The Standard Age for Medicare Coverage

You become may be able to access for Medicare at age 65, regardless of your work history or income. This is the primary entry point, and it applies to U.S. citizens and permanent residents who have lived in the country for at least five years. You do not have to wait until you retire — Medicare may be able to access is based on age alone, not employment status.

The month you turn 65, you enter your Initial Enrollment Period, which runs for seven months: three months before your birthday month, your birthday month itself, and three months after. During this window, you can enroll in Medicare Part A (hospital insurance) and Part B (medical insurance) without penalty. If you miss this window, you may face a permanent late-enrollment penalty on Part B premiums.

Not everyone waits until 65. Some people become may be able to access earlier through disability or end-stage renal disease, which are discussed below. Others delay enrollment past 65 if they are still working and covered by an employer plan — but the rules for doing this safely are specific and worth understanding before you make that choice.

Key Takeaways

  • You become may be able to access for Medicare at age 65 if you are a U.S. citizen or permanent resident who has lived in the country for at least five years.
  • Your Initial Enrollment Period spans seven months — three months before your 65th birthday, your birthday month, and three months after — and missing it can result in a permanent penalty on Part B premiums.
  • You can become may be able to access before age 65 if you have been receiving Social Security disability benefits for 24 months or if you have end-stage renal disease or ALS.
  • If you are still working at 65 and covered by your employer's health plan, you may be able to delay Part B enrollment without penalty, but you must meet specific conditions.
  • Enrollment happens through Social Security, Medicare.gov, or by phone at 1-800-MEDICARE, and the process takes about two weeks to complete.

Becoming may be able to access Before Age 65

Three groups of people can enroll in Medicare before they turn 65. The first and largest group consists of people who have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months. The 24-month clock starts from the month you first received a disability payment, not from the month you applied. Once you hit 24 months of payments, you automatically move to Medicare — no new process is needed, though you will receive a notice in the mail.

The second group includes people with end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant. You become may be able to access for Medicare the first month of dialysis treatment or, if you receive a transplant, the month of the transplant. You do not have to wait for a specific duration of treatment.

The third group is people with amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease. You become may be able to access for Medicare the month you are diagnosed, with no waiting period. This is the only condition that grants when ready Medicare may be able to access.

If you fall into any of these categories, you will receive a notice from Social Security or Medicare explaining your may be able to access and next steps. You do not need to do anything to trigger the enrollment — it happens automatically. However, you should still review the notice to confirm the effective date and check that your contact information is correct.

How to Enroll When You Turn 65

Enrollment happens through three main channels: Social Security, Medicare.gov, or by phone. If you are already receiving Social Security benefits when you turn 65, you will be enrolled automatically in Part A and Part B about three months before your 65th birthday. You will receive a notice in the mail confirming your coverage start date. If you do not want Part B, you must decline it in writing before coverage begins.

If you are not yet receiving Social Security, you must enroll yourself. You can do this online at Medicare.gov, by calling Social Security at 1-800-772-1213, or by visiting your local Social Security office in person. Online enrollment is the fastest route — you can complete it in about 15 minutes and receive confirmation when ready. By phone, expect to spend 20 to 30 minutes, and processing takes about two weeks. In person, bring your birth certificate, proof of citizenship or permanent residency, and proof of residence (a utility bill or lease).

Enrollment typically takes two weeks to process. Your Medicare card will arrive in the mail within two to three weeks of approval. If you need coverage to start on the first day of your birthday month, you should enroll by the 15th of the month before.

What Happens If You Miss Your Initial Enrollment Period

If you do not enroll during your seven-month Initial Enrollment Period, you enter a General Enrollment Period that runs from January 1 to March 31 each year. You can enroll during this window, but coverage does not start until July 1 of that year — a gap of several months. More importantly, you will owe a permanent penalty on your Part B premium.

The penalty is 10 percent of the standard Part B premium for each full 12-month period you were may be able to access but not enrolled. If you missed your Initial Enrollment Period by two years, your penalty would be 20 percent, and you would pay this surcharge for as long as you have Part B coverage. The only way to avoid this penalty is to prove you had creditable coverage (such as an employer plan) during the time you were not enrolled in Medicare.

If you were covered by an employer plan when you turned 65, you have eight months after that coverage ends to enroll in Medicare without penalty. This is called the Special Enrollment Period. You will need to provide proof of the employer coverage — usually a letter from your employer's benefits department or a copy of your insurance card.

Permanent Residents and Non-Citizens

Permanent residents (green card holders) can enroll in Medicare at 65 if they have lived in the United States for at least five years. The five years do not have to be consecutive, but they must add up to 60 months. You will need to provide your green card and proof of your five years of U.S. residence when you enroll.

Non-citizens who are not permanent residents are not may be able to access for Medicare, even if they have lived and worked in the United States for many years. If you are in this situation, you may be able to purchase a plan through the health insurance marketplace or look into state-specific programs for uninsured residents. Contact your state health department or call 211 to learn what options exist in your area.

Part A Versus Part B: What You Need to Know

Medicare has two main components, and understanding the difference matters for enrollment. Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working. Part A is nearly automatic — if you enroll in Medicare, you are enrolled in Part A.

Part B covers doctor visits, outpatient care, lab tests, and medical equipment. Part B requires a monthly premium, which changes each year. In 2024, the standard premium is $164.90 per month, though higher-income beneficiaries pay more. You can decline Part B at enrollment if you are still covered by an employer plan, but you must do this in writing. If you decline and later want to enroll, you will face the late-enrollment penalty described above unless you have a may have access to reason.

Many people also purchase Part D (prescription drug coverage) and Medigap (supplemental insurance) or enroll in a Medicare Advantage plan (Part C), which combines Parts A, B, and D. These choices happen during your Initial Enrollment Period or during the Annual Enrollment Period (October 15 to December 7 each year), and the decisions you make can affect your costs for years to come.

Delaying Enrollment If You Are Still Working

If you are still working at 65 and covered by your employer's health plan, you may be able to delay Part B enrollment without penalty. This is allowed only if your employer has 20 or more employees. If your employer is smaller, Medicare becomes your primary insurance at 65 regardless of your employer coverage.

To delay Part B safely, you must enroll in Part A (hospital insurance) during your Initial Enrollment Period, but you can decline Part B. You then have eight months after your employment or employer coverage ends to enroll in Part B without penalty. You will need to provide proof of employer coverage — a letter from your employer or a copy of your current insurance card — when you eventually enroll in Part B.

If you do not enroll in Part A during your Initial Enrollment Period, you cannot use this exception later. Part A has no monthly premium for most people, so there is no financial reason to skip it. Enroll in Part A, decline Part B if you wish, and keep documentation of your employer coverage in case you need it later.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65 if I am still working?

No, unless you meet one of the three exceptions: you have been receiving SSDI for 24 months, you have end-stage renal disease, or you have ALS. Age 65 is the standard may be able to access threshold. If you are still working and do not fall into one of these categories, you must wait until 65 to enroll.

What happens if I turn 65 while I am traveling outside the United States?

You can still enroll during your Initial Enrollment Period even if you are outside the country. You can enroll online at Medicare.gov or by calling 1-800-MEDICARE from abroad. Your Medicare card will be mailed to a U.S. address, so make sure Social Security has your correct mailing address on file before you leave.

Do I have to retire to enroll in Medicare at 65?

No. Medicare may be able to access is based on age, not retirement status. You can continue working full-time, part-time, or not at all — your age alone determines when you can enroll. If you are still working and covered by an employer plan, you may choose to delay Part B enrollment, but you can enroll in Part A at any time.

If I delay Social Security, do I also delay Medicare?

No. Medicare and Social Security are separate programs. You can delay claiming Social Security benefits past 65 to increase your monthly payment, but you should still enroll in Medicare at 65. If you do not enroll in Part B during your Initial Enrollment Period, you will face a permanent penalty even if you delay Social Security.

What if I moved to the United States after age 65?

If you are a permanent resident who moved to the U.S. after age 65, you can still enroll in Medicare once you have lived in the country for five years. Your Initial Enrollment Period begins the month you turn 65 or the month you become a permanent resident, whichever is later. Contact Social Security to confirm your may be able to access date.