When You Can Start Collecting Medicare: Age Requirements and Your Options

You can collect Medicare at 65, but you may be able to start earlier if you have a disability or end-stage renal disease

The standard age to start Medicare is 65. Most people become may be able to access at 65 whether they are still working or retired. However, the rules are different if you have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease (ESRD) or ALS — in those cases, you can start Medicare before 65.

You do not have to wait until your 65th birthday month to sign up. You can begin the process three months before you turn 65, and coverage can start as early as the first day of the month you turn 65. If you miss the window around your 65th birthday, you can still sign up later, but you may face a permanent penalty on your premiums.

Key Takeaways

You become may be able to access for Medicare at age 65, and you can sign up starting three months before your 65th birthday.
If you have been on Social Security disability for 24 months, you can start Medicare before 65 regardless of your age.
People with end-stage renal disease or ALS can start Medicare at any age without waiting.
Signing up during your initial enrollment period (the three months before and after your 65th birthday month) avoids late-enrollment penalties.

Medicare at 65: The Standard Timeline

Most people start Medicare the month they turn 65. Your initial enrollment period runs for seven months: three months before the month you turn 65, the month you turn 65, and three months after. During this window, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance) without penalty.

If you are still working at 65 and have health insurance through your job, you may be able to delay Part B without penalty — but only if your employer has 20 or more employees. If your employer is smaller, or if you are not working, you should sign up during your initial enrollment period to avoid a permanent 10% increase to your Part B premium for each year you delay.

You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. The process takes about 15 minutes online.

Starting Medicare Before 65 If You Have a Disability

If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare at any age. This means a 45-year-old on disability can start Medicare once those 24 months have passed. The 24-month waiting period is built into the disability program itself — you do not have to do anything extra to trigger it.

Once you reach 24 months of disability benefits, Medicare begins automatically. You do not need to sign up; Social Security will enroll you in Part A and Part B unless you decline Part B in writing. If you want to decline Part B (for example, because you have other insurance), you must contact Social Security before your coverage starts.

If you are unsure whether you have reached 24 months, check your Social Security statement online at ssa.gov or call Social Security at 1-800-772-1213 to confirm your may be able to access date.

Medicare Before 65 for End-Stage Renal Disease and ALS

Two conditions allow you to start Medicare at any age without waiting: end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS). If you have ESRD and need dialysis or a kidney transplant, or if you have been diagnosed with ALS, you can begin Medicare when ready upon meeting the medical criteria.

For ESRD, your doctor must refer you to a nephrologist or dialysis center, and Medicare coverage typically begins the month your dialysis treatment starts or the month you receive a kidney transplant. For ALS, your diagnosis alone is sufficient — you do not have to wait for a specific treatment to begin.

To start the process, ask your doctor or dialysis center to contact Medicare on your behalf, or call 1-800-MEDICARE to report your condition. You will need medical documentation of your diagnosis.

What Happens If You Miss Your Enrollment Window

If you do not sign up during your initial enrollment period and you do not have a may have access to reason for the delay, you will face a late-enrollment penalty. For Part B, the penalty is 10% of the standard premium for each full year you were may be able to access but not enrolled. This penalty is permanent — it stays on your premium for as long as you have Medicare.

There are a few exceptions. If you were covered by an employer health plan while working, or if you were covered as a spouse or dependent, you may have a special enrollment period that lets you sign up without penalty. You must sign up within eight months of losing that coverage. You will need to prove you had that coverage — usually a letter from your employer or insurance company.

If you missed your window and do not have an exception, you can still sign up during the general enrollment period (January 1 to March 31 each year), but the penalty will explore.

Deciding Between Part A and Part B

Part A covers hospital stays, skilled nursing care, hospice, and home health services. Part B covers doctor visits, outpatient care, and medical equipment. Most people at 65 sign up for both, but the rules are slightly different.

Part A is free for most people at 65 (because they or their spouse paid Medicare taxes while working). Part B has a monthly premium that varies by income. If you are still working and have employer coverage, you can delay Part B without penalty, but you should still enroll in Part A — it has no premium and covers hospital care your employer plan might not.

If you are unsure whether to take Part B, call 1-800-MEDICARE and ask to speak with a counselor. They can review your situation and explain what makes sense for your coverage.

Frequently Asked Questions

Can I start Medicare before 65 if I am retired?

No, unless you have a disability, ESRD, or ALS. Retirement alone does not lower the age to 65. If you are retired and under 65, you will need to find other coverage until you turn 65 or until you meet one of the medical exceptions.

What if I turn 65 but I am still working and have health insurance through my job?

You can delay Part B without penalty if your employer has 20 or more employees. You should still sign up for Part A (it is free and covers hospital care). Once you leave your job or lose that coverage, you have eight months to sign up for Part B without penalty.

Do I have to sign up for Medicare Part D (prescription drug coverage) at 65?

You do not have to, but if you go without creditable drug coverage and sign up later, you may face a permanent penalty. If you do not take any prescription drugs, you can skip Part D now and add it later without penalty, but you must sign up within 63 days of losing other drug coverage.

What if I am not a U.S. citizen — can I still get Medicare at 65?

You must be a U.S. citizen or a permanent resident who has lived in the United States for at least five years. If you meet those requirements, you can sign up for Medicare at 65 just like anyone else. Contact Medicare at 1-800-MEDICARE if you have questions about your status.

Can I change my mind after I sign up for Medicare?

Yes, during your initial enrollment period you can make changes. After that, you can change your coverage 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 or moving to a new state.

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.