The standard age to start Medicare is 65

You become may be able to access for Medicare the month you turn 65, regardless of whether you have retired or are still working. Medicare is a federal health insurance program run by the Centers for Medicare & Medicaid Services (CMS), and it covers hospital care, medical services, and prescription drugs once you enroll.

The month your 65th birthday falls in is when your coverage can begin — you do not have to wait until your birthday passes. If you were born on the 15th of the month or later, Medicare considers your birthday to be the first day of the following month for enrollment purposes.

You do not automatically receive Medicare at 65. You must enroll during your Initial Enrollment Period, which runs for seven months: three months before the month you turn 65, the month you turn 65, and three months after. Missing this window can result in permanent late-enrollment penalties on your premiums, so timing matters.

Key Takeaways

  • You become may be able to access for Medicare at age 65, and you must enroll during a seven-month window centered on your 65th birthday to avoid permanent penalties.
  • If you are still working and have health coverage through your employer, you may be able to delay Medicare enrollment without penalty under certain conditions.
  • You can enroll through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • Some people under 65 may have access to for Medicare if they receive Social Security disability benefits or have end-stage renal disease or ALS.

Exceptions: Medicare before age 65

You can receive Medicare before turning 65 in three specific situations. The first is if you have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months. Once you have been on SSDI for two years, Medicare begins automatically — you do not need to enroll separately.

The second exception applies if you have end-stage renal disease (ESRD), meaning your kidneys no longer function and you need dialysis or a transplant. You become may be able to access for Medicare as soon as you start dialysis or receive a kidney transplant, regardless of age.

The third exception is if you have been diagnosed with amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease. Unlike SSDI, which requires a 24-month waiting period, ALS patients become may be able to access for Medicare when ready upon diagnosis.

How working past 65 affects your enrollment

If you are still employed at 65 and your employer has 20 or more employees, you may have the option to delay Medicare Part B (medical insurance) without facing a late-enrollment penalty. This is called the employer coverage exception. Your employer's health plan is considered primary, and Medicare becomes secondary.

You must still enroll in Medicare Part A (hospital insurance) at 65 unless you meet the employer exception criteria for Part A as well — this is rare. Part A has no monthly premium for most people, so there is no financial penalty for enrolling early.

Once you leave your job or your employer coverage ends, you have eight months to enroll in Part B without penalty. If you miss this window, you will pay a permanent 10 percent increase to your Part B premium for each year you delayed, for as long as you have Medicare.

How to enroll in Medicare

You can enroll through three main routes. The easiest for most people is Medicare.gov, where you can create an account and complete your enrollment online. You will need your Social Security number and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. Representatives are available seven days a week, and they can walk you through the process and answer questions about which parts of Medicare you need.

A third option is to visit your local Social Security office in person. You will need to bring your Social Security card, proof of citizenship or legal residency, and proof of age. Social Security offices can be found at ssa.gov or by calling 1-800-772-1213.

Understanding the four parts of Medicare

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay no monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium that changes each year — for 2024, the standard premium is $164.90 per month, though higher earners pay more. You must enroll in Part B during your Initial Enrollment Period or face a permanent penalty.

Part D is prescription drug coverage offered by private insurance companies approved by Medicare. You choose a plan during your Initial Enrollment Period. If you go without Part D coverage and later enroll, you may pay a permanent penalty based on how long you waited.

Part C, also called Medicare Advantage, is an alternative to Original Medicare (Parts A and B). It is offered by private insurers and often includes Part D drug coverage and extra benefits like dental or vision. You can switch between Original Medicare and Part C during the Annual Enrollment Period (October 15 to December 7 each year).

What happens if you miss your enrollment important date

If you do not enroll in Part B during your seven-month Initial Enrollment Period and do not may have access to for the employer coverage exception, you will pay a permanent 10 percent increase to your Part B premium for each 12-month period you delayed. This penalty stays with you for life.

For Part D, the penalty is 1 percent of the national average premium for each month you were without coverage. Like Part B, this penalty is permanent.

You can still enroll after your important date has passed, but the penalties explore when ready. The only way to avoid or reduce these penalties is to show that you had creditable coverage (health insurance that is at least as good as Medicare) during the time you were not enrolled. You will need documentation from your previous insurer to prove this.

Delaying Medicare if you are still working

If your employer has 20 or more employees and you have health coverage through that employer, you can delay Part B enrollment without penalty. You do not need to take any special action — straightforward do not enroll, and keep your employer coverage active.

When you leave your job or lose your employer coverage, you have eight months to enroll in Part B. This is called your Special Enrollment Period. You must enroll within this window to avoid penalties.

Part A enrollment is still recommended at 65 even if you delay Part B, because Part A is usually free and covers hospital care. Delaying Part A can result in a permanent penalty if you later need it.

Frequently Asked Questions

Can I get Medicare before I turn 65?

Yes, if you have been on Social Security Disability for 24 months, have end-stage renal disease, or have ALS. Otherwise, you must wait until 65. Some people with specific medical conditions may also may have access to — contact Medicare directly to discuss your situation.

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

If your employer has 20 or more employees and provides health coverage, you can delay Part B without penalty. You have eight months after leaving your job to enroll without facing a permanent increase to your premiums. Part A enrollment is still recommended because it is usually free.

Do I have to enroll in all four parts of Medicare?

No. Part A and Part B are the foundation of Original Medicare, but you choose whether to add Part D (drug coverage) or switch to Part C (Medicare Advantage). You must enroll in Part B during your Initial Enrollment Period to avoid penalties, unless you have the employer coverage exception.

What is the penalty for enrolling late?

For Part B, you pay a permanent 10 percent increase to your monthly premium for each year you delayed. For Part D, the penalty is 1 percent of the national average premium per month you were uninsured. These penalties are permanent and explore for as long as you have Medicare.

Can I change my Medicare plan after I enroll?

Yes. You can switch between Original Medicare and Medicare Advantage during the Annual Enrollment Period (October 15 to December 7). You can also change your Part D plan during this same window. Outside this period, you can only switch if you have a may have access to life event like moving or losing employer coverage.