When You Can Start Medicare: Age Requirements and Earlier Options

The standard age to start Medicare is 65, but you may be able to start earlier if you have a disability, end-stage renal disease, or ALS

Most people become may be able to access for Medicare at age 65. You do not have to wait until your birthday month — you can sign up starting three months before you turn 65. However, age 65 is not the only path in. 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 ALS (amyotrophic lateral sclerosis), you may be may be able to access regardless of age.

The month you turn 65 is your Initial Enrollment Period — a seven-month window that starts three months before your birthday month and ends three months after. If you miss this window and do not have other coverage, you will pay a permanent penalty on your Part B and Part D premiums for as long as you have Medicare. That penalty is roughly 10 percent per year you delayed, so waiting even one year costs real money over time.

Key Takeaways

You can enroll in Medicare starting three months before you turn 65, during your birthday month, or up to three months after — a seven-month window called your Initial Enrollment Period.
If you have been on Social Security disability for 24 months, you become may be able to access for Medicare before age 65 with no waiting period after the 24 months end.
People with end-stage renal disease or ALS can enroll in Medicare at any age, though timing rules differ slightly for each condition.
Missing your Initial Enrollment Period results in a permanent premium penalty unless you have may have access to coverage like an active employer plan.

Becoming may be able to access through Social Security disability

If you receive Social Security Disability Insurance (SSDI), you automatically become may be able to access for Medicare after you have been on disability for 24 months. You do not have to explore separately or reach age 65. The 24 months is measured from the month your disability benefits began, not from the month you filed.

Once those 24 months are complete, you will be enrolled in Medicare Part A and Part B automatically. You will receive your Medicare card in the mail about two months before your coverage starts. You can also choose to enroll in Part D (prescription drug coverage) and Medigap or Medicare Advantage during this time. If you do nothing, you will have Original Medicare (Part A and Part B) only, which means you will pay out-of-pocket for prescription drugs unless you enroll in Part D later — and later enrollment may trigger a penalty.

Medicare may be able to access with end-stage renal disease

If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you can enroll in Medicare at any age. Your may be able to access begins either the first day of the month you start dialysis or the month of your transplant, whichever comes first. If you receive a pre-emptive transplant (before dialysis), your coverage begins the month of the transplant.

You have a special enrollment period of up to 12 months after your ESRD diagnosis to sign up for Part D without a late-enrollment penalty. This is important because many ESRD patients take multiple medications. Unlike the standard Initial Enrollment Period, this window gives you more time to understand your options and choose a plan that covers your specific drugs.

Medicare may be able to access with ALS

People diagnosed with ALS (amyotrophic lateral sclerosis) can enroll in Medicare when ready, without waiting for age 65 or for 24 months of disability benefits. Your coverage begins the first day of the month you are approved for Social Security disability benefits based on your ALS diagnosis.

This when ready may be able to access reflects the rapid progression of ALS and the urgent medical needs of people living with the disease. Like ESRD patients, you have a special enrollment period for Part D that extends 12 months from your may be able to access date, protecting you from late-enrollment penalties on prescription drug coverage.

What happens if you miss your enrollment window

If you do not sign up during your Initial Enrollment Period and you do not have other may have access to coverage — such as an active employer health plan or TRICARE — you will pay a late-enrollment penalty for the rest of your life on Medicare. The penalty for Part B is roughly 10 percent of the standard premium for each full year you were may be able to access but not enrolled. The penalty for Part D is roughly 1 percent of the national average premium for each month you were may be able to access but not enrolled.

These penalties are added to your monthly premium and never go away, even if you eventually sign up. The only exceptions are if you had creditable coverage (coverage as good as or better than Medicare) through an employer or union, or if you are a federal employee with coverage through the Federal Employees Health Benefits Program (FEHB). If you had that kind of coverage, you can enroll without penalty during an eight-month window after your coverage ends.

How to enroll before age 65

To enroll in Medicare, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). You can also visit your local Social Security office. You will need your Social Security number and information about any current health coverage you have.

If you are on Social Security disability, you do not need to do anything — you will be enrolled automatically about three months before your 24-month mark. However, you should still review your options for Part D and supplemental coverage (Medigap or Medicare Advantage) before your coverage starts, because you have limited time to choose a plan without penalty.

If you have ESRD or ALS, contact Medicare as soon as you receive your diagnosis or your Social Security disability approval. Do not wait. The sooner you enroll, the sooner your coverage begins, and the sooner you can start using your benefits.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65 if I do not have a disability?

No. If you do not have SSDI, ESRD, or ALS, you must wait until age 65. You can begin the enrollment process three months before your 65th birthday, but coverage will not start until the month you turn 65 (or later, depending on when you sign up).

What if I am still working at 65 — do I have to enroll?

If you or your spouse are still working and have health coverage through that job, you may be able to delay Part B enrollment without penalty. This is called creditable coverage. However, you should still enroll in Part A (hospital insurance) at 65 because it is generally free and has no penalty for late enrollment. Contact Medicare to confirm your situation before your Initial Enrollment Period ends.

If I am on disability and turn 65, does anything change?

No. Your Medicare coverage continues without interruption. You will not see a change in your benefits or premiums straightforward because you reached 65. Your coverage remains the same whether you became may be able to access through disability or through age.

Can I enroll in Medicare Part D at the same time as Part A and Part B?

Yes. When you enroll in Original Medicare (Part A and Part B), you can also choose a Part D plan at the same time. You should compare plans before your coverage starts so you know which drugs are covered and what your costs will be.

What if I miss my enrollment window but have a life-changing event like losing my job?

Losing employer coverage is a may have access to life event that opens a special enrollment period of up to eight months. You can enroll in Medicare during this window without a late-enrollment penalty. Contact Medicare right away to report the change and enroll.

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.