Medicare starts at age 65 for most people

You become may be able to access for Medicare the month you turn 65, regardless of whether you are still working. If your birthday is the 1st of the month, coverage begins the month before. If your birthday is any other day, coverage begins the month you turn 65. You do not have to retire or stop working to sign up — Medicare is available to you at 65 whether you are employed or not.

The only exception is if you are still covered by a current employer's health plan through your own job (not your spouse's). In that case, you can delay Medicare without penalty, but you will need to sign up within eight months after your employment or coverage ends, or face a permanent late-enrollment penalty on your premiums.

Key Takeaways

  • Medicare may be able to access begins the month you turn 65, or the month before if your birthday falls on the 1st.
  • You must sign up during your Initial Enrollment Period, which runs three months before, the month of, and three months after your 65th birthday.
  • If you miss your Initial Enrollment Period and do not have employer coverage, you will pay a permanent 10% increase on Part B premiums for each year you delayed.
  • You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • Some people under 65 with disabilities or end-stage renal disease may also be may be able to access for Medicare before reaching 65.

Your Initial Enrollment Period: The three-month window that matters

You have a seven-month window called your Initial Enrollment Period to sign up for Medicare. It runs for three months before you turn 65, the month of your birthday, and three months after. For example, if you turn 65 in June, your enrollment period runs from March through September.

If you sign up during this window, your coverage will begin on the first day of the month you turn 65 (or the first day of the month before, if your birthday is the 1st). If you wait until after your Initial Enrollment Period ends, there is a gap in coverage, and you will owe a permanent penalty on your Part B premiums for as long as you have Medicare.

The penalty is 10% of the standard Part B premium for each full year you delayed signing up. This penalty stays with you permanently — it does not go away after a certain time. That is why signing up during your Initial Enrollment Period, even if you do not plan to use Medicare right away, is important.

Who can get Medicare before age 65

Most people wait until 65, but some may have access to earlier. You may be may be able to access for Medicare at any age if you have been receiving Social Security Disability Insurance (SSDI) for 24 months. You become may be able to access for Medicare automatically after those 24 months pass — you do not need to explore again.

You are also may be able to access for Medicare at any age if you have end-stage renal disease (ESRD), which means your kidneys no longer work well enough to sustain life. You will need to sign up through your dialysis center or transplant team, as the process is different from the standard Medicare enrollment.

If you are under 65 and receive SSDI, you should receive a notice in the mail about three months before your 24-month mark. Read it carefully — it tells you when your Medicare coverage begins and what you need to do next.

How to sign up for Medicare at 65

You have three main ways to sign up. The easiest is online at Medicare.gov — you can create an account and complete your enrollment from home. You will need your Social Security number and information about any current health coverage you have.

You can also call 1-800-MEDICARE (1-800-633-4227) to sign up by phone. A representative can walk you through the process and answer questions about which parts of Medicare you need. The line is open 24 hours a day, seven days a week.

If you prefer to sign up in person, visit your local Social Security office. You can find the nearest one 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 (like a birth certificate or passport).

What happens if you miss your enrollment window

If you do not sign up during your Initial Enrollment Period and you do not have employer coverage through your own job, you will have to wait for the next General Enrollment Period, which runs January 1 through March 31 each year. Coverage would not begin until July 1 of that year — a gap of several months.

During that gap, you have no Medicare coverage. Any medical bills are your responsibility. When you finally do sign up, you will also owe the permanent 10% Part B penalty for each year you delayed, starting from the month after your Initial Enrollment Period ended.

The only way to avoid this penalty is if you had creditable coverage — meaning you were covered by an employer plan, COBRA, Medicaid, or another government health plan — during the time you were not enrolled in Medicare. If you did, you may be able to sign up without penalty during a Special Enrollment Period. You will need to show proof of that coverage when you sign up.

Medicare age and Social Security: They are separate decisions

Turning 65 and becoming may be able to access for Medicare is separate from claiming Social Security retirement benefits. You can sign up for Medicare at 65 without claiming Social Security, and you can claim Social Security at a different age without affecting your Medicare enrollment.

However, if you are not yet 65 and you claim Social Security, you will be automatically enrolled in Medicare Parts A and B three months before you turn 65. You will receive a notice in the mail about two months before this happens. If you do not want Part B, you can decline it, but you should do so before the enrollment takes effect to avoid penalties.

If you are already receiving Social Security when you turn 65, Medicare will start automatically. You do not need to do anything — you will get your Medicare card in the mail about two weeks before your coverage begins.

Special situations: Working past 65 and employer coverage

If you are still working and covered by your employer's health plan at 65, you can delay Medicare Part B without penalty. You must sign up within eight months after your employment ends or your coverage stops, whichever comes first. If you miss that important date, you will owe the permanent 10% Part B penalty.

You should still sign up for Part A (hospital insurance) at 65, even if you delay Part B. Part A is usually free if you or your spouse paid Medicare taxes for at least 10 years, and it has no penalty for late enrollment. Signing up for Part A does not require you to take Part B.

If you are self-employed or own a business, you are not considered to have employer coverage. You should sign up for Medicare during your Initial Enrollment Period to avoid penalties, even if you plan to keep working.

Frequently Asked Questions

What if my birthday is on the 1st of the month?

Your Medicare coverage begins the month before you turn 65, on the first day of that month. Your enrollment period still runs three months before, the month of, and three months after your actual birthday month. For example, if your birthday is July 1, coverage begins June 1, and your enrollment period runs from April through October.

Do I have to sign up for all parts of Medicare at 65?

No. Part A (hospital insurance) is automatic for most people, but you can decline Part B (medical insurance) if you have employer coverage. Part D (prescription drug) and Medigap or Medicare Advantage are optional. However, if you decline Part B and do not have employer coverage, you will owe a penalty when you eventually sign up.

What if I am still working and do not need Medicare yet?

If you have employer coverage through your own job, you can delay Part B without penalty. You must sign up within eight months after your employment or coverage ends. You should still sign up for Part A at 65 — it is usually free and has no late-enrollment penalty.

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

Yes, but only during certain times. You have a seven-day period after you receive your Medicare card to change or cancel your enrollment. After that, you can make changes during the Annual Enrollment Period (October 15 through December 7 each year) or if you have a may have access to life event, like losing employer coverage.

What happens 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 to be may be able to access for Medicare. When you sign up, you will need to show proof of citizenship or legal residency, such as a passport, birth certificate, or green card.