Medicare starts at age 65 for most people

You become may be able to access for Medicare at age 65, regardless of your work history or income. This is the standard age set by federal law. You do not have to be retired to sign up — you can still be working — but you must be a U.S. citizen or permanent resident who has lived in the country for at least five years.

The month you turn 65, you can enroll in Medicare Part A (hospital insurance) and Part B (medical insurance). If you wait past your 65th birthday to sign up, you may face a permanent penalty on your Part B premiums, so timing matters even if you do not plan to use the coverage right away.

Key Takeaways

  • You are may be able to access for Medicare when you turn 65, and you should enroll in the three months before or after your birthday to avoid penalties.
  • If you are already receiving Social Security before 65, you will be enrolled automatically; otherwise, you must sign up yourself through Medicare.gov or your local Social Security office.
  • Some people under 65 may be may be able to access if they receive Social Security disability benefits for at least 24 months or have end-stage renal disease or ALS.
  • Your coverage begins on the first day of the month you turn 65, or the first day of the month after you sign up, whichever is later.

Automatic enrollment if you receive Social Security early

If you are already collecting Social Security retirement or disability benefits before you turn 65, Medicare will enroll you automatically. You do not need to do anything — your Part A and Part B coverage will start the month you turn 65. You will receive your Medicare card in the mail about two weeks before your coverage begins.

If you are not yet receiving Social Security, you must enroll yourself. You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. The enrollment window is the three months before your 65th birthday, your birth month, and the three months after — a total of seven months. Signing up during this window means your coverage starts on the first day of the month you turn 65.

Coverage for people under 65

You may be may be able to access for Medicare before age 65 if you have received Social Security Disability Insurance (SSDI) for at least 24 consecutive months. Once you have been on SSDI for two years, Medicare becomes available to you regardless of your age. This means a 40-year-old on disability could be may be able to access, as long as they have been receiving SSDI for the required period.

Two other conditions also may have access to people under 65: end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — and ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease). People with ESRD or ALS do not have to wait 24 months; they become may be able to access as soon as they meet the medical criteria and begin treatment.

How to enroll when you turn 65

Start the enrollment process three months before your 65th birthday. The easiest method is online at Medicare.gov — you can complete the entire process in about 15 minutes if you have your Social Security number and citizenship documents ready. You will need to provide your date of birth, current address, and information about any current health insurance you have.

If you prefer to enroll by phone, call 1-800-MEDICARE (1-800-633-4227). Representatives are available Monday through Friday, 8 a.m. to 8 p.m. Eastern time. You can also visit your local Social Security office in person; bring your birth certificate, proof of citizenship (passport or naturalization papers), and proof of residence (a recent utility bill or lease).

If you miss the initial enrollment window, you can still sign up later, but you will face a permanent 10 percent increase to your Part B premium for each full year you delayed. For example, if you turn 65 in January 2024 but do not enroll until January 2026, your Part B premium will be 20 percent higher for the rest of your life.

When your coverage actually begins

Your Medicare coverage starts on the first day of the month you turn 65, provided you enroll during your initial enrollment window. If you enroll after your birthday, your coverage begins on the first day of the month after you sign up. For instance, if you turn 65 on March 15 and enroll on April 10, your coverage will not start until May 1.

You will receive your Medicare card by mail before your coverage begins. The card shows your Medicare number, which you will use at doctors' offices and hospitals. Keep it in a safe place — you do not need to carry it with you, but you will need the number when you schedule appointments or fill prescriptions.

Special situations and exceptions

If you are still working at 65 and have health insurance through your employer, you may be able to delay enrolling in Part B without penalty. This is called creditable coverage. You must have at least 20 employees at your workplace and be enrolled in the employer plan based on your current employment. Contact your employer's benefits office to confirm you have creditable coverage before you skip Medicare enrollment.

If you are a federal employee, railroad retiree, or military retiree, your enrollment process may differ slightly. Federal employees should contact the Office of Personnel Management; railroad retirees should contact the Railroad Retirement Board; military retirees should contact TRICARE. These groups have their own health systems that coordinate with Medicare.

What happens if you miss the enrollment important date

If you do not enroll during your initial seven-month window and do not have creditable coverage from an employer, you will face a permanent penalty. Your Part B premium increases by 10 percent for each full year you were may be able to access but not enrolled. This penalty stays with you for life, even if you eventually sign up.

You can still enroll after missing the important date during the general enrollment period, which runs January 1 through March 31 each year. Coverage would begin July 1 of that year. However, the penalty applies regardless of when you eventually sign up, so it is worth enrolling as soon as you turn 65 even if you do not plan to use Medicare when ready.

Frequently Asked Questions

Do I have to retire to sign up for Medicare at 65?

No. You can be working full-time and still enroll in Medicare at 65. If you have health insurance through your employer, you may be able to delay Part B enrollment without penalty, but you should still enroll in Part A (hospital insurance). Check with your employer's benefits office about whether your coverage is considered creditable.

What if I am a permanent resident but not a U.S. citizen?

You can enroll in Medicare at 65 if you have been a permanent resident for at least five years. You will need to provide proof of your permanent resident status (green card) when you sign up. The five-year clock starts from the date your green card was issued.

Can I sign up for Medicare before I turn 65?

You can begin the enrollment process three months before your 65th birthday, but your coverage will not start until the month you turn 65. If you are under 65 and on Social Security disability or have ESRD or ALS, you may be may be able to access now — contact Medicare directly to find out.

What if I turned 65 years ago and never signed up?

You can still enroll during the general enrollment period (January 1 through March 31), and your coverage will begin July 1. However, you will owe a permanent penalty on your Part B premium for each year you were may be able to access but not enrolled. The sooner you sign up, the sooner the penalty stops accumulating.

Does my spouse automatically get Medicare when I do?

No. Your spouse must enroll separately when they turn 65 or become may be able to access through disability or ESRD. They have their own seven-month enrollment window and their own Medicare number. If they miss their window, they will face the same premium penalties you would.