When You're Eligible for Medicare: Age and Other Starting Points

You can start Medicare at 65, but you may be able to start earlier if you have a disability or end-stage renal disease

The standard age to start Medicare is 65. You become may be able to access on the first day of the month you turn 65, or the month after, depending on your birthday. But 65 is not the only entry point. If you have been receiving Social Security disability benefits for 24 months, you can start Medicare at any age. If you have end-stage renal disease (ESRD) or ALS, you may start right away regardless of age.

The month you turn 65 is called your Initial Enrollment Period. This is a seven-month window: the three months before you turn 65, the month you turn 65, and the three months after. If you miss this window and do not have other coverage, you may face a permanent penalty on your premiums. That is why the timing matters even if you are not ready to retire.

Key Takeaways

You become may be able to access for Medicare the month you turn 65, and you have seven months to sign up without penalty.
If you are still working and have employer health insurance, you may be able to delay Medicare without penalty as long as your employer has 20 or more employees.
You can start Medicare before 65 if you have received Social Security disability benefits for 24 months, or if you have end-stage renal disease or ALS.
Missing your Initial Enrollment Period can result in a permanent increase to your Part B and Part D premiums, even if you sign up later.

Starting Medicare at 65: The standard timeline

Most people become may be able to access for Medicare the month they turn 65. You do not have to be retired, and you do not have to have applied for Social Security yet. may be able to access is based on age alone, as long as you are a U.S. citizen or permanent resident who has lived in the country for at least five years.

Your Initial Enrollment Period runs for seven months: three months before your 65th birthday, the month of your birthday, and three months after. 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 sign up during this window, your coverage typically starts on the first day of the month you turn 65.

If you sign up after your Initial Enrollment Period ends, your coverage will start the first day of the month after you sign up. You will also owe a penalty on your Part B premium (the part that covers doctor visits) for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but not signed up.

Starting Medicare before 65 if you have a disability

You can start Medicare at any age if you have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months. The 24 months do not have to be consecutive, but they must have occurred. Once you reach 24 months of SSDI, Medicare begins automatically the first day of the month after your 24-month period ends. You do not have to sign up.

If you are blind, the rules are different. You can start Medicare as soon as you begin receiving SSDI, without waiting 24 months. Your coverage will begin the first day of the month you become may be able to access.

If you receive Supplemental Security Income (SSI) instead of SSDI, you are not covered by this rule. SSI recipients become may be able to access for Medicare at 65, like everyone else.

Starting Medicare when ready if you have end-stage renal disease or ALS

If you have end-stage renal disease (ESRD) — kidney failure requiring dialysis or a transplant — you can start Medicare right away, regardless of age. Your coverage begins the first day of the month you start dialysis or the month after you receive a kidney transplant, whichever comes first. You do not have to wait for your 65th birthday.

If you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you can also start Medicare when ready. Your coverage begins the first day of the month you are diagnosed. Like ESRD, you do not need to reach 65.

If you have ESRD or ALS, you will receive a notice from Social Security telling you when your Medicare coverage starts. You do not have to sign up yourself, but you should confirm the start date and make sure you receive your Medicare card before your coverage begins.

Delaying Medicare if you are still working

If you are still working at 65 and have health insurance through your employer, you may be able to delay Medicare without penalty. This is called the Special Enrollment Period for people with group health plan coverage. The rule applies only if your employer has 20 or more employees.

If you are covered by an employer plan, you can wait to sign up for Medicare Part B (doctor and outpatient care) and Part D (prescription drugs) until you leave your job or lose your employer coverage. When you do sign up, you have eight months to do so without penalty. This window starts the month your employment or coverage ends.

You should still sign up for Part A (hospital insurance) when you turn 65, even if you delay Part B and Part D. Part A has no monthly premium for most people, and signing up does not affect your employer coverage.

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 face a permanent penalty. For Part B, the penalty is 10 percent of the standard monthly premium for each full year you were may be able to access but not enrolled. For Part D (prescription drug coverage), the penalty is 1 percent of the national average premium for each month you were without coverage.

These penalties stay with you for as long as you have Medicare. They do not go away if you sign up later. The only way to avoid them is to sign up during your Initial Enrollment Period or to have a valid reason for late enrollment, such as employer coverage or a Special Enrollment Period.

If you believe you have a valid reason for missing your important date, you can contact Social Security or Medicare to ask about a Special Enrollment Period. They will review your situation, but approval is not may provide.

Frequently Asked Questions

Can I start Medicare before I turn 65 if I am retired?

No, unless you have a disability, end-stage renal disease, or ALS. Retirement alone does not lower the age. You must wait until 65 or meet one of the other conditions. If you retire early, you will need to find other coverage until Medicare begins.

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

Your Initial Enrollment Period still runs for seven months: the three months before your birthday month, your birthday month, and the three months after. Your coverage will start on the first day of the month you turn 65.

Do I have to sign up for all parts of Medicare at once?

No. You can sign up for Part A and Part B separately from Part D. If you have employer coverage, you can delay Part B and Part D without penalty. Part A should be signed up for at 65 because it has no premium for most people and does not interfere with other coverage.

What if I am not a U.S. citizen?

You must be a U.S. citizen or permanent resident who has lived in the country for at least five years to be may be able to access for Medicare at 65. If you do not meet these requirements, you will need to explore other coverage options.

Can I change my mind after I sign up for Medicare?

Yes, during your Initial Enrollment Period you can change your choices. After that period ends, you can make changes only during the annual Open Enrollment Period (October 15 to December 7) or if you have a may have access to life event, such as losing employer coverage.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.