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

Most people become may be able to access for Medicare the month they turn 65. You do not have to wait until your birthday itself — you can file starting three months before you turn 65, and coverage can begin as early as the first day of the month you turn 65. If you are already receiving Social Security retirement benefits, Medicare will start automatically; if not, you will need to sign up.

There are two exceptions to the age 65 rule. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare regardless of your age — this can happen in your 50s or early 60s. If you have end-stage renal disease (ESRD) requiring dialysis or a transplant, you may be may be able to access at any age, though the timing depends on when your treatment begins.

Key Takeaways

  • You can file for Medicare three months before you turn 65, with coverage starting the month you turn 65.
  • If you receive Social Security retirement benefits, Medicare enrollment happens automatically — you do not need to do anything.
  • You become may be able to access for Medicare before age 65 if you have received SSDI for 24 months or if you have end-stage renal disease requiring dialysis or transplant.
  • Missing the important date to sign up when you first become may be able to access can result in a permanent penalty on your Part B and Part D premiums.
  • You can check your may be able to access and enroll through Medicare.gov, by phone, or in person at your local Social Security office.

How the three-month window works before you turn 65

You can begin the enrollment process three months before the month you turn 65. For example, if you turn 65 in June, you can file starting in March. Your coverage will not start until the first day of the month you turn 65 — in this case, June 1 — even if you enroll earlier.

This three-month window is important because it gives you time to choose your coverage and avoid a late enrollment penalty. If you miss this window and do not sign up by the end of the month you turn 65, you will face a permanent increase to your Part B premium (the outpatient coverage) and your Part D premium (prescription drug coverage) for as long as you have Medicare.

The penalty for Part B is 10 percent of the standard premium for each year you were may be able to access but not enrolled. The Part D penalty is 1 percent of the national average premium for each month you were not enrolled. These penalties do not go away, even if you sign up later.

When you already receive Social Security retirement benefits

If you are already collecting Social Security retirement benefits when you turn 65, Medicare will enroll you automatically. You do not need to file a separate process. Your Medicare card will arrive in the mail about two weeks before your coverage begins on the first day of the month you turn 65.

You will receive Part A (hospital insurance) and Part B (outpatient insurance) automatically. You can still choose to decline Part B if you have other health coverage, but you must do this in writing before your coverage starts or you will be enrolled. If you decline Part B and later want to enroll, you may face a late enrollment penalty unless you have may have access to coverage like employer insurance.

Becoming may be able to access before 65 through disability

If you have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months, you become may be able to access for Medicare regardless of your age. This means someone in their 50s or early 60s can may have access to. The 24-month clock starts from the month you first receive a disability benefit check, not from the month you applied.

Once you have received SSDI for 24 months, you will be enrolled in Medicare automatically. You do not need to explore separately. Your Medicare coverage will begin the 25th month of your SSDI benefits. Like those turning 65, you receive Part A and Part B automatically, and you can decline Part B in writing if you have other coverage.

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

Medicare may be able to access with end-stage renal disease

If you have end-stage renal disease (ESRD) and need dialysis or have had a kidney transplant, you may be may be able to access for Medicare at any age. Your may be able to access depends on when your treatment begins and your citizenship or residency status.

If you are a U.S. citizen or permanent resident, you become may be able to access for Medicare the first month you receive dialysis treatment or the month of your kidney transplant, whichever comes first. You do not have to wait until age 65. You will receive Part A (hospital insurance) automatically, which covers dialysis and transplant-related care. You can also enroll in Part B if you want outpatient coverage.

Your nephrologist (kidney specialist) or dialysis center can help you understand your may be able to access date and guide you through enrollment. If you are not yet a U.S. citizen or permanent resident, ask your treatment team about your options, as the rules differ.

What happens if you miss the enrollment window

If you do not sign up for Medicare during your initial enrollment period — the seven-month window that includes three months before, the month of, and three months after the month you turn 65 — you will face a permanent penalty on your premiums.

The Part B penalty is 10 percent of the standard monthly premium for each full year you were may be able to access but not enrolled. If you were may be able to access for two years and did not enroll, your Part B premium will be 20 percent higher for life. The Part D penalty for prescription drug coverage is 1 percent of the national average premium per month you were not enrolled.

There are limited exceptions. If you had creditable coverage through an employer or union while you were working, or if you were covered under a spouse's employer plan, you may not face a penalty. You will need to show proof of that coverage when you enroll. If you are unsure whether your coverage counts, contact Medicare at 1-800-MEDICARE before you enroll.

How to sign up for Medicare at 65

You have three ways to enroll in Medicare: online through Medicare.gov, by phone, or in person at your local Social Security office.

Online: Go to Medicare.gov and select "Sign up for Medicare." You will need your Social Security number and date of birth. The process takes about 10 minutes. You will receive a confirmation number and can check the status of your process online.

By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Have your Social Security number and date of birth ready. A representative can enroll you over the phone and answer questions about your coverage options. Wait times are typically shorter early in the morning on weekdays.

In person: Visit your local Social Security office. You can find the nearest office at ssa.gov/locator. Bring your Social Security card, proof of citizenship or permanent residency, and proof of age (such as a birth certificate or passport). No appointment is needed, but you may wait longer during peak hours.

Frequently Asked Questions

Can I delay Medicare past 65 without a penalty?

You can delay Part A (hospital insurance) without penalty if you are still working and covered by your employer's health plan. However, you should still enroll in Part B during your initial enrollment period to avoid a permanent penalty, unless your employer plan is large (50+ employees). For Part D (prescription drugs), delaying past your initial enrollment period results in a permanent penalty. Talk to your employer's benefits office about your specific situation.

What if I am still working at 65?

If you are covered by your employer's health plan and your employer has 20 or more employees, you can delay enrolling in Part B without penalty. You have eight months after your employment ends or your coverage stops to enroll without penalty. However, you should still enroll in Part A (hospital insurance) at 65, as it is free and has no penalty for late enrollment. Part D (prescription drugs) does have a late enrollment penalty, so check with your employer about whether their plan is considered creditable coverage.

Do I have to choose a Medicare plan before my coverage starts?

No. When you turn 65, you will be enrolled in Original Medicare (Part A and Part B) automatically if you receive Social Security, or you can choose it when you enroll. You then have until December 7 of that year to choose a Part D plan (prescription drug coverage) or a Medicare Advantage plan (Part C) if you want one. If you do not choose by December 7, you will stay in Original Medicare, but you may face a penalty if you enroll in Part D later.

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

You must be a U.S. citizen or permanent resident (green card holder) to enroll in Medicare at 65. If you are a permanent resident, you can enroll the same way as a citizen. If you are not a permanent resident, you may not be may be able to access for Medicare. Contact Medicare at 1-800-MEDICARE to discuss your immigration status and any coverage options that may be available to you.

Can I change my mind after I enroll?

Yes. You have until the end of the month after you enroll to cancel your Medicare coverage if you change your mind. After that, you can make changes only during the annual enrollment period (October 15 to December 7) or if you have a may have access to life event, such as losing employer coverage. If you decline Part B and later want it, you may face a late enrollment penalty unless you have may have access to coverage.