The standard age for Medicare is 65

You become may be able to access for Medicare at age 65, regardless of your work history or income. This is the age when most people in the United States can enroll in the federal health insurance program. You do not have to wait until you retire — you can keep working and still sign up at 65.

Medicare enrollment happens automatically for some people. If you are already receiving Social Security benefits when you turn 65, you will be enrolled in Medicare Part A and Part B without having to do anything. If you are not yet taking Social Security, you will need to sign up yourself during your enrollment window.

The enrollment window opens three months before the month you turn 65 and closes three months after. For example, if you turn 65 in June, you can enroll from March through September. Signing up late can result in a permanent penalty on your premiums, so timing matters.

Key Takeaways

  • You can enroll in Medicare starting three months before you turn 65 and must do so within three months after, or face a permanent premium penalty.
  • If you are already collecting Social Security at 65, Medicare enrollment happens automatically; otherwise you must sign up yourself.
  • You can work and earn any amount while enrolled in Medicare — there is no income limit or retirement requirement.
  • Some people under 65 may be may be able to access if they receive Social Security Disability Insurance (SSDI) for at least 24 months or have end-stage renal disease or ALS.

Enrolling before 65 if you have a disability

You may be able to enroll in Medicare before age 65 if you receive Social Security Disability Insurance (SSDI). After you have been on SSDI for 24 consecutive months, you become may be able to access for Medicare regardless of your age. This means someone who starts receiving disability benefits at age 40 would become may be able to access for Medicare at age 42.

Two other conditions also allow Medicare enrollment before 65: if you have end-stage renal disease (permanent kidney failure requiring dialysis or transplant) or if you have been diagnosed with ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease). People with ALS can enroll when ready upon diagnosis, without waiting for any period of disability payments.

If you fall into one of these categories, you will receive a notice from Social Security explaining your Medicare may be able to access. You still need to enroll during your enrollment window — the system does not enroll you automatically in these cases.

What happens if you delay enrollment past 65

If you miss your enrollment window and do not sign up within three months after turning 65, you will face a late enrollment penalty. This penalty is permanent — it stays on your premiums for as long as you have Medicare.

The penalty for Part B (medical insurance) is 10 percent of the standard premium for each full 12-month period you were may be able to access but not enrolled. If the standard Part B premium is $164.90 per month and you waited two years to enroll, your penalty would be 20 percent, raising your premium to about $198 per month for life.

There is one exception: if you were covered by a group health plan through your own job (or your spouse's job) when you turned 65, you may not face a penalty if you enroll within eight months of losing that coverage. You will need to show proof of the group plan coverage when you sign up.

How to enroll in Medicare at 65

You can enroll through three routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office.

Online enrollment through Medicare.gov is the fastest option. You will need your Social Security number and information about any current health coverage. The process takes about 10 minutes, and you receive confirmation when ready.

By phone, a representative will walk you through the same questions. Wait times vary, but calling early in the day or mid-week typically means shorter holds. In person, you can bring documents to a Social Security office, though you will need to schedule an appointment first.

Whichever method you choose, have ready: your Social Security number, your date of birth, your citizenship or immigration status, and information about any employer health coverage you currently have.

Medicare Parts and what each covers at 65

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. There is no monthly premium for Part A if you or your spouse paid Medicare taxes for at least 10 years while working. If you do not meet this requirement, you can still buy Part A, but the premium varies based on how many years you paid into the system.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium that changes each year — for 2024 it is $164.90 for most people, though higher earners pay more. You pay this premium whether you use Medicare or not.

Part D is prescription drug coverage. It is optional but recommended if you take medications regularly. If you do not enroll in Part D when you first become may be able to access and later decide you want it, you will pay a permanent penalty unless you had other creditable drug coverage in the meantime.

Part C, also called Medicare Advantage, is an alternative to Parts A and B offered by private insurance companies. It bundles hospital and medical coverage and usually includes drug coverage. You do not have to choose Part C — you can stick with Original Medicare (Parts A and B) instead.

Working while on Medicare at 65

You can continue working full-time and earn any amount while enrolled in Medicare at 65. There is no income limit, and your earnings do not affect your Medicare coverage or premiums.

However, if you are still working and your employer offers health insurance, you may want to delay enrolling in Medicare Part B. If you enroll in Part B while you have group coverage through work, you will pay the Part B premium even though you are using your employer plan. You can enroll in Part B later without penalty if you wait until you leave your job or lose the employer coverage, as long as you enroll within eight months.

Part A (hospital insurance) does not have this same rule — you can enroll in Part A at 65 without penalty even if you have employer coverage, since Part A has no monthly premium for most people.

Special situations: government employees and railroad workers

If you worked for the federal government and are covered by the Federal Employees Health Benefits Program (FEHB), you follow the same Medicare rules as everyone else. You become may be able to access at 65 and can enroll without penalty if you do so within three months of turning 65.

If you worked for a railroad and are covered by Railroad Retirement, your Medicare may be able to access works the same way — age 65 is the standard age. However, your enrollment process may be slightly different, and you should contact the Railroad Retirement Board directly to confirm your enrollment status.

If you are unsure whether your government or railroad employment affects your Medicare enrollment, contact Social Security at 1-800-772-1213 before your 65th birthday to ask.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

Only if you receive SSDI for 24 months, have end-stage renal disease, or have ALS. Otherwise, you must wait until age 65. You can contact Social Security at 1-800-772-1213 to confirm whether you meet one of these conditions.

What if I miss the enrollment window by a few days?

Missing the important date by even one day means you have entered the late enrollment period and will face a permanent penalty. The only exception is if you had group health coverage through work — then you have eight months from losing that coverage to enroll without penalty.

Do I have to enroll in Part D if I do not take any medications?

Part D is optional, but if you do not enroll when first may be able to access and later decide you want it, you will pay a permanent penalty. If you truly do not take medications, you can skip it, but if your situation changes, the penalty applies.

Will my Medicare premiums increase if I keep working after 65?

Your Part B premium does not increase based on work income. However, if your modified adjusted gross income is above a certain threshold (which changes yearly), you will pay an additional amount called an Income-Related Monthly Adjustment Amount (IRMAA).

What if I am still covered by my employer's health plan at 65?

You can delay enrolling in Part B without penalty as long as you enroll within eight months of losing the employer coverage. Part A has no such rule — you can enroll in Part A at 65 even with employer coverage. Contact your employer's benefits office to understand how the two plans coordinate.