When You Become Eligible for Medicare: Age and Other Pathways

You become may be able to access for Medicare at 65, but some people may have access to earlier

The standard age to enroll in Medicare is 65. You can sign up starting three months before your 65th birthday and have coverage begin the month you turn 65. However, you do not have to wait until 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease or amyotrophic lateral sclerosis (ALS). These conditions can make you may be able to access at any age.

If you are still working at 65 and have health coverage through your employer, you may delay enrollment without penalty, but the rules depend on how many employees your company has. Understanding your specific situation now can save you from late-enrollment penalties later.

Key Takeaways

You become may be able to access for Medicare at age 65, and you can enroll three months before your birthday.
If you receive SSDI, you become may be able to access after 24 months of receiving benefits, regardless of your age.
People with end-stage renal disease or ALS can enroll in Medicare at any age.
Delaying enrollment past 65 without may have access to coverage can result in a permanent penalty on your premiums.

How the 65-Year-Old Enrollment Window Works

Your Initial Enrollment Period is seven months long: it starts three months before the month you turn 65 and ends three months after. During this window, you can enroll in Medicare Part A (hospital coverage) and Part B (medical coverage) without any waiting period or penalty.

If you miss this window, you can still enroll later, but you will face a late-enrollment penalty on Part B premiums. The penalty is 10 percent of the standard Part B premium for each full year you delayed, and it stays on your bill for as long as you have Part B. For example, if you were may be able to access at 65 but did not enroll until age 68, you would pay an extra 30 percent on your Part B premium permanently.

The same penalty applies to Part D (prescription drug coverage) if you go without creditable coverage for more than 63 days in a row. Part A does not carry a late-enrollment penalty unless you also delayed Part B.

may have access to Before 65 Through Disability

If you have been receiving SSDI for 24 consecutive months, you become may be able to access for Medicare regardless of your age. The 24-month clock starts from the month your disability benefits begin, not from the month you applied. Once you hit 24 months, you are automatically enrolled in Medicare Part A and Part B — you do not have to do anything.

You will receive a Medicare card in the mail about a month before your coverage starts. If you want to add Part D (prescription drug coverage), you must enroll during your Initial Enrollment Period, which is the same seven-month window as for people turning 65.

Medicare at Any Age for Specific Conditions

Two medical conditions make you may be able to access for Medicare before age 65: end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS). If you have ESRD, you become may be able to access the month your kidney failure is diagnosed, even if you have not yet started dialysis or a transplant. If you have ALS, you become may be able to access when ready upon diagnosis.

Unlike SSDI beneficiaries, you do not enroll automatically. You will need to contact Social Security or visit your local Social Security office to enroll in Medicare. Bring documentation of your diagnosis and any relevant medical records. Once enrolled, your coverage typically begins the first day of the month following your process.

What Happens If You Are Still Working at 65

If you are covered by a health plan through your current employer, you may be able to delay Part B enrollment without penalty. This is called the Special Enrollment Period for people with group health plan coverage. The rules depend on the size of your employer: if your company has 20 or more employees, you can delay Part B. If it has fewer than 20 employees, you must enroll in Part B when you turn 65 or face a penalty.

Part A (hospital coverage) has no penalty for delay, so you can enroll in Part A at 65 and wait on Part B if you have employer coverage. When you leave your job or lose that coverage, you have eight months to enroll in Part B without penalty — this is your Special Enrollment Period.

If you are self-employed or have coverage through a spouse's employer, different rules may explore. Contact Social Security to confirm your specific situation before your 65th birthday.

How to Enroll When You Turn 65

You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online enrollment is the fastest option and takes about 10 minutes. You will need your Social Security number and information about any current health coverage.

If you are already receiving Social Security retirement benefits, you may be enrolled automatically in Medicare Part A and Part B. Check your Social Security account online or call Social Security to confirm. If you are not automatically enrolled, you must enroll yourself during your Initial Enrollment Period to avoid penalties.

Keep a record of your enrollment confirmation. You will receive your Medicare card in the mail within two to four weeks. If you do not receive it by the time your coverage starts, you can print a temporary card from Medicare.gov.

Frequently Asked Questions

What if I turn 65 but do not want Medicare yet?

You can delay Part B if you have may have access to employer coverage through your job or a spouse's job. You must enroll in Part A at 65 unless you also have employer coverage that counts as creditable. When you lose that coverage, you have eight months to enroll in Part B without penalty.

Do I have to enroll in Part D when I turn 65?

No, but if you do not have creditable prescription drug coverage and you delay Part D, you will pay a penalty when you do enroll. The penalty is 1 percent of the national average Part D premium for each month you were without coverage. This penalty stays on your bill for as long as you have Part D.

What if I miss my Initial Enrollment Period?

You can still enroll during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage begins July 1. However, you will owe a late-enrollment penalty on Part B and possibly Part D. It is better to enroll during your Initial Enrollment Period if you can.

Can I enroll in Medicare if I am not yet receiving Social Security?

Yes. You can enroll in Medicare at 65 even if you have not claimed Social Security retirement benefits yet. In fact, many people delay Social Security to increase their benefit amount while enrolling in Medicare on time to avoid penalties.

What if I am still working and have not turned 65 yet?

If you are under 65 and still working, you are not may be able to access for Medicare unless you may have access to through disability, ESRD, or ALS. Continue with your employer health plan. When you turn 65 or stop working, you can enroll in Medicare during your Initial Enrollment Period.

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.