Medicare may be able to access starts at age 65 for most people

You become may be able to access for Medicare the month you turn 65, regardless of whether you are still working. You do not have to retire or stop earning income. The program is federal health insurance run by the Centers for Medicare & Medicaid Services (CMS), and it covers hospital stays, doctor visits, prescription drugs, and preventive care once you enroll.

Enrollment does not happen automatically for everyone. If you are already receiving Social Security benefits when you turn 65, Medicare enrollment happens on your behalf. If you are not yet taking Social Security, you must enroll yourself during your enrollment window, or you may face a permanent penalty on your premiums.

Key Takeaways

  • You are may be able to access for Medicare at 65, but you must enroll during your Initial Enrollment Period (the three months before, the month of, and three months after your 65th birthday) to avoid penalties.
  • If you are already receiving Social Security at 65, you are enrolled automatically in Medicare Parts A and B.
  • You can become may be able to access before 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have End-Stage Renal Disease (ESRD) or ALS, regardless of age.
  • Medicare has four parts—A (hospital), B (medical), D (drugs), and C (Medicare Advantage)—and you choose which ones you need based on your situation.
  • Delaying enrollment past your Initial Enrollment Period can result in a permanent 10 percent increase to your Part B premium for each year you delay.

Automatic enrollment if you receive Social Security

If you are already collecting Social Security retirement, spousal, or survivor benefits when you turn 65, the Social Security Administration automatically enrolls you in Medicare Part A (hospital insurance) and Part B (medical insurance). You will receive your Medicare card in the mail about two weeks before your 65th birthday. You do not need to do anything.

This automatic enrollment applies only to people already receiving Social Security payments. If you have not yet claimed Social Security, you must enroll in Medicare yourself, even if you are 65 or older.

Enrolling yourself if you are not on Social Security

If you are 65 and not yet receiving Social Security benefits, you must enroll in Medicare during your Initial Enrollment Period. This window runs for seven months: the three months before you turn 65, the month you turn 65, and the three months after. For example, if your birthday is in June, your enrollment period runs from March through September.

You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. You will need your Social Security number and information about your current health coverage, if you have any.

If you miss this window and do not have a may have access to reason (such as losing employer coverage), you cannot enroll until the next General Enrollment Period, which runs January 1 through March 31 each year. Any gap in coverage means you will owe a penalty when you do enroll.

Becoming may be able to access before 65

You do not have to wait until 65 if you meet one of three conditions. If you have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months, you become may be able to access for Medicare at any age. The 24-month waiting period begins the month your disability benefits start, not the month you applied.

You are also may be able to access when ready, regardless of age, if you have been diagnosed with End-Stage Renal Disease (ESRD)—permanent kidney failure requiring dialysis or a transplant. Similarly, if you have ALS (amyotrophic lateral sclerosis), you become may be able to access for Medicare right away without any waiting period.

If you fall into one of these categories, contact Social Security or Medicare directly to enroll. The enrollment process is the same, but your may be able to access date is different.

Understanding Medicare Parts and what you need to choose

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay no monthly premium for Part A because they or their spouse paid Medicare taxes while working. Part A has a deductible you pay when you are admitted to the hospital.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium (the amount varies by income) and requires you to pay a deductible and coinsurance for most services. You choose whether to enroll in Part B; it is not automatic unless you are already on Social Security.

Part D is prescription drug coverage. It is optional, but if you go without it and later enroll, you may owe a penalty. Part D plans are offered by private insurance companies approved by Medicare, and the cost and drugs covered vary by plan.

Part C, also called Medicare Advantage, is an alternative to Parts A, B, and D. It is offered by private insurers and bundles hospital, medical, and usually drug coverage into one plan. Part C plans often have lower out-of-pocket costs but restrict you to a network of doctors and hospitals.

Penalties for late enrollment

If you do not enroll in Part B during your Initial Enrollment Period and you do not have a may have access to reason for the delay, you will pay a permanent penalty. The penalty is 10 percent of the standard Part B premium for each full year you delay enrollment. This penalty stays with you for life, even if you switch plans later.

For Part D (prescription drugs), the penalty is 1 percent of the national average monthly premium for each month you delay, rounded to the nearest dollar. Like the Part B penalty, this is permanent.

may have access to reasons that waive the penalty include being covered by an employer health plan while you are still working, or losing coverage involuntarily. If you believe you have a may have access to reason, contact Medicare to discuss your situation.

What happens after you enroll

Once you enroll, your coverage begins on the first day of the month you turn 65 (or the month your may be able to access begins, if you may have access to before 65). You will receive your Medicare card by mail. Your card shows your Medicare number, which you use at doctor offices, hospitals, and pharmacies.

You can use your Medicare coverage at any hospital or doctor's office in the United States that accepts Medicare. If you choose Part C (Medicare Advantage), you are limited to in-network providers unless it is an emergency.

You can change your coverage during the Annual Enrollment Period, which runs October 15 through December 7 each year. Changes take effect January 1. Outside this window, you can make changes only if you have a may have access to life event, such as losing other coverage or moving out of your plan's service area.

Frequently Asked Questions

Do I have to enroll in Medicare at 65 if I am still working?

If you are still working and covered by your employer's health plan, you can delay enrolling in Part B without penalty. However, you should still enroll in Part A (hospital insurance) at 65, since it is usually free and covers hospital stays. When you leave your job or lose coverage, you have eight months to enroll in Part B without penalty.

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

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 to be may be able to access for Medicare. Undocumented immigrants are not may be able to access. If you are a permanent resident, bring your green card when you enroll.

Can I enroll in Medicare before my 65th birthday?

Your Initial Enrollment Period begins three months before you turn 65. You can enroll during this time, and your coverage will start the month you turn 65. You cannot enroll earlier than three months before your birthday.

What if I miss my enrollment important date?

If you miss your Initial Enrollment Period and do not have a may have access to reason, you must wait until the next General Enrollment Period (January 1 through March 31). Your coverage will not start until July 1 of that year. You will also owe a permanent penalty on your Part B premium.

Does Medicare cover everything?

Medicare covers many services, but it does not cover dental, vision, hearing aids, or long-term care. Some people buy supplemental insurance (called Medigap) to cover costs Medicare does not pay. Others choose Part C (Medicare Advantage) plans, which sometimes include dental or vision benefits.