the standard rate for life. There is no way to remove this penalty once it is applied.

Automatic Enrollment If You Receive Social Security

If you are already collecting Social Security retirement, spousal, or survivor benefits when you turn 65, the Social Security Administration will enroll you in Medicare Parts A and B automatically. You do not have to do anything. Your Medicare card will arrive in the mail about two weeks before your coverage starts.

You will still need to decide whether to enroll in Part D (prescription drug coverage) and whether to choose a Medigap or Medicare Advantage plan. These choices are separate from your automatic Parts A and B enrollment. If you do not choose a Part D plan during your enrollment period and you go without coverage, you may pay a penalty when you do enroll later.

If You Are Still Working at 65

You can delay enrolling in Medicare if you are still working and covered by your employer's health plan, but the rules depend on your employer's size. If your employer has 20 or more employees, you can usually delay Part B enrollment without penalty. Your employer coverage is considered creditable coverage, meaning it is as good as or better than Medicare.

You must still enroll in Part A (hospital insurance) at 65, even if you are working, unless you are covered by your employer's plan. Part A has no monthly premium if you or your spouse paid Medicare taxes for at least 10 years, so there is no financial reason to delay it.

When you leave your job or lose your employer coverage, you have eight months to enroll in Part B without penalty. This is called a Special Enrollment Period. Keep records of your employer coverage dates and plan details, because Medicare will ask for proof that your coverage was creditable.

Enrolling Before You Turn 65

You can begin the enrollment process three months before your birthday month. The easiest way is to visit Medicare.gov and use the enrollment tool. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. Representatives are available seven days a week, and the call is free. If you prefer to enroll in person, visit your local Social Security office — you can find the nearest one at ssa.gov/locator.

Enrollment usually takes 15 to 30 minutes online or by phone. Your coverage will begin on the first day of the month in which you turn 65, as long as you enroll by the last day of that month. If you enroll after that important date, your coverage will start the following month.

What Happens If You Miss Your Enrollment Window

If you miss your Initial Enrollment Period and do not have a may have access to reason, you can still enroll during the General Enrollment Period, which runs from January 1 through March 31 each year. However, your coverage will not start until July 1 of that year, and you will owe the permanent premium surcharge.

Some situations allow you to enroll outside your normal window without penalty. These include losing employer coverage, moving to a new state, or experiencing a life event like marriage or divorce. These are called Special Enrollment Periods, and they last 60 days from the date of the may have access to event. You must report the event to Medicare and provide documentation.

If you believe you have a valid reason for missing your important date, contact Medicare at 1-800-MEDICARE to ask about your options. Do not assume you will be penalized — some reasons are accepted even if you did not enroll on time.

Medicare Parts and What Each Covers

Part A covers hospital stays, skilled nursing care, hospice, and some home health services. Most people pay nothing for Part A because they or their spouse paid Medicare taxes while working. Part A enrollment is automatic if you are on Social Security.

Part B covers doctor visits, outpatient care, lab tests, and medical equipment. Part B has a monthly premium that changes each year. In 2024, the standard premium is $164.90 per month, but higher earners pay more. You must enroll in Part B during your Initial Enrollment Period to avoid penalties.

Part D covers prescription drugs through private insurance plans. You choose a plan during your enrollment period. If you go without Part D coverage and later enroll, you will pay a penalty based on how long you went without it.

Part C (Medicare Advantage) is an alternative to Original Medicare. It combines Parts A, B, and usually D into one plan run by a private insurer. You can choose Part C instead of Part B, but you must have Part A.

Frequently Asked Questions

What if I turn 65 but am not ready to retire?

You can enroll in Medicare and keep working. If your employer has 20 or more employees and covers you, you can delay Part B without penalty. You must still enroll in Part A at 65. When you leave your job, you have eight months to enroll in Part B penalty-free.

Do I have to enroll in all four parts of Medicare?

No. Part A is automatic if you are on Social Security. You must choose Part B, Part C, or neither. If you choose Part C, it replaces Part B. Part D is optional but recommended if you take prescription drugs regularly, because the penalty for late enrollment can be steep.

Can I change my mind after I enroll?

Yes, during the Annual Enrollment Period (October 15 through December 7 each year), you can switch between Original Medicare and Medicare Advantage, or change your Part D plan. Changes take effect January 1. Outside this window, changes are limited to specific situations.

What if I am not a U.S. citizen?

You must be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years to enroll in Medicare. Proof of citizenship or legal residency is required when you sign up. Contact Medicare at 1-800-MEDICARE if you have questions about your status.

Will Medicare cover me if I move out of the country?

Original Medicare (Parts A and B) covers emergency care in Canada and Mexico under limited circumstances. Most Medicare Advantage and Part D plans do not cover care outside the United States. If you plan to live abroad, discuss your options with Medicare before you move.