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

Medicare may be able to access begins the month you turn 65. You do not need to have worked a certain number of years, and you cannot be turned down because of a pre-existing condition. If your birthday falls on the first of the month, your coverage starts the previous month. For any other birthday, coverage begins the first day of the month you turn 65.

You should enroll during your Initial Enrollment Period, which runs for seven calendar months: the three months before you turn 65, the month you turn 65, and the three months after. Missing this window can cost you. If you do not sign up when you first become may be able to access and you do not have other may have access to coverage, you will pay a permanent penalty on your premiums for as long as you have Medicare.

Key Takeaways

  • Medicare enrollment begins the month you turn 65, and your seven-month Initial Enrollment Period starts three months before that birthday.
  • Signing up during your Initial Enrollment Period avoids a permanent late-enrollment penalty on your Part B and Part D premiums.
  • If you are still working and covered by your employer's health plan, you may be able to delay Part B enrollment without penalty, but you must report this to Social Security.
  • You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • Some people become may be able to access before 65 due to disability, end-stage renal disease, or ALS, and should contact Social Security directly to learn their enrollment date.

How the Initial Enrollment Period works

Your seven-month window is your best chance to enroll without penalties. It includes three months before your 65th birthday, the month of your birthday, and three months after. For example, if you turn 65 in June, your Initial Enrollment Period runs from March through September.

During this period, you can sign up for Part A (hospital insurance), Part B (medical insurance), Part D (prescription drug coverage), or a Medicare Advantage plan. You do not have to sign up for everything at once. However, waiting until after your Initial Enrollment Period closes means you may face a late-enrollment penalty, and your coverage will not start until the following month.

The cost of missing your enrollment window

If you do not sign up for Part B during your Initial Enrollment Period and you do not have other may have access to coverage, you will pay a permanent late-enrollment penalty. This penalty is 10 percent of the standard Part B premium for each full 12-month period you were may be able to access but not enrolled. Once you do enroll, this penalty stays on your bill for life.

Part D (prescription drug coverage) carries a similar penalty: 1 percent of the national average Part D premium for each month you were may be able to access but not enrolled. If you go 63 days or more without Part D coverage, you also pay this penalty permanently. The only way to avoid these penalties is to enroll during your Initial Enrollment Period or to have other may have access to coverage that counts as creditable prescription drug coverage.

If you are still working at 65

You may be able to delay Part B enrollment without penalty if you are still working and covered by your employer's group health plan. This is called creditable coverage. However, you must still enroll in Part A (hospital insurance) at 65 if you are receiving Social Security benefits, because Part A is usually free.

If you want to delay Part B, you must tell Social Security that you are still working and have employer coverage. Do this during your Initial Enrollment Period, even if you do not sign up for Part B. When you leave your job or your employer coverage ends, you have eight months to enroll in Part B without penalty. Keep your enrollment notice from Social Security as proof of this special enrollment period.

Enrolling before 65: disability, ESRD, and ALS

Some people become may be able to access for Medicare before age 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare. If you have end-stage renal disease (ESRD) requiring dialysis or a transplant, you may be may be able to access regardless of age. If you have ALS (amyotrophic lateral sclerosis), you become may be able to access when ready upon approval for SSDI.

If any of these situations explore to you, contact Social Security directly at 1-800-772-1213 to learn your specific enrollment date and important date. Your Initial Enrollment Period rules are different, and Social Security will walk you through the process.

How to enroll in Medicare

You have three main ways to sign up. The easiest is online at Medicare.gov, where you can create an account and complete your enrollment in about 15 minutes. You can also call 1-800-MEDICARE (1-800-633-4227) and speak with a representative who can answer questions and process your enrollment over the phone. Representatives are available seven days a week, 24 hours a day.

If you prefer to enroll in person, visit your local Social Security office. You can find the nearest office at ssa.gov or by calling 1-800-772-1213. Bring your Social Security card, proof of citizenship or legal residency, and proof of age. If you are enrolling in Part B or Part D, have your current health insurance information available.

What happens after you enroll

Once you enroll, Medicare will send you a Medicare card in the mail within two weeks. Your coverage begins on the first day of the month you turn 65 (or the month before, if your birthday is the first of the month). You will also receive information about your coverage choices, including which hospitals and doctors are in your plan network if you chose a Medicare Advantage plan.

If you enrolled in Part D, your prescription drug coverage begins on the same date. Keep your Medicare card with you when you see a doctor or fill a prescription. If you have questions about your coverage after enrollment, call the number on the back of your card or visit Medicare.gov.

Frequently Asked Questions

What if I turn 65 but am not yet receiving Social Security?

You can still enroll in Medicare at 65 even if you have not started receiving Social Security benefits. You will need to sign up separately through Medicare.gov, by phone, or at your local Social Security office. Your Medicare enrollment is independent of your decision to claim Social Security benefits.

Can I enroll in Medicare after my Initial Enrollment Period ends?

Yes, but you may face a late-enrollment penalty and your coverage will not start until the month after you enroll. The only exception is if you have may have access to coverage, such as an active employer health plan or COBRA. If you have creditable coverage, contact Social Security to report it and ask about your options.

Do I have to choose between Original Medicare and Medicare Advantage during my Initial Enrollment Period?

No. You can enroll in Original Medicare during your Initial Enrollment Period and switch to a Medicare Advantage plan later during the Annual Enrollment Period (October 15 to December 7 each year). However, if you wait until after your Initial Enrollment Period to enroll in any Medicare coverage, you may face penalties.

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 be may be able to access for Medicare. If you meet these requirements, you can enroll at 65 just like any other person. Bring proof of your legal status when you enroll.

Can my spouse enroll in Medicare at the same time I do?

Your spouse has their own Initial Enrollment Period based on their own birthday. They cannot use your enrollment window. However, if your spouse is within their own seven-month Initial Enrollment Period, they can enroll at the same time you do by visiting Medicare.gov or calling 1-800-MEDICARE together.