What Age You Can Enroll in Medicare

Medicare starts at 65 for most people

You become may be able to access for Medicare on the first day of the month you turn 65, or the month after, depending on your birthday. If you turn 65 on the first of any month, coverage begins that same month. If your birthday falls on any other day, coverage begins the first day of the following month.

You do not have to wait until you actually turn 65 to sign up. You can enroll during the three months before you turn 65, the month you turn 65, and the three months after. This seven-month window is called your Initial Enrollment Period. If you miss this window, you may face a permanent penalty on your premiums.

Key Takeaways

Medicare may be able to access begins at age 65 for U.S. citizens and permanent residents who have lived in the country for at least five years.
You can enroll starting three months before you turn 65, giving you time to choose a plan before coverage begins.
If you delay enrollment past your Initial Enrollment Period without a valid reason, you will pay higher premiums for the rest of your life.
Some people under 65 may be may be able to access if they receive Social Security Disability Insurance or have end-stage renal disease or ALS.

Who qualifies at 65

You must be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years. If you are a permanent resident, you will need to provide proof of your status when you enroll.

You do not need to be retired or working to enroll. Medicare is available to anyone who meets the age and residency requirements, regardless of your employment status or income. You can be working full-time and still sign up at 65.

Younger enrollment: disability, ESRD, and ALS

You may be may be able to access before 65 if you have received Social Security Disability Insurance (SSDI) for at least 24 months. The 24-month waiting period starts from the month your disability benefits began, not from when you applied. Once you have been on SSDI for two years, you become may be able to access for Medicare regardless of your age.

You are also may be able to access at any age if you have End-Stage Renal Disease (ESRD) — permanent kidney failure requiring dialysis or a transplant. Coverage can begin as early as the first month of dialysis treatment or the month of your transplant, whichever comes first.

A third group may be able to access before 65 are people diagnosed with Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig's disease. You become may be able to access for Medicare the same month your ALS benefits begin under Social Security, with no waiting period.

When to enroll and what happens if you miss the important date

Your Initial Enrollment Period is seven months long: three months before the month you turn 65, the month you turn 65, and three months after. For example, if you turn 65 in June, you can enroll from March through September.

If you enroll during this window, your coverage will start on the first day of the month you turn 65 (or the month after, depending on your birthday). If you enroll after your Initial Enrollment Period ends, your coverage will not start until the first day of the month after you enroll.

Missing your Initial Enrollment Period can be costly. If you do not enroll when you first become may be able to access and you do not have other health coverage that counts as "creditable coverage," you will pay a late enrollment penalty for as long as you have Medicare. This penalty is added to your Part B and Part D premiums permanently, even if you enroll years later.

Exceptions that delay your enrollment important date

You may have a longer window to enroll without penalty if you have creditable coverage — health insurance through an employer, a spouse's employer, TRICARE, or the Veterans Administration. If your employer coverage ends or you leave your job, you have eight months from the date coverage ends to enroll in Medicare without penalty.

If you are still working and your employer has 20 or more employees, you may be able to delay Part B enrollment without penalty as long as you are covered under the employer plan. You will need to enroll in Part A at 65, but Part B enrollment can wait. Once you leave the job or the employer coverage ends, you have eight months to enroll in Part B.

How to enroll at 65

You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. If you are already receiving Social Security benefits, you will be enrolled automatically in Parts A and B when you turn 65, unless you ask not to be.

If you are not yet receiving Social Security, you will need to contact Social Security or Medicare to enroll. Have your Social Security number, birth certificate, and proof of citizenship or permanent residency ready. The enrollment process usually takes 15 to 30 minutes.

After you enroll in Parts A and B, you will need to choose a Part D prescription drug plan and either a Medigap policy or a Medicare Advantage plan. These choices should be made during your Initial Enrollment Period as well, since they have their own enrollment important date and penalties.

What Medicare covers at 65

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Together, they form Original Medicare.

You will have a deductible and coinsurance costs under Original Medicare. Part D covers prescription drugs and requires a separate enrollment. Many people also buy a Medigap policy to cover costs that Original Medicare does not pay, or they choose a Medicare Advantage plan instead, which is an all-in-one alternative to Original Medicare.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

Yes. You can enroll during the three months before you turn 65. Your coverage will begin on the first day of the month you turn 65 (or the month after, depending on your birthday). Enrolling early gives you time to review your options and avoid missing your important date.

What happens if I'm still working at 65?

You can enroll in Medicare at 65 even if you are still working. If your employer has 20 or more employees and provides health coverage, you may delay Part B enrollment without penalty, but you should still enroll in Part A. Check with your employer's benefits office about your specific situation.

Do I lose Medicare if I move out of the United States?

Medicare generally does not cover care outside the U.S., with limited exceptions for care in Canada and Mexico near the border. If you move abroad permanently, you should contact Medicare to understand how your coverage will work. You can keep your Medicare enrollment even while living outside the country.

What if I missed my Initial Enrollment Period?

You can still enroll, but you may face a late enrollment penalty on your premiums for life. The penalty is 10 percent of the Part B premium for each full 12 months you were may be able to access but not enrolled. If you have creditable coverage through an employer or other source, you may be able to enroll without penalty within eight months of losing that coverage.

Can my spouse enroll at 65 if they are not a U.S. citizen?

Your spouse must be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years to enroll in Medicare. Citizenship or permanent residency status is required, not just marriage to someone may be able to access for Medicare.

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.