What Age You Need to Be for Medicare Coverage

Medicare starts at 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. The program does not require you to retire first. If your birthday falls on the first of the month, your coverage begins that day; if it falls on any other day, coverage starts the first day of the following month.

You do not have to sign up the moment you turn 65 — you have a window to enroll without penalty — but waiting too long costs you money in higher premiums for the rest of your life. The enrollment window is seven months long: it starts three months before the month you turn 65 and ends three months after.

Some people become may be able to access before 65. If you have received Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease or ALS, you can enroll in Medicare regardless of age.

Key Takeaways

Medicare may be able to access begins the month you turn 65, even if you are still employed.
Your enrollment window lasts seven months — three months before and three months after the month of your 65th birthday.
Missing your enrollment window results in a permanent increase to your Part B and Part D premiums.
You may become may be able to access before 65 if you have been on SSDI for 24 months, have end-stage renal disease, or have ALS.
Citizenship or legal residency in the United States is required; you must also have lived in the country for at least five consecutive years.

When to sign up if you turn 65

Your seven-month Initial Enrollment Period (IEP) is your main chance to sign up without consequences. It runs from the first day of the third month before you turn 65 through the last day of the third month after. For example, if you turn 65 in June, your window opens January 1 and closes September 30.

You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. Online enrollment is fastest — you can complete it in about 15 minutes if you have your Social Security number and information about your current health coverage.

If you miss your IEP, you can still enroll during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage begins July 1 of that year. However, you will pay a 10 percent higher Part B premium for each full year you delayed enrollment past your IEP — that penalty is permanent and stays with you for life.

People who become may be able to access before 65

If you have been receiving SSDI for at least 24 consecutive months, Medicare begins automatically the 25th month of your SSDI payments. You do not have to sign up; Social Security will enroll you. You will receive your Medicare card in the mail about two months before your coverage starts.

If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you can enroll in Medicare when ready, regardless of age. You have a four-month enrollment window: two months before the month dialysis or a transplant is scheduled, and two months after it begins. If you miss that window, you can enroll during the General Enrollment Period (January 1 through March 31), with coverage starting July 1.

If you have amyotrophic lateral sclerosis (ALS), you become may be able to access for Medicare when ready upon diagnosis. You do not need to wait for SSDI approval. Enroll through Medicare.gov, by phone, or at your local Social Security office.

Citizenship and residency requirements

You must be a U.S. citizen or a lawful permanent resident (green card holder) to enroll in Medicare. You also must have lived in the United States for at least five consecutive years when ready before you explore.

If you are a lawful permanent resident, you will need to provide proof of your status when you enroll. Acceptable documents include your green card, a passport with an I-551 stamp, or a Permanent Resident Card. If you are a citizen, you will need proof of citizenship — a birth certificate, passport, or naturalization certificate.

What happens if you delay enrollment past 65

Delaying enrollment beyond your seven-month IEP triggers a permanent premium penalty on Part B (medical insurance) and Part D (prescription drug coverage). The penalty is 10 percent of the standard Part B premium for each full 12-month period you were may be able to access but not enrolled.

For example, if you turn 65 in January 2024 but do not enroll until March 2026, you delayed for two full years. Your Part B premium would increase by 20 percent for the rest of your life. The same penalty applies to Part D if you go without prescription drug coverage for 63 days or more in a row.

There is one exception: if you were covered by a group health plan through your employer or your spouse's employer when you turned 65, you may not face a penalty if you enroll within eight months of losing that coverage. This is called the Special Enrollment Period. You will need to provide proof of your employer coverage when you enroll.

How to prepare before you turn 65

Start gathering documents about two months before your birthday. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health insurance (employer coverage, individual plans, or Medicaid). If you have ESRD or ALS, gather medical records showing your diagnosis.

Review your current medications and find out which Medicare Part D plans cover them in your area. Prescription drug coverage varies by plan and by location, so a plan that works for your neighbor may not cover your drugs. You can use the Medicare Plan Finder tool on Medicare.gov to compare options.

If you are still working and have employer health insurance, contact your employer's benefits office to ask whether you must enroll in Medicare when you turn 65 or whether you can delay. Some employers require it; others allow you to stay on their plan. Knowing this before your birthday prevents costly mistakes.

Frequently Asked Questions

Do I have to retire to enroll in Medicare at 65?

No. You can enroll in Medicare and keep working. If you have employer health insurance through your job, you may be able to keep both. Contact your employer's benefits office to confirm whether your plan allows this, as some employers require you to drop their coverage once you enroll in Medicare.

What if I turn 65 outside the United States?

You can still enroll in Medicare during your seven-month Initial Enrollment Period. You can enroll online through Medicare.gov or by calling 1-800-MEDICARE from abroad. However, Medicare generally does not cover care outside the U.S., except in limited situations near the border or on a cruise ship in U.S. waters.

Can I enroll in Medicare before I turn 65 if I am still working?

No, unless you have SSDI, ESRD, or ALS. If you have one of those conditions, you become may be able to access before 65 and can enroll when ready. Otherwise, you must wait until the month you turn 65.

What is the penalty for missing my enrollment window?

You pay a permanent 10 percent increase to your Part B premium for each full year you delayed past your Initial Enrollment Period. This penalty stays with you for life, even if you enroll later. The same penalty applies to Part D if you go 63 or more days without prescription drug coverage.

Do I need to be a U.S. citizen to get Medicare?

You must be a U.S. citizen or a lawful permanent resident who has lived in the country for at least five consecutive years. If you are a permanent resident, bring your green card or other proof of status when you enroll.

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.