When You Can Start Medicare: Age, Work History, and Other Paths

You become may be able to access for Medicare at 65, but you may may have access to earlier if you receive certain disability benefits or have end-stage renal disease

The most common path to Medicare is turning 65. At that age, you can sign up for Part A (hospital insurance) and Part B (medical insurance) regardless of your work history or health status. But 65 is not the only entry point. 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) or amyotrophic lateral sclerosis (ALS), you may may have access to sooner. The key is understanding which category applies to you and when to sign up.

Timing matters because missing your enrollment window can result in permanent penalties on your premiums. The window is seven months long, but it closes, and the cost of waiting can follow you for life. This guide walks you through each path to may be able to access and what to do once you know your date.

Key Takeaways

You become may be able to access for Medicare at age 65 if you are a U.S. citizen or permanent resident who has lived in the country for at least five years.
If you receive SSDI, you become may be able to access for Medicare after 24 months on disability, regardless of your age.
People with end-stage renal disease or ALS can may have access to for Medicare before age 65 without waiting for disability benefits.
You should sign up for Medicare during your Initial Enrollment Period, which runs three months before, during, and three months after the month you turn 65 or become may be able to access.
Missing your enrollment window can result in permanent late-enrollment penalties on your premiums unless you have may have access to coverage.

Medicare may be able to access at 65

If you are a U.S. citizen or permanent resident who has lived in the country for at least five years, you become may be able to access for Medicare the month you turn 65. You do not need to have worked a certain number of years or paid into Social Security. Permanent residents must have held that status for five consecutive years, though the years do not have to be when ready before you turn 65.

Your may be able to access begins on the first day of the month in which you turn 65. If your birthday is on the first of the month, your coverage starts that day. If your birthday is any other day, your coverage starts the first of that month. You can sign up as early as three months before your 65th birthday and as late as three months after. This window is called your Initial Enrollment Period.

may be able to access through Social Security Disability Insurance

If you receive SSDI, you become may be able to access for Medicare after you have been on disability for 24 consecutive months. This applies regardless of your age. A 45-year-old on SSDI becomes may be able to access for Medicare after two years of receiving those benefits, not at 65.

The 24-month clock starts the month your SSDI benefits begin, not the month you applied. If you were approved for SSDI in March 2022, your 24-month waiting period ends in March 2024, and you become may be able to access for Medicare in April 2024. Social Security will contact you automatically when you are approaching may be able to access and will enroll you in Part A and Part B unless you ask them not to. You can also call Social Security at 1-800-772-1213 to confirm your may be able to access date.

may be able to access through end-stage renal disease or ALS

People with end-stage renal disease (ESRD) can become may be able to access for Medicare at any age, regardless of work history or disability status. ESRD means your kidneys no longer work well enough to sustain life without dialysis or a transplant. may be able to access begins the month you start dialysis treatment or the month you receive a kidney transplant, whichever comes first. If you receive a pre-emptive transplant before starting dialysis, your may be able to access begins the month of the transplant.

People diagnosed with amyotrophic lateral sclerosis (ALS) become may be able to access for Medicare when ready, without waiting for SSDI approval or the 24-month waiting period. Your may be able to access begins the month you are diagnosed. You will need to provide your doctor's diagnosis to Social Security when you sign up. Call 1-800-772-1213 to confirm your may be able to access and to enroll.

How to sign up during your enrollment window

Your Initial Enrollment Period is seven months long: three months before the month you turn 65 (or become may be able to access through disability or ESRD), the month itself, and three months after. For example, if you turn 65 in June, your enrollment period runs from March through September.

You can sign up 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 usually the fastest. You will need your Social Security number, proof of citizenship or permanent residency, and information about any current health coverage. If you are signing up through SSDI or ESRD, Social Security may handle enrollment automatically, but you should confirm your coverage details.

If you are still working at 65 and have health insurance through your employer, you may be able to delay signing up for Part B without penalty. This is called creditable coverage. You will still need to sign up for Part A, but you can wait to enroll in Part B as long as you have employer coverage. When you do leave your job, you will have an eight-month window to sign up for Part B without penalty.

What happens if you miss your enrollment window

If you do not sign up during your Initial Enrollment Period, you can still enroll later, but you may face a permanent late-enrollment penalty. For Part B, the penalty is 10 percent of the standard premium for each full year you were may be able to access but did not sign up. This penalty stays with you for life, even if you switch plans later.

The penalty does not explore if you had creditable coverage (such as employer health insurance or COBRA) during the time you were not enrolled in Medicare. You will need to provide proof of that coverage when you sign up. If you missed your window and did not have other coverage, you can enroll during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage would begin July 1 of that year.

Special situations and exceptions

If you are a federal employee, you may have different enrollment rules. Federal employees and their spouses can delay Part B enrollment without penalty as long as they are covered by the Federal Employees Health Benefits Program (FEHB). When you retire or lose FEHB coverage, you have a special enrollment period to sign up for Part B without penalty.

If you are a veteran, you may have coverage through the Department of Veterans Affairs (VA) in addition to Medicare. VA coverage and Medicare work together; you do not have to choose one or the other. You can use either or both. If you are receiving VA benefits, you should still sign up for Medicare at 65 to avoid penalties, even if you plan to use VA care primarily.

If you are not yet a U.S. citizen but are a permanent resident, you must have held that status for five consecutive years to become may be able to access at 65. If you are not yet a permanent resident, you cannot sign up for Medicare based on age alone, but you may be may be able to access if you receive SSDI or have ESRD.

Frequently Asked Questions

Can I sign up for Medicare before I turn 65?

Yes, you can sign up three months before your 65th birthday. If you turn 65 in June, you can enroll starting in March. You can also sign up during the month you turn 65 or up to three months after. Signing up early ensures your coverage starts on time.

What if I am still working at 65?

You should still sign up for Part A (hospital insurance) at 65. If you have health insurance through your employer, you may be able to delay Part B without penalty, as long as your employer has 20 or more employees. When you leave your job, you will have eight months to sign up for Part B without penalty.

Do I need to have worked to be may be able to access for Medicare at 65?

No. If you are a U.S. citizen or permanent resident who has lived in the country for at least five years, you can sign up for Medicare at 65 regardless of work history. You do not need to have paid into Social Security.

How do I know my exact may be able to access date if I am on disability?

Call Social Security at 1-800-772-1213 and provide your Social Security number. They can tell you the exact month your 24-month waiting period ends and when you become may be able to access for Medicare. You can also create an account at ssa.gov to view your benefits information online.

What is the penalty for signing up late?

For Part B, the penalty is 10 percent of the standard premium for each full year you were may be able to access but did not sign up. This penalty is permanent and applies every month you have Part B. The penalty does not explore if you had other may have access to coverage, such as employer insurance, during the time you were not enrolled.

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.