You can sign up for Medicare starting three months before you turn 65

Medicare enrollment opens on the first day of the month you turn 65, but you can start the process three months earlier. Most people enroll during their Initial Enrollment Period, which lasts seven months total: three months before the month you turn 65, the month itself, and three months after. If you miss this window, you can still sign up later, but you may pay higher premiums for the rest of your life.

You do not have to wait until your birthday month to contact Medicare. Starting early gives you time to understand your options, compare plans, and make changes without rushing. The sooner you reach out, the sooner you can choose coverage that fits your health needs and budget.

Key Takeaways

  • Your Initial Enrollment Period starts three months before you turn 65 and ends three months after, giving you seven months to sign up without penalty.
  • You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, by mail, or in person at your local Social Security office.
  • Medicare Part A (hospital insurance) and Part B (medical insurance) are the foundation; Part D (prescription drugs) and Part C (Medicare Advantage) are optional add-ons you choose separately.
  • If you delay enrollment past your Initial Enrollment Period without a valid reason, you will pay a permanent penalty on your premiums.
  • You can change your plan once a year during the Annual Enrollment Period, which runs October 15 to December 7.

Where and how to sign up for Medicare

You have four ways to enroll: online, by phone, by mail, or in person. The fastest route is Medicare.gov, where you can create an account, review your options, and submit your enrollment in one sitting. You will need your Social Security number and information about your current health coverage.

If you prefer to speak with someone, call 1-800-MEDICARE (1-800-633-4227). Representatives are available seven days a week, and they can walk you through your choices and answer questions about costs. If you do not have internet access or prefer paper forms, you can request an process by mail or visit your local Social Security office to enroll in person.

Whichever method you choose, have your information ready: your date of birth, Social Security number, current insurance details (if you have coverage now), and any information about your income if you think you may may have access to for help paying premiums.

Understanding Part A and Part B — the foundation of Medicare

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Part B covers doctor visits, outpatient care, lab tests, and preventive services. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Part B has a monthly premium that changes each year; in 2024, the standard premium was $164.90 per month, though it varies based on your income.

Part A and Part B work together as your basic Medicare coverage. Part A pays for inpatient care; Part B pays for outpatient care. You will have a deductible for each part and will pay coinsurance (a percentage of costs) for services. Understanding these two parts first makes it easier to decide whether you need additional coverage.

When you sign up, you will be enrolled in both Part A and Part B automatically if you are receiving Social Security benefits. If you are not yet receiving Social Security, you will need to sign up for Medicare separately to avoid delays.

Choosing Part D (prescription drug coverage) and Part C (Medicare Advantage)

After you understand Part A and Part B, you decide whether to add Part D (prescription drug coverage) and whether to switch to Part C (Medicare Advantage). These are optional but important choices.

Part D covers prescription medications. If you take regular medications, Part D can save you hundreds of dollars a year. Plans vary in which drugs they cover and how much you pay, so compare plans based on your specific prescriptions. If you do not sign up for Part D when you first become may be able to access and you go without coverage, you will pay a penalty if you join later. The penalty is 1% of the national average Part D premium for each month you were not covered.

Part C (Medicare Advantage) is an alternative to Original Medicare (Part A and Part B). Instead of using Original Medicare, you join a private insurance plan that covers everything Part A and Part B cover, usually with lower out-of-pocket costs and often including Part D. However, Medicare Advantage plans have networks, so you may have fewer choices of doctors and hospitals. Part C plans change their coverage and costs every year, so you need to review your plan annually during the Annual Enrollment Period.

What happens after you enroll

After you submit your enrollment, Medicare will send you a Medicare card in the mail within two weeks. Your coverage starts on the first day of the month you turn 65, even if your card arrives later. You can check the status of your process online at Medicare.gov or by calling 1-800-MEDICARE.

Once you have your card, you can use it at any doctor, hospital, or pharmacy that accepts Medicare. Keep your card with you when you go to medical appointments. If you enrolled in Part D or Part C, your coverage for those parts starts on January 1 of the year after you enroll, unless you enrolled during a Special Enrollment Period.

After your first year, you can make changes to your coverage once a year during the Annual Enrollment Period (October 15 to December 7). This is when you can switch between Original Medicare and Medicare Advantage, change your Part D plan, or make other adjustments. Changes take effect January 1 of the following year.

What to do if you miss your Initial Enrollment Period

If you did not sign up during your Initial Enrollment Period, you can still enroll, but you may face consequences. You will pay a permanent late enrollment penalty on your Part B and Part D premiums for as long as you have Medicare. The penalty is 10% of the Part B premium for each full 12-month period you were not enrolled, and 1% of the national average Part D premium for each month you were not covered.

There are exceptions. If you had creditable coverage (health insurance through an employer, union, or spouse's coverage) when you turned 65, you may not owe a penalty. You have eight months after your coverage ends to sign up for Medicare without penalty. If you believe you have a valid reason for late enrollment, contact Medicare to discuss your situation.

Even if you owe a penalty, enroll as soon as you can. The sooner you have coverage, the sooner you are protected against large medical bills.

Help paying for Medicare premiums and costs

If your income is low, you may may have access to for programs that help pay your Medicare premiums and out-of-pocket costs. Medicaid (run by your state) can pay your Part B premium and help with deductibles and coinsurance if you meet income and asset limits. Medicare Savings Programs help pay premiums, deductibles, and coinsurance for people with limited income. Extra Help (also called the Low-Income Subsidy) helps pay Part D premiums and drug costs.

To learn whether you may have access to, contact your state Medicaid office, call 1-800-MEDICARE, or visit Medicare.gov. You will need to provide information about your income and assets. These programs have different income limits depending on where you live and which program you are asking about, so it is worth checking even if you think your income is too high.

Frequently Asked Questions

What if I am still working at 65 — do I have to sign up for Medicare?

If you or your spouse are still working and you have health coverage through your employer, you can delay Part B without penalty as long as your employer has 20 or more employees. You must sign up for Part A when you turn 65 to avoid penalties. When you leave your job or lose coverage, you have eight months to sign up for Part B without penalty.

Can I change my mind after I enroll?

Yes. You have a limited time to make changes. If you enroll during your Initial Enrollment Period, you can make changes during the Annual Enrollment Period (October 15 to December 7). If you enroll in a Medicare Advantage plan and change your mind within the first three months, you can switch back to Original Medicare. Outside these windows, you need a may have access to life event (like moving, losing coverage, or getting married) to make changes.

Do I need to sign up for Part D if I do not take any medications?

You do not have to sign up right away, but if you go without Part D coverage and later need medications, you will pay a penalty. If you think you might need prescriptions in the future, it is safer to enroll. If you truly never take medications, you can decline Part D, but document your decision in case you need to prove you had a good reason for not enrolling.

What if I move to a different state?

Your Medicare coverage works in all 50 states, but if you move, you should update your address with Medicare and review your Part D and Part C plans. Some plans do not serve all areas, so you may need to switch plans when you move. Contact Medicare to update your information and see what plans are available in your new location.

How much will Medicare cost me each month?

Part A has no premium for most people, but Part B has a monthly premium (the standard amount in 2024 was $164.90, though it varies by income). Part D premiums vary by plan, usually between $5 and $100 per month. Part C plans vary widely and may have no premium, a low premium, or a higher premium depending on the plan and your location. Your out-of-pocket costs also depend on which services you use and which plan you choose.