You must sign up for Medicare at 65, or face penalties that last for life
You become may be able to access for Medicare the month you turn 65. You do not have to wait until your birthday month ends — you can sign up as early as three months before you turn 65. Most people should sign up during their initial enrollment period, which runs for seven months: the three months before the month you turn 65, the month you turn 65, and the three months after.
If you do not sign up during this window, you will pay a permanent penalty on your Part B and Part D premiums for as long as you have Medicare. The penalty is 10 percent of the Part B premium for each full year you delayed, and 1 percent of the Part D premium for each month you delayed. These penalties do not go away if you sign up later — they are added to your premium every month for the rest of your life.
There are narrow exceptions. If you have health insurance through a current job or a spouse's current job, you may be able to delay without penalty. If you receive Social Security benefits before 65, you are automatically enrolled in Medicare Part A and Part B the month you turn 65, though you still need to choose Part D coverage if you want it.
Key Takeaways
- 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 miss this window, you pay a permanent 10 percent penalty on Part B premiums and 1 percent per month on Part D premiums for life.
- You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
- If you have health insurance through your job, you may be able to delay without penalty — ask your employer's benefits office before you turn 65.
- If you already receive Social Security, you are automatically enrolled in Part A and Part B at 65, but you must choose Part D coverage yourself.
What happens if you sign up before you turn 65
You can sign up as early as three months before your 65th birthday. Your coverage will start on the first day of the month you turn 65, regardless of when during that three-month window you sign up. There is no advantage to signing up earlier than three months before — the system will not let you enroll before that point.
If you sign up in the month you turn 65 or in the three months after, your coverage start date depends on when you sign up. If you sign up in the month you turn 65, coverage starts the first of that month. If you sign up one month after your birthday month, coverage starts the first of the following month. If you sign up two months after your birthday month, coverage starts the first of the month after that. This delay is why signing up early — during those first three months — is usually the safest choice.
What to do if you already missed the important date
If you are past your initial enrollment period and did not sign up, you can still enroll, but you will owe the permanent penalty. You can sign up during the general enrollment period, which runs from January 1 to March 31 each year. Coverage will start July 1 of that year. You will pay the penalty on top of your regular premium.
There is one exception: if you have a may have access to life event, you may be able to sign up outside the normal windows without penalty. may have access to events include losing job-based health insurance, moving to a different state, or getting married or divorced. You have 63 days from the event to sign up. Contact Medicare at 1-800-MEDICARE to report the event and ask whether you may have access to for this exception.
How to sign up for Medicare at 65
You have three ways to sign up: online, by phone, or in person. The online method is the fastest. Go to Medicare.gov, click "Sign up for Medicare," and follow the steps. You will need your Social Security number and information about any current health insurance you have. You can complete the whole process in about 15 minutes.
If you prefer to sign up by phone, call 1-800-MEDICARE (1-800-633-4227). Representatives are available Monday through Friday, 8 a.m. to 8 p.m. Eastern time. Have your Social Security number and insurance information ready. The call usually takes 20 to 30 minutes.
You can also sign up in person at your local Social Security office. Find the office nearest you at ssa.gov/locator. Bring your Social Security card, proof of citizenship or legal residency, and proof of age. Bring information about any current health insurance as well. You do not need an appointment — you can walk in during business hours, though wait times vary.
What you need to know about Part A and Part B enrollment
Part A covers hospital stays, skilled nursing facility care, hospice, and home health services. Part B covers doctor visits, outpatient services, and some preventive care. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working. Part B has a monthly premium that changes each year — in 2024 it is $164.90 for most people, though higher earners pay more.
When you sign up for Medicare, you are signing up for both Part A and Part B together. You cannot get Part B without Part A, and you cannot delay Part B without a penalty unless you have job-based insurance. If you have job-based insurance through your employer or your spouse's employer, you can delay Part B without penalty as long as you are still working and covered by that plan. You have eight months after you leave that job or lose that coverage to sign up without penalty.
Part D coverage and the sign-up important date
Part D is prescription drug coverage. It is optional, but if you do not sign up when you are first may be able to access and you go without creditable coverage, you will pay a 1 percent penalty on your Part D premium for each month you were not covered. Unlike Part B, this penalty applies even if you have job-based insurance — unless that job-based plan includes prescription drug coverage that is at least as good as Medicare Part D.
You sign up for Part D at the same time you sign up for Part A and Part B, or you can sign up separately during your initial enrollment period. If you already have prescription drug coverage through your job or a retiree plan, check whether it is creditable coverage by asking your benefits office. If it is, you can delay Part D without penalty. If it is not, sign up for Part D during your initial enrollment period.
Special situations: working past 65 or living abroad
If you are still working at 65 and have health insurance through your job, you may be able to delay Medicare without penalty. This is true whether you are the employee or the spouse of an employee. You must have actual coverage through that job — coverage through a spouse's job counts, but coverage through a part-time job that does not offer benefits does not. Contact your employer's benefits office to confirm your coverage is creditable before you turn 65.
If you live outside the United States, you can still sign up for Medicare at 65. Part A and Part B work the same way. Part D (prescription drug coverage) is more limited if you live abroad — some plans do not cover prescriptions filled outside the U.S. Check the plan details before you sign up. You can sign up online at Medicare.gov or by phone at 1-800-MEDICARE even if you are overseas.
Frequently Asked Questions
What if I turn 65 and I am still working?
You still become may be able to access for Medicare at 65. If you have health insurance through your job, you can delay Part B without penalty as long as you stay employed and covered. Part A is usually free, so most people sign up for it. You must sign up for Part B within eight months of leaving that job or losing that coverage, or you will owe a penalty.
Can I sign up for Medicare before I turn 65?
You can sign up starting three months before your 65th birthday. Your coverage will begin the first day of the month you turn 65. There is no advantage to signing up more than three months early — the system will not let you. Signing up during those first three months is the safest way to make sure you have coverage on time.
What happens if I miss my enrollment period by a few months?
You can still sign up during the general enrollment period (January 1 to March 31), and coverage will start July 1. You will owe a permanent penalty on your Part B and Part D premiums. If you had a may have access to life event like losing job-based insurance, you have 63 days from that event to sign up without penalty — call 1-800-MEDICARE to report it.
Do I have to sign up for Part D if I do not take prescription drugs?
You do not have to sign up for Part D right now, but if you go without creditable coverage and later want it, you will pay a 1 percent penalty for each month you were not covered. If you think you might need prescriptions in the future, it is usually cheaper to sign up during your initial enrollment period and pay the regular premium than to wait and pay the penalty.
What if I am on Social Security — do I still need to sign up for Medicare?
If you are already receiving Social Security benefits when you turn 65, you are automatically enrolled in Part A and Part B. You will receive a Medicare card in the mail about three months before your 65th birthday. You still need to choose Part D coverage yourself if you want prescription drug coverage — you will not be automatically enrolled in that.