You can enroll in Medicare at 65, or earlier if you have a disability or end-stage renal disease

The standard age to start Medicare is 65. You do not have to wait until your birthday month—you can enroll starting three months before you turn 65, during the month you turn 65, and for three months after. That seven-month window is called your Initial Enrollment Period.

If you miss that window, you can still enroll later, but you may pay a permanent penalty on your premiums. The penalty amount depends on how long you waited and which part of Medicare you are joining.

You can also enroll before 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease (permanent kidney failure requiring dialysis or transplant). People with ALS (amyotrophic lateral sclerosis) can enroll when ready without the 24-month wait.

Key Takeaways

  • You become may be able to access for Medicare at 65, and your enrollment window opens three months before your 65th birthday.
  • If you are receiving SSDI, you can enroll in Medicare after 24 months on disability, even if you are younger than 65.
  • People with end-stage renal disease or ALS can enroll in Medicare regardless of age.
  • Missing your Initial Enrollment Period results in a permanent late-enrollment penalty added to your Part B and Part D premiums.
  • You can enroll online through Medicare.gov, by phone, or in person at your local Social Security office.

How the Initial Enrollment Period works

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

You do not have to enroll on your birthday. You can sign up any time during those seven months, and coverage will begin on the first day of the month you turn 65—or the first day of the following month if you enroll after your birthday month. Enrolling early gives you time to receive your Medicare card and learn how your coverage works before it starts.

If you are still working at 65 and have health insurance through your employer, you may be able to delay Part B enrollment without penalty. This is called creditable coverage. You will still need to enroll in Part A (hospital insurance) at 65 unless you are still working and your employer has 20 or more employees. Talk to your employer's benefits office to understand your situation before you turn 65.

Enrolling before 65 with a disability

If you receive SSDI, you become may be able to access for Medicare after you have been on disability for 24 consecutive months. The 24 months starts from the date your disability benefits began, not from when you applied. Social Security will contact you automatically when you reach 24 months and send you information about enrolling.

You do not have to do anything to receive this notice—Social Security tracks your case. However, you should still enroll during your Initial Enrollment Period (which is the same seven-month window, centered on the month you become may be able to access) to avoid late-enrollment penalties.

If you have ALS, you skip the 24-month wait entirely. You can enroll in Medicare as soon as your ALS diagnosis is approved by Social Security. End-stage renal disease works the same way—you can enroll when ready once your condition is documented, even if you are in your 20s or 30s.

What happens if you miss your enrollment window

If you do not enroll during your Initial Enrollment Period, you can still sign up later during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage begins July 1 of that year. However, you will owe a late-enrollment penalty.

The penalty for Part B is 10 percent of the standard premium for each full 12 months you were may be able to access but not enrolled. If you waited two years, your penalty would be 20 percent. This penalty stays on your premium for as long as you have Part B—it does not go away after a certain time.

Part D (prescription drug coverage) has a similar penalty: 1 percent of the national average premium for each month you were without creditable coverage. If you have a gap of 63 days or more without Part D or other creditable drug coverage, the penalty applies. Unlike Part B, the Part D penalty is recalculated each year based on the current national average premium.

Enrolling through Social Security or Medicare

You can enroll in Medicare three ways: online at Medicare.gov, by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or by visiting your local Social Security office in person. You will need your Social Security number and proof of citizenship or legal residency.

If you are already receiving Social Security benefits, you may be enrolled automatically in Medicare Part A and Part B when you turn 65. Check your mail for a Medicare card about two weeks before your 65th birthday. If you do not receive one, contact Social Security to confirm your enrollment.

If you are not yet receiving Social Security benefits, you must enroll in Medicare separately. You can do this online, by phone, or in person. The process takes about 15 minutes online or on the phone.

Special situations: Still working or covered by an employer plan

If you are still working at 65 and your employer offers health insurance, you may not need to enroll in Medicare Part B right away. This is allowed only if your employer has 20 or more employees. Your employer's plan is considered primary, meaning it pays first, and Medicare pays second.

You must still enroll in Part A (hospital insurance) at 65 unless you meet the employer exception. Part A has no premium if you or your spouse paid Medicare taxes for 10 years or more, so there is no financial reason to delay it.

When you leave your job or lose your employer coverage, you have eight months to enroll in Part B without penalty. This is called a Special Enrollment Period. Keep documentation of when your employer coverage ended so you can prove you may have access to for this exception.

Medicare enrollment for non-citizens

You must be a U.S. citizen or a lawful permanent resident (green card holder) to enroll in Medicare. If you are a lawful permanent resident, you must have held your green card for at least five years and be a resident of the United States.

If you are not yet a citizen or permanent resident, you cannot enroll in Medicare, even at 65. You may be able to purchase private health insurance or look into other coverage options through your state's health insurance marketplace.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65 if I am not disabled?

No. The only ways to enroll before 65 are through SSDI (after 24 months), end-stage renal disease, or ALS. If you do not have one of these conditions, you must wait until 65. If you need coverage before then, you can purchase a plan through your state's health insurance marketplace.

What if I turn 65 but am still working and do not want Medicare yet?

You can delay Part B if your employer has 20 or more employees and offers you health insurance. You must still enroll in Part A at 65. When you leave your job, you have eight months to enroll in Part B without penalty. Keep proof of your employer coverage end date.

Do I lose my Medicare may be able to access if I move out of the United States?

No. Once you are enrolled in Medicare, you keep your coverage even if you move abroad. However, Medicare generally does not pay for care received outside the U.S., except in limited situations near the border. Talk to Medicare before you move to understand what coverage will explore.

What if I was on SSDI but my benefits were stopped—do I still may have access to for Medicare?

Yes. Once you have been on SSDI for 24 months, you become may be able to access for Medicare. If your disability benefits end later, your Medicare coverage continues. You do not lose Medicare if your SSDI stops.

Can I enroll in Medicare online if I do not have a Social Security account?

You can start the online process at Medicare.gov, but you may need to call or visit a Social Security office to complete it if you do not have a Social Security account set up. Calling 1-800-772-1213 is often faster if you do not have online access set up.