You become may be able to access for Medicare at 65, but the exact timing depends on when you were born and whether you have a disability or end-stage renal disease

Most people become may be able to access for Medicare the month they turn 65. If your birthday falls on the first of the month, your coverage starts the month before. If your birthday is any other day, coverage starts the first day of the month you turn 65. You do not have to wait until your birthday itself — Medicare coverage begins on a specific calendar date based on these rules.

Some people become may be able to access before 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access at any age. If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — you become may be able to access when ready, regardless of age. If you have amyotrophic lateral sclerosis (ALS), you become may be able to access right away without waiting.

Key Takeaways

  • Most people become may be able to access at 65, with coverage starting the first day of the month they turn 65 (or the month before if their birthday is the first of the month).
  • You become may be able to access before 65 if you have received SSDI for 24 months, have ESRD, or have been diagnosed with ALS.
  • You should sign up during your Initial Enrollment Period, which is seven months long and centered on the month you turn 65.
  • If you miss your Initial Enrollment Period, you may face a permanent penalty on your premiums unless you have a may have access to reason for the delay.
  • You can check your may be able to access and sign up through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

Your Initial Enrollment Period and when to sign up

Your Initial Enrollment Period is a seven-month window that includes the month you turn 65, the three months before, and the three months after. For example, if you turn 65 in June, your enrollment period runs from March through September. You should sign up during this window so your coverage starts on time.

If you sign up before the month you turn 65, your coverage will start the first day of the month you turn 65. If you sign up during the month you turn 65 or after, there may be a delay — coverage could start as late as the following month. Signing up early avoids this gap.

If you miss your Initial Enrollment Period, you can still sign up later, but you may owe a late enrollment penalty — a permanent increase to your Part B and Part D premiums. The penalty is 10 percent of the standard Part B premium for each full 12 months you were may be able to access but not signed up. This penalty stays with you for life, so signing up during your Initial Enrollment Period is important.

Exceptions: when you can sign up late without a penalty

You may avoid the late enrollment penalty if you have what Medicare calls creditable coverage — health insurance from your job or your spouse's job that is at least as good as Medicare. If you had this coverage and did not sign up for Medicare, you can sign up later without penalty. You must sign up within 63 days of losing this job-based coverage.

Other may have access to reasons include being out of the United States for more than six months, being in active military duty, or being in a U.S. territory. If you believe you have a reason to sign up late without penalty, contact Medicare at 1-800-MEDICARE to explain your situation. They will tell you whether your reason qualifies.

How to sign up for Medicare

You can sign up through three main routes: online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. The online route at Medicare.gov is fastest — you can create an account, review your may be able to access, and complete your sign-up in one session. You will need your Social Security number and information about any current health coverage.

If you call 1-800-MEDICARE, a representative will walk you through the process and answer questions about your specific situation. The call is free and available seven days a week. If you prefer to sign up in person, visit your local Social Security office — you can find the nearest one at ssa.gov/locator.

When you sign up, you will choose your coverage. Most people start with Medicare Part A (hospital insurance) and Part B (medical insurance). You will also choose a Part D plan (prescription drug coverage) if you want it. If you do not choose a plan, Medicare will assign you one automatically, though this is not always the best fit for your needs.

What happens if you are still working at 65

If you are still working and have health insurance through your job, you may not need to sign up for Medicare right away. If your employer has 20 or more employees, your job-based insurance is primary — it pays first — and Medicare is secondary. You can delay signing up for Part B without penalty as long as you have this coverage.

You must still sign up for Part A (hospital insurance) at 65, even if you are working, because Part A has no premium for most people. Part B can wait until you leave your job or lose your coverage, as long as you sign up within 63 days of that change. If you do not sign up within this window, you will owe the late enrollment penalty.

If your employer has fewer than 20 employees, Medicare becomes primary at 65, and you should sign up for both Part A and Part B to avoid gaps in coverage.

Medicare may be able to access if you are not yet a U.S. citizen

To be may be able to access for Medicare at 65, you must be a U.S. citizen or a lawful permanent resident (green card holder) who has lived in the United States for at least five consecutive years. If you are a lawful permanent resident but have not yet met the five-year requirement, you will become may be able to access once you do.

If you are not yet a citizen or permanent resident, you cannot sign up for Medicare. You may have other coverage options through your state or through the health insurance marketplace. Contact your state health department or visit healthcare.gov to learn what is available to you.

Frequently Asked Questions

What if my birthday is on the first of the month?

Your Medicare coverage starts the month before you turn 65. For example, if you were born on June 1, your coverage begins May 1. You should still sign up during your seven-month enrollment period, which runs from February through August in this case.

Can I sign up for Medicare before I turn 65?

Yes. You can sign up up to three months before the month you turn 65. Signing up early ensures your coverage starts on time. If you wait until after the month you turn 65, your coverage may not start until the following month.

What if I do not sign up during my Initial Enrollment Period?

You can sign up later, but you will likely owe a late enrollment penalty on your Part B and Part D premiums for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full 12 months you were may be able to access but not signed up. Some exceptions exist — contact Medicare to ask about yours.

Do I have to sign up for all parts of Medicare at once?

No. You must sign up for Part A at 65 (it has no premium for most people). You can delay Part B if you have job-based coverage, and you can delay Part D if you have creditable prescription drug coverage. However, delaying any part without a may have access to reason will result in a permanent penalty.

What if I am not a U.S. citizen yet?

You must be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years to be may be able to access for Medicare. If you do not meet this requirement, contact your state health department or visit healthcare.gov to learn about other coverage options.