You can start Medicare at age 65, or earlier if you have a disability or end-stage renal disease

Medicare may be able to access begins at 65 for most people. If you are younger than 65, you may still be able to start Medicare if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). The month you turn 65 is the month your coverage can begin — you do not have to wait until your birthday itself.

You do not automatically get Medicare when you turn 65. You must sign up during your enrollment window, or you may face a permanent penalty on your premiums. The enrollment process is straightforward, but the timing matters.

Key Takeaways

  • Most people become may be able to access for Medicare the month they turn 65, regardless of whether they are still working.
  • If you have been on SSDI for 24 months, you can start Medicare before age 65 without waiting.
  • You must sign up during your enrollment window — usually the three months before, the month of, and three months after your 65th birthday — or face a late enrollment penalty.
  • If you have employer health insurance and are still working, you may be able to delay Medicare without penalty under certain conditions.

may be able to access at age 65

You become may be able to access for Medicare the month you turn 65 if you are a U.S. citizen or permanent resident who has lived in the United States for at least five years. You do not have to be retired. You do not have to stop working. You do not have to be receiving Social Security yet. may be able to access is based on age alone.

If you are not yet a U.S. citizen but are a permanent resident, you must have held that status for at least five years. If you are unsure about your residency status, contact Social Security before your 65th birthday to confirm you will be may be able to access.

may be able to access before age 65 through disability

If you have been receiving SSDI for 24 consecutive months, you become may be able to access for Medicare at that point, regardless of your age. This means a person who started receiving SSDI at age 40 would become may be able to access for Medicare at age 42. The 24-month waiting period is a rule of Social Security, not Medicare itself.

If you are receiving SSDI, Social Security will contact you automatically when you become Medicare-may be able to access. You will receive a notice in the mail explaining your options. You do not need to do anything to trigger this notice — it comes automatically.

may be able to access before age 65 with end-stage renal disease or ALS

If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you become may be able to access for Medicare when ready, regardless of age. You do not have to wait 24 months. You do not have to be receiving SSDI. Your may be able to access begins the first day of the month in which you start dialysis, or the month of your kidney transplant.

If you have been diagnosed with amyotrophic lateral sclerosis (ALS), you become may be able to access for Medicare when ready as well. You do not have to wait for SSDI approval or any other condition. Your may be able to access begins the first day of the month in which you are diagnosed.

If you have ESRD or ALS, you will need to sign up for Medicare yourself. Social Security does not automatically enroll you. Contact Social Security or Medicare to begin the process as soon as you receive your diagnosis or begin treatment.

When to sign up: your enrollment window

Your Initial Enrollment Period is seven months long: the three months before the month you turn 65, the month you turn 65, and the three months after. If your birthday is in March, your enrollment window runs from December through June. You can sign up any time during this window, and coverage will begin on the first day of the month you turn 65 (or the first of the month you become may be able to access through disability or ESRD).

If you sign up after your Initial Enrollment Period ends, you may face 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 sign up. If you waited three years, your premium would be 30 percent higher for as long as you have Medicare. There is no time limit on this penalty; it does not go away.

There is one exception: if you were covered by an employer health plan while you or your spouse was still working, you may be able to delay Medicare without penalty. This is called the Special Enrollment Period. You must sign up within eight months of losing that employer coverage or losing the job itself. Keep documentation of your employer coverage dates.

How to sign up

You can sign up for Medicare through three routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online signup is fastest — you can complete it in 10 to 15 minutes if you have your Social Security number and proof of citizenship or permanent residency ready.

If you are already receiving Social Security, you will see an option to sign up for Medicare when you log into your Social Security account online. If you are not yet receiving Social Security, you can still sign up for Medicare separately through Medicare.gov or by calling the Medicare line.

Have these documents ready: your Social Security number, proof of U.S. citizenship or permanent residency (passport, birth certificate, or naturalization papers), and your current mailing address. The process takes about 15 minutes online or 20 to 30 minutes by phone.

What happens after you sign up

After you sign up, Medicare will send you a Medicare card in the mail within two to four weeks. Your coverage begins on the first day of the month you are may be able to access, even if your card has not arrived yet. You can use your Social Security number as your Medicare number until the card arrives.

When you sign up, you will also choose between Original Medicare (Part A and Part B) and a Medicare Advantage plan (Part C). This is a separate decision from signing up for Medicare itself. If you do not choose a plan, you will be automatically enrolled in Original Medicare. You can change your plan choice during the Annual Enrollment Period (October 15 to December 7 each year) or if you experience a may have access to life event.

Frequently Asked Questions

Can I delay Medicare if I am still working at 65?

You can delay Part B (medical insurance) without penalty if you are covered by an employer health plan through your job or your spouse's job. You must sign up within eight months of losing that coverage. Part A (hospital insurance) has no premium, so most people sign up for it at 65 even if they delay Part B.

What if I miss my enrollment window?

You can still sign up after your Initial Enrollment Period ends, but you will face a late enrollment penalty on Part B. The penalty is 10 percent of the standard premium for each full year you were may be able to access but did not sign up, and it is permanent. You can sign up during the General Enrollment Period (January 1 to March 31 each year), with coverage beginning July 1.

Do I have to be retired to get Medicare at 65?

No. You become may be able to access for Medicare at 65 regardless of whether you are working, retired, or receiving Social Security. Your work status does not affect your may be able to access, though it may affect whether you can delay Part B without penalty.

If I am on disability, when exactly does Medicare start?

If you have been on SSDI for 24 months, Medicare begins the 25th month of your SSDI may be able to access. Social Security will notify you by mail when you become may be able to access. If you have ESRD or ALS, Medicare begins the first day of the month you start dialysis, receive a transplant, or are diagnosed.

Can I sign up for Medicare before I turn 65?

Yes, during your Initial Enrollment Period, which begins three months before the month you turn 65. You can sign up as early as three months before your birthday, and coverage will still begin on the first day of the month you turn 65.