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

Medicare starts at age 65 for most people. You do not have to be retired, and you do not have to stop working — you can sign up whether you are still employed or not. The program is federal health insurance run by the Centers for Medicare & Medicaid Services (CMS), and it covers hospital stays, doctor visits, and prescription drugs through different parts.

If you are under 65, you may still be able to get Medicare if you have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease (permanent kidney failure) or ALS (amyotrophic lateral sclerosis). These are the only exceptions to the age 65 rule.

Key Takeaways

  • Medicare begins at age 65 for most people, regardless of whether you are still working.
  • You can get Medicare before 65 if you have received Social Security disability benefits for 24 months, or if you have end-stage renal disease or ALS.
  • You should sign up during your initial enrollment period, which starts three months before the month you turn 65 and lasts seven months total.
  • Missing your enrollment window can result in permanent late penalties added to your monthly premium.

When to sign up if you are turning 65

Your initial enrollment period runs for seven months: it starts three months before the month you turn 65, includes the month you turn 65, and ends three months after. For example, if you turn 65 in June, you can sign up starting in March and must sign up by September.

You should sign up during this window even if you do not plan to use Medicare right away. If you miss it and do not have other health coverage, you will pay a permanent penalty on top of your regular premium for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but did not sign up.

If you are still working and covered by your employer's health plan, you may have a grace period to sign up without penalty, but you need to check with your employer's benefits office first. Do not assume you are protected — the rules depend on the size of your employer and the type of coverage you have.

Getting Medicare before 65 through disability

If you receive Social Security Disability Insurance (SSDI) or Railroad Retirement Board disability benefits, you become may be able to access for Medicare after you have been receiving those benefits for 24 months. You do not have to wait until 65. Medicare will start automatically two months after you hit the 24-month mark, so you do not need to sign up separately.

If you have end-stage renal disease, you can get Medicare regardless of age or work history. You must sign up during a specific enrollment period tied to when your kidney disease is diagnosed or when you start dialysis or get a transplant. Contact your dialysis center or transplant team — they can tell you the exact dates for your situation.

If you have ALS, you become may be able to access for Medicare when ready upon approval for Social Security disability benefits. There is no 24-month waiting period for ALS as there is for other disabilities.

How to sign up for Medicare

You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online is usually fastest — you can complete the process in about 15 minutes if you have your Social Security number and birth certificate information ready.

If you are already receiving Social Security benefits, you may be able to sign up for Medicare through your Social Security account online. If you are not yet receiving Social Security, you will need to explore for Social Security at the same time you explore for Medicare, or explore for Social Security first.

Have your birth certificate, proof of citizenship or legal residency, and proof of income (like a recent tax return) available when you sign up. The process is faster if you have these documents ready, though you can submit them later if needed.

Medicare Parts and what each one covers

Part A covers hospital stays, skilled nursing facility care, hospice, and home health services. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working for at least 10 years.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. It has a monthly premium (the standard amount is $164.90 per month in 2024, though it varies by income). You pay a yearly deductible before Part B coverage starts, and then you pay 20 percent of the cost of most services.

Part D is prescription drug coverage. It is optional but recommended — if you do not sign up when you first become may be able to access and go without coverage, you will pay a permanent penalty if you sign up later. You choose a Part D plan from private insurance companies, and the premium and coverage vary by plan.

Part C (Medicare Advantage) is an alternative to Original Medicare (Parts A and B). It is offered by private insurance companies and usually includes Part D drug coverage. It often has lower out-of-pocket costs than Original Medicare, but you are limited to doctors and hospitals in the plan's network.

What happens if you miss your enrollment window

If you do not sign up during your initial enrollment period, you can still sign up later, but you will pay a penalty. For Part B, the penalty is 10 percent of the standard premium for each full year you were may be able to access but did not sign up. This penalty stays on your bill for as long as you have Medicare.

For Part D, the penalty is 1 percent of the national average Part D premium for each month you were without coverage. If you go without Part D for two years, your penalty is 2 percent of that average premium, and it also stays with you permanently.

You can sign up outside your initial enrollment period during the General Enrollment Period, which runs from January 1 to March 31 each year. Coverage would start July 1 of that year, so there is a delay. If you have a life event like losing employer coverage, you may have a Special Enrollment Period that lets you sign up without penalty.

Frequently Asked Questions

Can I get Medicare at 62?

No, not unless you have a disability, end-stage renal disease, or ALS. Age 65 is the standard may be able to access age. If you have a disability and have been receiving Social Security disability benefits for 24 months, you can get Medicare before 65, but the disability must be approved by Social Security first.

Do I have to retire to get Medicare?

No. You can be working full-time and still sign up for Medicare at 65. Your employment status does not affect your may be able to access. If you are covered by your employer's health plan, you may want to check with your benefits office about how Medicare coordinates with that coverage.

What if I am still working and have health insurance through my job?

You can keep your employer coverage and sign up for Medicare at the same time. The two plans will coordinate — usually your employer plan pays first and Medicare pays second. Ask your employer's benefits office whether you should sign up for Medicare Part B right away or wait, because the rules vary by company size.

Can my spouse sign up for Medicare at a different age than me?

Yes. Each person signs up based on their own age or disability status. Your spouse can sign up at 65 even if you signed up earlier due to disability, or vice versa. You do not have to sign up together, though you can if you want to.

What if I am not a U.S. citizen?

You must be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five years to get Medicare. Bring proof of citizenship or legal residency when you sign up. If you are not sure whether you meet this requirement, call 1-800-MEDICARE to ask.