You can sign up for Medicare when you turn 65, regardless of whether you are still working
Medicare may be able to access begins the month you turn 65. You do not have to be retired, and you do not have to stop working. If your birthday falls on the first of the month, your coverage starts that month. If your birthday is any other day, your coverage starts the first day of the month after you turn 65.
You should sign up during your Initial Enrollment Period, which runs for seven months: three months before the month you turn 65, the month you turn 65, and three months after. Missing this window can cost you more in premiums for the rest of your life, even if you sign up later.
If you are already receiving Social Security benefits when you turn 65, you will be enrolled in Medicare automatically. If you are not yet taking Social Security, you will need to sign up yourself through Medicare.gov, by phone, or at your local Social Security office.
Key Takeaways
- You become may be able to access for Medicare the month you turn 65, and you have seven months total to sign up without penalty.
- If you miss your Initial Enrollment Period, you will pay a permanent penalty on your Part B and Part D premiums unless you have employer coverage or other may have access to circumstances.
- Social Security will enroll you automatically in Medicare Parts A and B if you are already receiving benefits; otherwise you must sign up yourself.
- Working past 65 does not delay your Medicare may be able to access, though your coverage choices may differ if your employer offers health insurance.
What happens if you sign up late
If you do not sign up during your seven-month Initial Enrollment Period, you will face a late enrollment penalty on Part B (medical insurance) and Part D (prescription drug coverage). This penalty is permanent — you will pay it for as long as you have Medicare, even if you eventually sign up.
The Part B penalty is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. The Part D penalty is calculated differently and depends on the cost of drug plans in your area, but it also compounds year after year. For example, if you wait three years to sign up, you will owe three years of penalties.
You can avoid the penalty if you have creditable coverage — health insurance through a current employer, a spouse's employer, TRICARE, the Veterans Health Administration, or certain other sources. If you have this coverage, you can delay signing up for Medicare without penalty, but you must sign up within eight months of losing that coverage.
Special situations that change your enrollment window
If you are still working at 65 and your employer has 20 or more employees, you may be able to delay Medicare Part B without penalty. You can stay on your employer's plan and sign up for Medicare later. However, you should still sign up for Part A (hospital insurance) at 65, since it has no premium for most people and covers hospital stays.
If you are a federal employee, railroad retiree, or have coverage through the Veterans Health Administration, your enrollment rules may differ. Contact your benefits administrator before your 65th birthday to understand your specific situation.
If you are not yet a U.S. citizen or permanent resident, you cannot sign up for Medicare at 65. You become may be able to access only after you have been a permanent resident for five consecutive years.
How to sign up during your enrollment period
You have three main ways to sign up: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online is usually fastest — you can complete the process in about 10 minutes if you have your Social Security number and information about any current health coverage.
By phone, a representative will walk you through the same questions and can answer questions about your specific situation. Wait times vary, but calling early in the week or early in the day is usually faster.
At a Social Security office, staff can help you in person and answer questions about both Medicare and Social Security benefits. You can find your local office at ssa.gov or by calling 1-800-772-1213.
What to have ready when you sign up
Gather your Social Security number, birth date, and citizenship information before you start. If you are currently covered by an employer or union health plan, have that information available — the program will ask whether your coverage is through your own job or a spouse's job, and whether your employer has 20 or more employees.
If you are signing up for Part D (prescription drug coverage) at the same time, have a list of your current medications and the pharmacies you use. This helps you choose a plan that covers your drugs at the lowest cost.
You do not need to bring documents in person unless you are explore for help paying your premiums. If you are, bring proof of income and citizenship.
Understanding Part A and Part B enrollment
Part A is hospital insurance. It covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. You are automatically enrolled in Part A when you sign up, and you should accept it even if you are still working.
Part B is medical insurance. It covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium that changes each year. In 2024, the standard premium is $164.90 per month, but it is higher for people with higher incomes. You must actively choose to enroll in Part B; it is not automatic unless you are already receiving Social Security.
If you delay Part B because you have employer coverage, you must sign up within eight months of losing that coverage. If you wait longer, you will owe the late enrollment penalty.
Frequently Asked Questions
Can I sign up for Medicare before I turn 65?
No. You can begin the enrollment process three months before you turn 65, but your coverage will not start until the month you turn 65. You can start gathering documents and information early, and you can call Medicare to ask questions, but you cannot complete enrollment until three months before your birthday.
What if I am still working and do not want Medicare yet?
You must sign up during your Initial Enrollment Period to avoid penalties, even if you do not use it right away. If your employer has 20 or more employees, you can delay Part B without penalty, but you should still enroll in Part A. Talk to your employer's benefits department about how Medicare coordinates with your work coverage.
Do I lose Medicare if I go back to work after 65?
No. Once you are enrolled in Medicare, you keep it regardless of whether you work. Your coverage does not change if you return to work or change jobs. However, if you have both Medicare and employer coverage, you will need to understand which one pays first for your medical bills.
What if I was not a permanent resident when I turned 65?
You become may be able to access for Medicare five years after you become a permanent resident, not at age 65. Once you meet the five-year requirement, you have a seven-month enrollment period starting three months before you become may be able to access. Contact Medicare at 1-800-MEDICARE to confirm your may be able to access date.
Can my spouse sign up for Medicare at 65 even if I am younger?
Yes. Each person becomes may be able to access at 65 regardless of their spouse's age. Your spouse should sign up during their own seven-month Initial Enrollment Period. You can be on different Medicare plans or different plan types — there is no requirement to enroll together.