The standard age to start Medicare is 65
You become may be able to access for Medicare the month you turn 65, regardless of whether you are still working. Most people sign up during the three months before their 65th birthday — the month they turn 65, and the three months after. If you miss this window, you can still sign up later, but you may pay a higher monthly premium for the rest of your life.
You do not have to retire to get Medicare. You can be working full-time and still enroll at 65. Your may be able to access depends on your age and your work history, not on whether you have left your job.
Key Takeaways
- You can enroll in Medicare starting three months before you turn 65, during the month you turn 65, and for three months after your birthday.
- If you miss your initial enrollment window, you will pay a permanent penalty on your monthly premium unless you had may have access to coverage through an employer.
- You may be able to start Medicare before 65 if you have been receiving Social Security disability benefits for 24 months or have end-stage renal disease or ALS.
- If you are still working and covered by your employer's health plan, you can delay Medicare enrollment without penalty as long as your employer has 20 or more employees.
Who can get Medicare before age 65
Three groups of people under 65 can enroll in Medicare. The first group includes people who have been receiving Social Security Disability Insurance (SSDI) for at least 24 months. Once you have been on SSDI for two years, you automatically move to Medicare, usually without having to sign up separately.
The second group includes people with end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant. You can enroll in Medicare as soon as your doctor determines you have ESRD, even if you are in your 20s or 30s.
The third group includes people with ALS (amyotrophic lateral sclerosis), also called Lou Gehrig's disease. You become may be able to access for Medicare when ready upon diagnosis, without waiting for SSDI approval or any other condition.
What happens if you miss your enrollment window
Your initial enrollment period is seven months long: three months before you turn 65, the month you turn 65, and three months after. If you do not sign up during this time and you do not have a valid reason for the delay, you will pay a late enrollment penalty.
The penalty is 10 percent of the standard Part B premium for each full 12 months you were may be able to access but not enrolled. If the standard premium is $165 per month and you wait two years to sign up, you will pay an extra $33 per month for the rest of your life. This penalty does not go away.
You can avoid this penalty if you had creditable coverage — health insurance through an employer with 20 or more employees, or coverage through a spouse's employer. If you were covered through your job or your spouse's job when you turned 65, you can enroll in Medicare later without penalty, as long as you sign up within eight months of losing that coverage or leaving the job.
How to sign up for Medicare at 65
You have three 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 will need your Social Security number and information about any current health coverage.
You can also call 1-800-MEDICARE (1-800-633-4227) and speak to someone who can walk you through the process. 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/locator. Bring your Social Security card, proof of citizenship or legal residency, and proof of age.
Delaying Medicare if you are still working
If you are still working and your employer offers health insurance, you may not need to sign up for Medicare at 65. You can delay enrollment without penalty if your employer has 20 or more employees and you are covered under the employer's plan.
When you do leave your job or lose coverage, you have eight months to sign up for Medicare without paying a late penalty. This is called your Special Enrollment Period. Tell Medicare when you are signing up that you had employer coverage, so they know not to charge you the penalty.
If your employer has fewer than 20 employees, you should sign up for Medicare at 65 even if you are still working. Employer plans for small companies are not considered creditable coverage for Medicare purposes.
Medicare Part A versus Part B at 65
When you turn 65, you are may be able to access for both Part A (hospital insurance) and Part B (medical insurance). Most people get Part A automatically if they or their spouse paid Medicare taxes while working. You do not pay a monthly premium for Part A if you have 40 quarters of work history.
Part B requires you to sign up and pay a monthly premium. The standard premium in 2024 varies based on your income, but most people pay between $165 and $560 per month. If you do not sign up during your initial enrollment period and you do not have creditable coverage, you will pay a permanent 10 percent penalty on top of the regular premium.
You can choose to delay Part B if you are still working and covered by your employer's plan, but you must sign up within eight months of losing that coverage. Part A has no late penalty, so you can delay it without consequence if you do not need hospital coverage yet.
What to ask your doctor and when to seek help
About three months before you turn 65, ask your doctor whether you should sign up for Original Medicare (Part A and Part B) or explore a Medicare Advantage plan instead. Your doctor can tell you which option works best with your current medications and the specialists you see.
If you are unsure whether you have creditable coverage through your employer, ask your HR department or benefits administrator in writing. Request a letter stating the dates you were covered and whether the plan meets Medicare's definition of creditable coverage. Keep this letter — you may need it to avoid a late penalty.
If you turned 65 more than three months ago and did not sign up, contact Medicare right away to understand your penalty and your options. Call 1-800-MEDICARE or visit Medicare.gov. The sooner you enroll, the sooner your coverage begins.
Frequently Asked Questions
Can I get Medicare before 65 if I am retired but not disabled?
No. If you are not receiving SSDI, do not have ESRD or ALS, and are not yet 65, you cannot enroll in Medicare. You will need to purchase coverage through the Affordable Care Act marketplace or continue coverage through a former employer's retiree plan until you turn 65.
What if I was born on the first of the month — when does my Medicare start?
If you were born on the first day of the month, Medicare coverage begins the first day of the month before your birthday. For all other birth dates, coverage begins the first day of the month in which you turn 65. Your enrollment window opens three months before this date.
Do I have to sign up for 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 will pay a permanent penalty. If you do not take prescription drugs, you can skip Part D now and sign up later without penalty only if you enroll within 63 days of gaining creditable coverage through another source.
What if I am a non-citizen — can I still get Medicare at 65?
You must be a U.S. citizen or a lawful permanent resident (green card holder) who has lived in the United States for at least five years. If you meet these requirements and have the required work history, you can enroll in Medicare at 65 just like any other person.
Can my spouse sign up for Medicare on my work record?
Yes. If your spouse is 65 or older and you have been married for at least one year, they can enroll in Part A based on your work history even if they did not work enough to may have access to on their own. They still need to sign up for Part B separately and pay the monthly premium.