The age when Medicare begins

You can enroll in Medicare the month you turn 65, regardless of whether you have retired. Medicare Part A (hospital insurance) and Part B (medical insurance) both start on the first day of the month you turn 65, as long as you sign up during your enrollment window. If you delay enrollment past 65, your coverage will start later, and you may pay higher premiums for the rest of your life.

You do not have to be retired to collect Medicare. Some people work past 65 and carry both employer health insurance and Medicare at the same time. Others retire before 65 and must wait, or they may have access to retiree coverage from a former employer until Medicare begins.

If you are already receiving Social Security benefits when you turn 65, you will be enrolled in Medicare Parts A and B automatically. If you are not yet collecting Social Security, you must sign up for Medicare yourself during your enrollment window, even if you plan to delay your Social Security claim.

Key Takeaways

  • Medicare enrollment begins three months before the month you turn 65 and ends three months after, a seven-month window called your Initial Enrollment Period.
  • If you miss your Initial Enrollment Period and do not have may have access to coverage, you will pay a permanent penalty on your Part B and Part D premiums.
  • You can delay Part B enrollment without penalty only if you have employer coverage through your own job or your spouse's current job.
  • People under 65 with end-stage renal disease, ALS, or permanent disability may become may be able to access for Medicare before their 65th birthday.
  • Sign up through Medicare.gov, by phone at 1-800-MEDICARE, or at your local Social Security office.

Your enrollment window: the Initial Enrollment Period

Your Initial Enrollment Period is a seven-month window that runs from three months before the month you turn 65 through three months after. For example, if you turn 65 in June, your window opens in March and closes in September. During this time, you can enroll in Part A and Part B without waiting and without penalty.

Signing up during this window is important because missing it can cost you money for years. If you enroll late in Part B, you will pay a 10 percent higher premium for each 12-month period you delayed. That penalty stays with you for as long as you have Part B coverage. The same penalty applies to Part D (prescription drug coverage) if you go without it and then enroll later.

The only exception is if you have creditable coverage — health insurance through your current job, your spouse's current job, or certain other sources. If you have creditable coverage, you can delay Part B enrollment without penalty, but you must sign up within eight months of losing that coverage or the penalty will explore.

Who can enroll before age 65

Most people must wait until 65 to enroll in Medicare. However, three groups of younger people become may be able to access earlier: those with end-stage renal disease (permanent kidney failure requiring dialysis or transplant), those with ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease), and those who have been receiving Social Security disability benefits for 24 months.

If you have end-stage renal disease or ALS, you become may be able to access for Medicare the month your condition is diagnosed, regardless of age. If you receive Social Security disability benefits, Medicare begins automatically after you have been on disability for two years. You do not need to sign up separately — the Social Security Administration will enroll you.

If you are under 65 and think you may may have access to, contact Social Security at 1-800-772-1213 to confirm your may be able to access and enrollment status.

What happens if you miss your enrollment window

If you do not sign up during your Initial Enrollment Period and you do not have creditable coverage, you will pay a permanent penalty. For Part B, the penalty is 10 percent of the standard premium for each full 12-month period you were may be able to access but not enrolled. For Part D, the penalty is 1 percent of the national average premium for each month you were without coverage.

These penalties do not go away. They explore to your premiums every month for as long as you have Medicare. The only way to avoid the penalty is to enroll as soon as you realize you missed your window, but the penalty will still explore to the months you were uninsured.

If you missed your Initial Enrollment Period but have a may have access to life event — such as losing employer coverage, moving to a new state, or becoming may be able to access for Medicaid — you may have a Special Enrollment Period that allows you to sign up without penalty. Contact Medicare to ask whether your situation qualifies.

How to sign up for Medicare

You can enroll in Medicare through three main routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. The online option is fastest if you have your Social Security number and basic health information ready.

When you sign up, you will choose between Original Medicare (Part A and Part B) and a Medicare Advantage plan (Part C). Original Medicare is run by the federal government and works with any doctor or hospital that accepts Medicare. Medicare Advantage plans are run by private insurance companies and often include prescription drug coverage, but they usually limit you to a network of providers.

You will also need to decide about prescription drug coverage (Part D) if you choose Original Medicare. If you do not enroll in Part D during your Initial Enrollment Period, you will pay the late enrollment penalty when you do sign up, unless you have had creditable coverage through another source.

Delaying Part B if you are still working

If you are still working and have health insurance through your job or your spouse's job, you can delay Part B enrollment without penalty. This is called creditable coverage. You must enroll in Part B within eight months of retiring or losing that coverage, or you will pay the late enrollment penalty.

Part A (hospital insurance) works differently. You should still enroll in Part A when you turn 65, even if you are working, because it has no premium and no penalty for late enrollment. Part A covers hospital stays, skilled nursing care, and hospice.

If you are unsure whether your employer coverage qualifies as creditable, ask your employer's benefits department or call Medicare at 1-800-MEDICARE. Getting this right matters because the penalty for missing Part B can add up to hundreds of dollars per year.

Medicare and Social Security: how they connect

If you are already receiving Social Security retirement, survivor, or disability benefits when you turn 65, you will be automatically enrolled in Medicare Parts A and B. You do not need to do anything — Medicare will start on the first day of the month you turn 65, and your Social Security check will be reduced by the amount of your Part B premium.

If you are not yet collecting Social Security, you must sign up for Medicare yourself, even if you plan to delay your Social Security claim. Delaying Social Security does not delay Medicare. You can enroll in Medicare at 65 and wait to claim Social Security at 70 if you wish.

Some people choose to delay Social Security to get a higher monthly benefit, but they still need Medicare coverage at 65. If you are in this situation, sign up for Medicare during your Initial Enrollment Period through Medicare.gov or by calling 1-800-MEDICARE.

Questions to ask your doctor or Medicare

Before your 65th birthday, have a conversation with your primary care doctor about which Medicare plan might work best for your health needs. Ask whether they accept Original Medicare, whether they are in any Medicare Advantage networks you are considering, and whether they can help you understand your prescription drug options.

Call Medicare at 1-800-MEDICARE if you have questions about your enrollment window, whether you have creditable coverage, or whether you may have access to for an exception. Medicare staff can also help you compare plans and understand the costs of each option. You can also visit Medicare.gov to use their plan comparison tool.

Frequently Asked Questions

What if I turn 65 but I am still working full-time?

You can still enroll in Medicare at 65. If you have health insurance through your job, you can delay Part B without penalty, but you should still enroll in Part A because it is free and has no penalty for late enrollment. You must enroll in Part B within eight months of retiring or losing your job coverage, or you will pay a permanent penalty.

Can I change my mind after I enroll in a Medicare plan?

Yes, during the Annual Enrollment Period (October 15 to December 7 each year), you can switch between Original Medicare and Medicare Advantage plans, or change your prescription drug plan. If you enroll in a plan outside your Initial Enrollment Period and then want to change, you must wait until the next Annual Enrollment Period unless you have a may have access to life event.

What if I was not a U.S. citizen for the full five years before I turn 65?

You must be a U.S. citizen or permanent resident and have lived in the United States for at least five years to be may be able to access for Medicare Part A without paying a premium. If you do not meet these requirements, you may still be able to purchase Part A coverage. Contact Social Security or Medicare to discuss your situation.

Do I have to enroll in Part D if I do not take prescription medications?

You are not required to enroll in Part D if you do not take medications, but if you enroll later when you do need prescriptions, you will pay a late enrollment penalty. If your situation changes and you start needing medications, you can enroll in Part D during the Annual Enrollment Period without penalty.

What happens to my Medicare if I move to another country?

Medicare generally does not cover care outside the United States, except in limited situations near the border or on a cruise ship. If you move abroad permanently, contact Medicare to discuss your options. You may be able to keep your Medicare coverage, but you should understand what is and is not covered before you leave.