The standard age to start Medicare is 65

You become may be able to access for Medicare at age 65, regardless of whether you are still working. This is the age when you can enroll in Medicare Part A (hospital insurance) and Part B (medical insurance). You do not have to retire or stop working to sign up — the two are separate decisions.

If you were born on the first of the month, Medicare considers your birthday to be the day before. This matters for enrollment important date and when your coverage starts. Most people become may be able to access the first day of the month in which they turn 65, or the month after, depending on their birth date.

Key Takeaways

  • You can enroll in Medicare starting three months before the month you turn 65, and you have until three months after that month to sign up without a penalty.
  • If you delay enrollment past your initial window and do not have other may have access to coverage, you will pay a permanent surcharge on your Part B and Part D premiums.
  • You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • Some people under 65 can get Medicare if they receive Social Security Disability Insurance (SSDI) for 24 months, or if they have end-stage renal disease or ALS.

When your enrollment window opens and closes

Your Initial Enrollment Period is seven months long: it starts three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, you can enroll from March through September. During this window, you can sign up for Part A and Part B without waiting or paying extra.

If you miss this window, you can still enroll during the General Enrollment Period, which runs January 1 through March 31 each year. However, coverage does not start until July 1 of that year, and you will owe a late enrollment penalty — a permanent increase to your Part B premium. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but did not enroll. This surcharge stays with you for life.

The same penalty applies to Part D (prescription drug coverage) if you delay enrollment. If you go 63 days or longer without Part D coverage and later sign up, you pay an extra amount each month based on how long you went without it.

Exceptions: Getting Medicare before 65

You can receive Medicare before age 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months. You become may be able to access for Medicare on the first day of the 25th month of your SSDI payments. You do not have to wait until age 65 — your coverage begins automatically, though you should still verify your enrollment.

Two other conditions allow Medicare before 65: end-stage renal disease (ESRD) requiring dialysis or a kidney transplant, and ALS (amyotrophic lateral sclerosis), also called Lou Gehrig's disease. People with ESRD can enroll when ready upon diagnosis. People with ALS become may be able to access for Medicare the first month they receive SSDI or Railroad Retirement Board benefits, without the usual 24-month wait.

How to sign up for Medicare

You have three main ways to enroll. The easiest is online at Medicare.gov — you can create an account and submit your enrollment information without leaving home. You will need your Social Security number and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to speak with a representative who can walk you through enrollment over the phone. The line is open 24 hours a day, seven days a week. Have your Social Security number and any insurance information ready.

A third option is to visit your local Social Security office in person. 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 information about any current coverage.

What happens if you are still working at 65

You can delay enrolling in Part B (but not Part A) if you are still working and covered by your employer's health plan. This is called creditable coverage. If your employer has 20 or more employees, your employer coverage is primary, meaning it pays first, and Medicare pays second.

You have an eight-month Special Enrollment Period after your employment or coverage ends to sign up for Part B without a late penalty. This gives you time to transition from employer coverage to Medicare without the permanent surcharge. You must enroll within this window or face the penalty.

Part A (hospital insurance) is different — you should enroll at 65 even if you are working, because there is no penalty for enrolling early and it does not cost extra if you have earned enough work credits. Delaying Part A enrollment can result in a penalty if you wait past your Initial Enrollment Period.

Understanding Part A and Part B premiums

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay nothing for Part A premiums if they or their spouse paid Medicare taxes for at least 10 years (40 quarters). If you do not meet this requirement, you can still enroll and pay a monthly premium, which varies based on how many quarters of coverage you have.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium that changes each year. In 2024, the standard premium was $164.90 per month, but the amount you pay depends on your income — higher earners pay more through an Income-Related Monthly Adjustment Amount (IRMAA). If you enroll late, your premium increases by 10 percent for each full year you delayed.

You can view current premium amounts and income thresholds at Medicare.gov. Premiums are usually deducted from your Social Security check automatically once you enroll.

Coordinating Medicare with other coverage

If you have retiree health coverage from a former employer, check whether it coordinates with Medicare or ends when you turn 65. Some employer plans continue alongside Medicare; others stop. Contact your former employer's benefits office to understand how your coverage works with Medicare.

If you have a Medigap policy (supplemental insurance), you have a six-month window from the date you enroll in Part B to buy a Medigap plan without medical underwriting or waiting periods. After this window closes, insurers can deny you or charge more based on your health history. This is one reason to enroll in Part B on time — it protects your access to supplemental coverage.

If you are covered by a spouse's employer plan, you may be able to delay Part B enrollment without penalty. Verify this with your spouse's benefits administrator and with Medicare before your Initial Enrollment Period ends, because the rules are specific and mistakes can be costly.

Frequently Asked Questions

Do I have to enroll in Medicare at 65 if I am still working?

You should enroll in Part A at 65 even if you are working, because it has no premium for most people and no penalty for early enrollment. Part B enrollment can be delayed if you have creditable coverage from your employer with 20 or more employees, but you must enroll within eight months of losing that coverage to avoid a permanent penalty.

What is the penalty for enrolling late?

The Part B late enrollment penalty is 10 percent of the standard monthly premium for each full year you were may be able to access but did not enroll. This amount is added to your premium permanently. Part D has a similar penalty based on months without coverage. These penalties do not go away, even if you move to a different plan.

Can I change my mind after I enroll?

Yes. You have a seven-day period after you enroll to cancel and restart your enrollment if you change your mind. After that, you can make changes during the annual Open Enrollment Period from October 15 through December 7 each year, when coverage changes take effect January 1.

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 enroll in Medicare. Bring proof of citizenship or legal residency when you sign up. Refugees and asylees have different rules — contact Medicare directly at 1-800-MEDICARE to discuss your situation.

Do I need to enroll in Part D at 65?

You should enroll in Part D (prescription drug coverage) when you turn 65, even if you do not take medications now. If you go without Part D coverage for 63 days or longer and later enroll, you pay a permanent monthly penalty. You can enroll during your Initial Enrollment Period or during the annual Open Enrollment Period.