When and how to sign up for Medicare at 65

You can sign up for Medicare starting three months before the month you turn 65. Social Security will automatically enroll you in Part A (hospital insurance) and Part B (medical insurance) if you are already receiving Social Security benefits. If you are not yet on Social Security, you must sign up yourself during your Initial Enrollment Period, which runs from three months before your 65th birthday through three months after. Missing this window without a valid reason triggers a permanent penalty on your Part B premiums.

The easiest method is to create an account on Medicare.gov and complete enrollment online. You can also call 1-800-MEDICARE (1-800-633-4227) to sign up by phone, or visit your local Social Security office in person. Have your Social Security number, birth date, and citizenship or immigration status ready before you start.

If you are still working and have health insurance through your employer, you may be able to delay Part B enrollment without penalty — but you must sign up for Part A at 65 even if you stay on your employer plan. The rules differ depending on your employer's size and your spouse's coverage, so check with your employer's benefits office before your birthday.

Key Takeaways

  • You can enroll in Medicare three months before you turn 65, and you have until three months after your birthday to sign up without penalty.
  • If you receive Social Security, Medicare will enroll you automatically in Parts A and B, but you should verify the enrollment on Medicare.gov.
  • If you do not receive Social Security, you must sign up yourself through Medicare.gov, by phone at 1-800-MEDICARE, or at a Social Security office.
  • Working past 65 with employer coverage does not exempt you from signing up for Part A, though you may delay Part B under certain conditions.
  • Missing your Initial Enrollment Period without employer coverage or other may have access to reasons results in a permanent 10 percent increase to your Part B premium for each year you delayed.

What documents you need to have ready

Gather these items before you start the enrollment process: your Social Security number, proof of citizenship or lawful permanent resident status (a birth certificate, passport, or naturalization papers), and your current mailing address. If you are signing up by phone or in person, you may also need to show a photo ID.

If you are still working and want to delay Part B, bring documentation from your employer showing your group health plan coverage — typically a benefits summary or insurance card. If you are married and your spouse's coverage affects your decision, have their Social Security number and information about their plan as well.

You do not need to provide income information to enroll in Parts A and B. However, if you think you may owe income-related premiums on Part B or Part D (prescription drug coverage), gather your most recent tax return so you can discuss this with Medicare when you call.

Step-by-step enrollment through Medicare.gov

Go to Medicare.gov and select "Sign up for Medicare" from the homepage. Click "Create an account" and enter your email address, password, and security questions. You will receive a verification email — click the link to confirm your address.

Log in and select "Enroll in Medicare." Answer questions about your citizenship, whether you receive Social Security, and your current health coverage. If you receive Social Security, the system will pull your information automatically and show you what you are already enrolled in. Review it carefully — errors are rare but do happen.

If you do not receive Social Security, you will enter your name, date of birth, and Social Security number manually. Select the coverage you want (Part A, Part B, or both) and choose your effective date. The system will confirm your enrollment and show you a confirmation number — save or print this for your records.

After you submit, Medicare will mail you a Medicare card within 30 days. You can use your confirmation number to check the status of your card on Medicare.gov before it arrives.

Signing up by phone or in person

Call 1-800-MEDICARE (1-800-633-4227) Monday through Friday, 8 a.m. to 8 p.m. Eastern time. Have your Social Security number, date of birth, and citizenship information ready. The representative will walk you through the same questions as the online form and will confirm your enrollment by phone. Ask them to mail you a written confirmation.

You can also visit your local Social Security office to enroll. Find the nearest office at ssa.gov/locator or call 1-800-772-1213. Bring your Social Security card, proof of citizenship, and photo ID. The office staff will help you complete the enrollment form and will give you a receipt showing your process was submitted.

Phone and in-person enrollment take the same amount of time as online enrollment — usually 15 to 30 minutes. Choose whichever method feels most comfortable to you. All three routes produce the same result: your enrollment in Medicare Parts A and B, effective on the date you choose.

What happens after you enroll

Medicare will send you a card in the mail within 30 days of your enrollment. Until it arrives, you can use your confirmation number as proof of coverage. Your coverage begins on the first day of the month you choose during enrollment — usually the first day of the month you turn 65, or the first day of the following month if you enroll late.

You will receive a bill for your Part B premium each month, usually deducted from your Social Security check if you receive benefits. Part A has no monthly premium if you or your spouse paid Medicare taxes for at least 10 years while working. If you do not meet this requirement, you may owe a premium for Part A as well.

About two weeks after you enroll, you will receive a "Welcome to Medicare" packet in the mail. It includes information about preventive care you can use at no cost, your coverage details, and information about Part D (prescription drug coverage) and Medigap supplemental insurance. Review this packet carefully — it contains important important date for other coverage decisions.

Delaying Part B if you have employer coverage

If you or your spouse are still working and covered by an employer group health plan, you may delay Part B enrollment without penalty. You must still enroll in Part A at 65. To may have access to for this exception, your employer must have at least 20 employees (or your spouse's employer must, if you are covered under their plan).

When you do enroll in Part B later — either when you leave your job or when your employer coverage ends — you have eight months from the end of your coverage to sign up without penalty. If you miss this window, you will owe the permanent 10 percent monthly premium increase for each year you delayed.

Notify Medicare in writing that you are delaying Part B due to employer coverage. You can do this by checking a box during online enrollment, or by calling 1-800-MEDICARE and telling the representative. Keep documentation of your employer coverage (a benefits letter or insurance card) in case Medicare questions your delay later.

Common mistakes to avoid

The most costly mistake is missing your Initial Enrollment Period. If you turn 65 in June, your enrollment window opens in March and closes in September. If you do not sign up by September 30, you cannot enroll until the following January 1 — and you will owe a permanent penalty on your Part B premium. The only exceptions are if you have employer coverage, COBRA, or Tricare (military coverage).

Do not assume Social Security will automatically enroll you if you are not yet receiving benefits. Social Security only auto-enrolls people already on the rolls. If you are still working and have not claimed benefits, you must sign up for Medicare yourself or face the penalty.

Do not ignore the "Welcome to Medicare" packet. It contains important date for Part D (prescription drug coverage) and Medigap supplemental insurance. If you want either of these, you have specific windows to sign up without penalty. Missing these important date can cost you thousands in higher premiums later.

Do not assume your employer coverage exempts you from Part A. Even if you delay Part B, you must enroll in Part A at 65. Part A covers hospital stays, and delaying it can trigger the same permanent penalty as delaying Part B.

Frequently Asked Questions

What if I am still working and do not want Medicare yet?

You must enroll in Part A at 65 even if you are still working and have employer coverage. You can delay Part B if your employer has at least 20 employees, but only Part B — not Part A. If you do not enroll in Part A, you will owe a permanent penalty when you finally do.

Can I change my mind after I enroll?

Yes, but only during specific windows. You have until the end of the month after you enroll to cancel your coverage and restart your Initial Enrollment Period. After that, you can make changes only during the Annual Enrollment Period (October 15 to December 7 each year) or if you have a may have access to life event like losing employer coverage.

What if I miss my enrollment important date?

If you miss your Initial Enrollment Period and do not have employer coverage, COBRA, or Tricare, you can enroll during the General Enrollment Period (January 1 to March 31 each year), but your coverage will not start until July 1. You will also owe a permanent 10 percent premium increase for each year you delayed.

Do I need to enroll in Part D when I turn 65?

Part D (prescription drug coverage) is optional, but if you go without it and later enroll, you may owe a permanent penalty. If you do not take any prescription drugs, you can skip Part D now and enroll later without penalty as long as you join within 63 days of losing other creditable coverage.

Will Medicare automatically deduct my premium from my Social Security check?

Yes, if you receive Social Security benefits. Medicare will deduct your Part B premium from your monthly check. If you do not receive Social Security, Medicare will bill you directly by mail each month, and you will pay by check or electronic payment.