You can sign up for Medicare when you turn 65, regardless of whether you are still working

Medicare may be able to access begins the month you turn 65. You do not have to wait until your birthday month ends — coverage can start as early as the first day of the month in which you turn 65. This applies whether you are retired, still employed, or self-employed. The only exception is if you are receiving Social Security Disability Insurance (SSDI) or have end-stage renal disease, in which case different rules explore.

You do not have to be retired to sign up. Many people continue working past 65 and carry both employer health insurance and Medicare. If you are still covered by an employer plan through your own job (not your spouse's), you may be able to delay Medicare Part B without penalty, though you should still enroll in Part A when you turn 65.

Key Takeaways

  • Medicare enrollment opens three months before the month you turn 65 and closes three months after, giving you a seven-month window to sign up.
  • If you miss your initial enrollment window, you will pay a permanent penalty on Part B and Part D premiums for as long as you have Medicare.
  • You can sign up online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • If you are still working and covered by your employer's health plan, you may delay Part B enrollment without penalty, but Part A enrollment is still recommended at 65.

Your seven-month enrollment window

Your Initial Enrollment Period (IEP) lasts seven months total. It begins three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, your window opens in March and closes in September.

You can enroll during any of those seven months. There is no advantage to signing up early versus late within this window — your coverage start date depends on when you actually enroll. If you enroll in March for a June birthday, coverage typically starts in June. If you enroll in September, coverage typically starts in September.

This window is important because missing it triggers lifetime penalties. If you do not enroll during these seven months and you do not have a valid reason for the delay, you will pay more for Part B and Part D for the rest of your life.

What happens if you miss the important date

If you do not enroll during your Initial Enrollment Period, you enter a General Enrollment Period each year from January 1 to March 31. You can sign up then, but your coverage will not start until July 1 of that year. More importantly, you will owe a late enrollment penalty.

The Part B penalty is 10 percent of the standard premium for each full 12-month period you were may be able to access but not enrolled. If you were may be able to access for three years and did not enroll, your penalty is 30 percent added to your Part B premium permanently. The Part D penalty works the same way for prescription drug coverage. These penalties do not go away — you pay them for life.

There are exceptions. If you were covered by an employer health plan through your own job, you have what is called creditable coverage. You can delay Part B without penalty. However, you should still enroll in Part A at 65, as it has no penalty for delay and covers hospital care.

Special situations: Before 65 or after 65

Most people sign up at 65, but some become may be able to access earlier. If you have been receiving SSDI for 24 months, you become may be able to access for Medicare at any age. If you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you can sign up when ready, regardless of age. These groups have their own enrollment rules and should contact Social Security or Medicare directly to understand their timeline.

If you are already receiving Social Security retirement benefits when you turn 65, you will be enrolled in Part A and Part B automatically. You will receive a Medicare card in the mail. You do not need to do anything unless you want to decline Part B, which you must do in writing.

If you are not yet receiving Social Security at 65, you must sign up for Medicare yourself. Reaching 65 does not automatically enroll you — you have to take action during your seven-month window.

How to sign up

You have three main ways to enroll. The fastest is online at Medicare.gov. You can create an account, review your options, and submit your enrollment in one session. 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). Representatives are available seven days a week. They can answer questions about your specific situation and help you enroll over the phone. Calls are free.

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 proof of age.

Working past 65 and Medicare

If you are still employed and your employer offers health insurance, you do not have to choose between the two. You can have both. However, the rules differ depending on the size of your employer.

If your employer has 20 or more employees, their health plan is considered primary. Medicare is secondary and pays only after the employer plan has paid its share. You can delay Part B enrollment without penalty as long as you remain employed and covered. When you leave that job, you have eight months to enroll in Part B without penalty.

If your employer has fewer than 20 employees, Medicare is primary. You should enroll in Part B when you turn 65. You should also enroll in Part A, which has no penalty for delay and covers hospital stays.

Frequently Asked Questions

Do I have to retire to sign up for Medicare at 65?

No. You can sign up for Medicare while still working. If your employer has 20 or more employees and offers health coverage, you can delay Part B without penalty. Part A is still recommended at 65 to cover hospital care.

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

You must sign up for Medicare yourself during your seven-month Initial Enrollment Period. Reaching 65 does not automatically enroll you. You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or at your local Social Security office.

Can I sign up for Medicare before I turn 65?

Your enrollment window opens three months before the month you turn 65. So if you turn 65 in June, you can start the process in March. Coverage typically begins the month you turn 65.

What is the penalty for signing up late?

The Part B penalty is 10 percent of the standard premium for each full 12-month period you were may be able to access but not enrolled. This penalty is permanent and added to your premium for life. Part D has the same penalty structure for prescription drug coverage.

Does my employer health insurance count as a reason to delay Medicare?

Yes, but only if your employer has 20 or more employees. This is called creditable coverage. You can delay Part B without penalty. When you leave that job, you have eight months to enroll in Part B without penalty.