When You Can Start Medicare: Age Requirements and Your Options

You become may be able to access for Medicare at 65, though some people may have access to earlier due to disability or kidney disease

The standard age to start Medicare is 65. At that age, you become may be able to access for Part A (hospital insurance) and Part B (medical insurance) regardless of your work history, as long as you or your spouse paid Medicare taxes for at least 10 years. You do not have to wait until 65 to enroll — you can sign up as early as three months before your 65th birthday, and your coverage can start on the first day of the month you turn 65.

Some people may have access to before 65. If you have been receiving Social Security disability benefits for 24 months, you become may be able to access at any age. If you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you may may have access to when ready without waiting. These exceptions exist because the conditions themselves, not age, determine your need for coverage.

Key Takeaways

You can enroll in Medicare starting three months before you turn 65, with coverage beginning the first day of that month.
If you delay enrollment past 65 without other health coverage, you may pay a permanent penalty on your Part B and Part D premiums.
People on Social Security disability for 24 months, those with ESRD, and those with ALS can join Medicare before age 65.
You must actively enroll in Medicare — it does not happen automatically even if you receive Social Security.

How to enroll when you turn 65

You have a seven-month window called your Initial Enrollment Period (IEP). It runs from three months before the month you turn 65 through three months after. For example, if you turn 65 in June, your IEP is March through September. During this window, you can enroll in Part A and Part B without penalty, even if you do not need them right away.

You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need your Social Security number and information about any current health coverage. If you are still working and covered by your employer's plan, you can delay Part B enrollment without penalty — but you must enroll in Part A at 65 unless you are actively employed and covered by a group health plan through that job.

If you miss your Initial Enrollment Period, you can still enroll during the General Enrollment Period (January 1 through March 31 each year), but your coverage will not start until July 1 of that year, and you will likely pay a higher premium for Part B going forward.

What happens if you delay enrollment past 65

If you do not enroll in Part B when you first become may be able to access and you do not have other may have access to coverage (such as an active employer plan), you will pay a late enrollment penalty. This penalty is a percentage increase on your Part B premium that you pay for as long as you have Medicare. The exact amount depends on how many months you delayed, but it is permanent — you cannot get it removed later.

The same penalty applies to Part D (prescription drug coverage) if you go without it for more than 63 days. If you had creditable coverage (coverage as good as Medicare's) through an employer or union, you can avoid this penalty by enrolling within 63 days of losing that coverage. You will need to show proof of your previous coverage when you enroll.

Part A does not carry a late enrollment penalty if you are not working, but if you are still employed and covered by your employer's group health plan, you must enroll in Part A at 65 anyway. The rules are different for people still working — talk to your employer's benefits office or call Medicare to confirm your situation.

Enrolling before 65 if you have a disability or kidney disease

If you receive Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) disability benefits, you automatically become may be able to access for Medicare after 24 months of receiving those benefits. You do not have to do anything — Medicare will contact you about two months before your may be able to access date. You can choose to enroll or decline, but if you want coverage, you should confirm your enrollment rather than assume it happened.

If you have end-stage renal disease, you can enroll in Medicare regardless of age or work history. You become may be able to access the first day of the month you start dialysis or the month of your kidney transplant. Contact Medicare or your dialysis center to enroll — your medical provider can often help with the paperwork.

If you have ALS (Lou Gehrig's disease), you become may be able to access for Medicare when ready upon diagnosis. You do not have to wait for Social Security to approve your disability claim. Contact Medicare directly to enroll.

What to do if you are still working at 65

If you are still employed and your employer offers health coverage, you can delay enrolling in Part B without penalty. You must still enroll in Part A at 65 (unless you are covered by your employer's group plan and meet specific conditions). When you leave your job or lose your employer coverage, you have eight months to enroll in Part B without penalty — this is called your Special Enrollment Period.

Tell your employer's benefits office that you are turning 65 so they can explain your options. Some employers require you to enroll in Medicare when you become may be able to access, even if you are still working. Others let you stay on their plan. The rules vary by employer, so ask before your birthday arrives.

If you are self-employed or a business owner, the rules are stricter. You must enroll in Part B at 65 even if you are still working, or you will face a late enrollment penalty. Contact Medicare to confirm your situation if you own a business.

Coordinating Medicare with other coverage

If you have coverage through a current employer, a spouse's employer, COBRA, or a retiree health plan, you can keep that coverage and delay Medicare Part B. Your employer coverage is considered creditable coverage — coverage that is at least as good as Medicare. As long as you have it, you can wait to enroll in Part B without penalty.

When your employer coverage ends, you have a Special Enrollment Period of eight months to sign up for Part B. During this time, you will not pay a late enrollment penalty. You will need to show proof that you had creditable coverage — your employer or health plan can provide a letter stating the dates you were covered.

If you have Medicaid, TRICARE (military coverage), or Veterans benefits, you can coordinate these with Medicare. Medicaid can help pay your Medicare premiums and cost-sharing. TRICARE and VA benefits work alongside Medicare, not instead of it. Contact each program to understand how they work together in your situation.

Frequently Asked Questions

Do I have to enroll in Medicare if I am still working and have employer coverage?

You must enroll in Part A at 65, but you can delay Part B if your employer offers health coverage and you are actively employed. When you leave your job or lose coverage, you have eight months to enroll in Part B without penalty. Check with your employer's benefits office about their specific rules.

What if I turn 65 and forget to enroll?

You can still enroll during the General Enrollment Period (January 1 through March 31), but your coverage will not start until July 1, and you will likely pay a higher Part B premium permanently. If you had other may have access to coverage when you missed the important date, you may avoid the penalty — contact Medicare to explain your situation.

Can I enroll in Medicare before I turn 65 if I am not disabled?

No, unless you have end-stage renal disease or ALS. For everyone else, 65 is the earliest age. You can begin the enrollment process three months before your 65th birthday, but coverage cannot start before the month you turn 65.

Does Social Security automatically sign me up for Medicare?

Social Security will contact you about Medicare enrollment a few months before you turn 65, but you must actively enroll. If you receive disability benefits, Medicare will reach out after 24 months of benefits. Do not assume you are enrolled — confirm it by checking your Medicare account online or calling 1-800-MEDICARE.

What is the difference between Part A and Part B, and do I need both?

Part A covers hospital stays, skilled nursing, hospice, and some home health care. Part B covers doctor visits, outpatient care, and preventive services. Most people need both. Part A has no monthly premium if you paid Medicare taxes for 10 years, but Part B has a monthly premium that varies by income. You can enroll in both at the same time.

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.