How Old You Need to Be to Get Medicare

Medicare 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. If your birthday falls on the first of the month, coverage begins the previous month. If your birthday is any other day, coverage starts the first day of the month you turn 65. You do not have to retire to sign up — you can keep working and have Medicare at the same time.

There are a few exceptions to the age 65 rule. If you have received Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare at any age. If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — you may be may be able to access regardless of age. If you have ALS (amyotrophic lateral sclerosis), you become may be able to access when ready without waiting for SSDI payments to begin.

Key Takeaways

Most people become may be able to access for Medicare when they turn 65, even if they continue working.
You can sign up for Medicare starting three months before you turn 65 and should do so during your initial enrollment period to avoid late penalties.
If you have received SSDI for 24 months or have end-stage renal disease or ALS, you may be may be able to access for Medicare before age 65.
Signing up late can result in permanent premium increases on Part B and Part D coverage.

When your initial enrollment period opens

Your Initial Enrollment Period (IEP) is a seven-month window centered on the month you turn 65. It begins three months before your 65th birthday and ends three months after. For example, if you turn 65 in June, your IEP runs from March through September.

You should sign up during this window, even if you plan to delay coverage. The reason is financial: if you wait past your IEP to sign up for Part B (medical insurance) or Part D (prescription drug coverage), your monthly premiums increase by 10 percent for each year you were late. This increase is permanent — it does not go away after you finally sign up. The only exception is if you have creditable coverage (health insurance through an employer or union) during the time you delay.

How to sign up before age 65

You can sign up for Medicare three months before your 65th birthday by visiting Medicare.gov, calling 1-800-MEDICARE (1-800-633-4227), or visiting your local Social Security office. You will need your Social Security number and information about your current health coverage if you have it.

If you are already receiving Social Security benefits, Medicare will be set up automatically the month you turn 65. You do not need to do anything — your coverage will start and your premium will be deducted from your Social Security check. If you are not yet receiving Social Security, you must sign up for Medicare separately.

What happens if you miss your enrollment period

If you do not sign up during your Initial Enrollment Period and you do not have creditable coverage through an employer or union, you will face a permanent penalty. For Part B, your premium increases by 10 percent for each full year you were late. For Part D, the penalty is calculated differently but is also permanent.

You can still sign up after your IEP ends, but only during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage would not begin until July 1 of that year. If you have creditable coverage through work, you can sign up without penalty during a Special Enrollment Period within 63 days of losing that coverage.

Age exceptions: SSDI, ESRD, and ALS

If you have been receiving SSDI for 24 consecutive months, you become may be able to access for Medicare at any age. Your coverage begins the month after your 24-month SSDI period ends. You still need to sign up; it does not happen automatically, though Social Security will notify you when you become may be able to access.

If you have end-stage renal disease, you may be may be able to access for Medicare regardless of age. You must be a U.S. citizen or permanent resident and either be insured under an employer group health plan or be may have access to to Social Security or Railroad Retirement benefits. If you have ALS, you become may be able to access for Medicare the month your SSDI benefits begin — there is no 24-month waiting period.

Deciding whether to delay coverage after 65

You can delay signing up for Medicare Part A (hospital insurance) without penalty if you are still covered by an employer health plan and you or your spouse is still working. However, you should still sign up for Part B during your Initial Enrollment Period unless you have creditable coverage. If you do not sign up for Part B when you are first may be able to access and you do not have creditable coverage, your premium will increase permanently.

Part A (hospital insurance) does not have a late enrollment penalty if you have employer coverage, but Part B and Part D do. Before you decide to delay, contact your employer's benefits office to confirm that your coverage counts as creditable coverage under Medicare rules. Not all employer plans may have access to.

What to do if you turned 65 and did not sign up

If you are past your Initial Enrollment Period and did not sign up, you can still enroll during the General Enrollment Period (January 1 through March 31). Coverage would begin July 1 of that year. You will owe the late enrollment penalty unless you had creditable coverage during the time you delayed.

If you recently lost employer coverage, you may be able to sign up during a Special Enrollment Period without waiting for the General Enrollment Period. Contact Medicare at 1-800-MEDICARE to explain your situation and ask whether you may have access to for a Special Enrollment Period.

Frequently Asked Questions

Can I sign up for Medicare before I turn 65?

Yes. You can sign up starting three months before your 65th birthday. Your coverage will begin the month you turn 65 (or the previous month if your birthday is the first of the month). Signing up early is a good idea because it ensures your coverage starts on time and you avoid missing your Initial Enrollment Period.

What if I am still working at 65?

You can sign up for Medicare and keep working. If you have health insurance through your employer, you may be able to delay Part B without penalty, but you should check with your benefits office first to confirm your coverage is creditable under Medicare rules. Part A (hospital insurance) has no late penalty if you have employer coverage.

Do I lose Medicare if I go back to work after 65?

No. Once you are enrolled in Medicare, you keep it even if you return to work or change jobs. Your coverage does not depend on your employment status. You will continue to pay your Medicare premiums whether you are working or not.

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

You must be a U.S. citizen or permanent resident to be may be able to access for Medicare. You also must have lived in the United States for at least five consecutive years. If you do not meet these requirements, you cannot sign up for Medicare, even after you turn 65.

Can I sign up for Medicare online?

Yes. You can create an account on Medicare.gov and sign up online. You can also call 1-800-MEDICARE or visit your local Social Security office. Online signup is often the fastest option and you can do it from home.

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.