Medicare starts at age 65 for most people

You become may be able to access for Medicare on the first day of the month you turn 65. If your birthday is the first of the month, that is your start date. If your birthday is any other day, Medicare begins on the first day of the following month.

You do not have to wait until you actually turn 65 to sign up. You can enroll during the three months before you turn 65, the month you turn 65, and the three months after. This seven-month window is called your Initial Enrollment Period. If you miss this window, you may face a permanent penalty on your premiums.

Some people become may be able to access before 65 because of a disability or end-stage renal disease. If you have received Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare at any age. If you have end-stage renal disease, you may be may be able to access regardless of age.

Key Takeaways

  • Medicare may be able to access begins the first day of the month in which you turn 65, or the month after if your birthday is not the first.
  • You can enroll up to three months before you turn 65 and should do so to avoid late penalties.
  • If you are still working and have health insurance through your employer, you may be able to delay Part B enrollment without penalty.
  • People under 65 who receive SSDI for 24 months or have end-stage renal disease may be may be able to access early.
  • Signing up during your Initial Enrollment Period takes place through Social Security, Medicare.gov, or your local Social Security office.

When to sign up before you turn 65

You should enroll in Medicare during the three months before your 65th birthday. This gives Medicare time to process your enrollment and have your coverage ready on your start date. If you wait until the month you turn 65 or after, there may be a gap before your coverage begins.

The easiest way to enroll is online at Medicare.gov. You can also call Social Security at 1-800-772-1213 or visit your local Social Security office in person. Have your Social Security number and birth certificate or passport ready.

If you are already receiving Social Security benefits, you will be enrolled automatically in Medicare Part A and Part B. You do not need to do anything. Medicare will send you a card in the mail about two weeks before your 65th birthday.

If you are still working at 65

If you are still employed and your employer has 20 or more workers, you may have group health plan coverage through your job. In this case, you can delay enrolling in Medicare Part B without facing a late penalty, as long as you enroll within eight months of leaving your job or losing your employer coverage.

You must still enroll in Part A (hospital insurance) at 65, even if you are working. Part A is free for most people and does not affect your employer coverage. However, you can delay Part B (medical insurance) if your employer plan is primary.

Tell your employer's benefits office that you are turning 65 and ask whether your plan is considered creditable coverage. This term means it covers at least as much as Medicare Part B. If it does, you have the right to delay Part B enrollment.

What happens if you miss your enrollment window

If you do not sign up during your Initial Enrollment Period and you do not have a valid reason for the delay, you will pay a late enrollment penalty for the rest of your life. The penalty is added to your Part B and Part D premiums each month.

The penalty for Part B 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 would be 30 percent. This penalty stays with you even if you move to a different state or change plans.

There are a few situations where you may not face a penalty. If you had creditable coverage through an employer or union, or if you were covered under a spouse's plan, you may have a grace period. You must be able to show proof of that coverage. Contact Medicare at 1-800-MEDICARE to ask whether your situation qualifies.

Medicare enrollment for people under 65

If you receive SSDI, you become may be able to access for Medicare automatically after you have been on disability for 24 months. You do not need to enroll; Medicare will contact you. Your coverage will begin on the 25th month of your disability.

If you have end-stage renal disease (ESRD) and need dialysis or a kidney transplant, you may be may be able to access for Medicare at any age. You must enroll through Social Security or Medicare.gov. Your coverage can begin as early as the first day of the month you start dialysis treatment, or three months before a scheduled transplant.

If you have amyotrophic lateral sclerosis (ALS), you become may be able to access for Medicare when ready, without waiting 24 months on SSDI. You can enroll as soon as you are approved for SSDI benefits.

Understanding Part A and Part B enrollment

Medicare has different parts, and the age rules explore to all of them. Part A covers hospital stays, skilled nursing care, and hospice. Part B covers doctor visits, outpatient care, and medical equipment. Most people enroll in both at the same time when they turn 65.

Part A is free for most people because they or their spouse paid Medicare taxes while working. Part B requires a monthly premium, which changes each year. In 2024, the standard Part B premium is $164.90 per month, but this amount varies based on your income.

If you delay Part B because you are still working, you will need to enroll later. You have eight months from the date you lose your employer coverage or stop working, whichever comes first. After that window closes, the late penalty applies.

What to do right now if you are turning 65 soon

Write down your 65th birthday and mark three months before it on your calendar. This is when you should enroll. Gather your Social Security number, birth certificate or passport, and information about any current health insurance you have.

If you are still working, contact your employer's benefits office and ask whether your health plan is creditable coverage. Get the answer in writing. This document will protect you if you need to delay Part B enrollment.

Visit Medicare.gov and create an account. You can enroll online, by phone at 1-800-MEDICARE, or in person at your local Social Security office. Enrolling online is usually fastest and you will get confirmation right away.

Frequently Asked Questions

What if my birthday is on the first day of the month?

Your Medicare coverage starts on your birthday itself. You can enroll up to three months before that date. If you are born on January 1st, for example, you can enroll starting October 1st of the previous year.

Do I have to enroll in Part D (prescription drug coverage) at 65?

You do not have to, but if you do not enroll when you first become may be able to access and you go without creditable drug coverage, you will pay a late penalty when you do enroll. The penalty is about 1 percent of the national average Part D premium for each month you were may be able to access but not enrolled.

Can I change my mind after I enroll in Medicare?

Yes. You have a seven-month Initial Enrollment Period, and you can change your choices during this time. After that, you can make changes during the annual Open Enrollment Period from October 15 to December 7 each year, or if you have a may have access to life event like moving or losing other coverage.

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. If you meet these requirements, you can enroll in Medicare at 65 just like anyone else. Bring proof of citizenship or permanent residency when you enroll.

Do I lose Medicare if I move out of the United States?

Medicare coverage generally ends if you move outside the United States for more than six months. Part A and Part B do not cover care outside the U.S., except in limited situations near the border or on a ship. If you plan to move abroad, contact Medicare to understand how this affects your coverage.