When You Can Sign Up for Medicare: Age and Other Starting Points

The standard age to enroll in 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 main entry point, and most people sign up during the three months before their 65th birthday, the month they turn 65, or the three months after. That seven-month window is called your Initial Enrollment Period.

You do not have to wait until you turn 65 to start thinking about Medicare. You can look at your options starting three months before your birthday. The Social Security Administration sends you information about Medicare enrollment in the mail about three months before you turn 65.

Key Takeaways

You can enroll in Medicare starting three months before you turn 65, during the month you turn 65, or up to three months after your 65th birthday.
If you miss your Initial Enrollment Period, you will pay a permanent penalty on your Part B and Part D premiums unless you have employer coverage or other may have access to circumstances.
You can enroll before 65 if you receive Social Security Disability Insurance (SSDI) for at least 24 months, or if you have end-stage renal disease or ALS.
If you are still working and covered by your employer's health plan at 65, you may be able to delay enrollment without penalty.

Enrolling before 65: disability, kidney disease, and ALS

Three groups of people can enroll in Medicare before they turn 65. The first group is people who have received Social Security Disability Insurance (SSDI) for at least 24 months. Once you have been on SSDI for two years, you become may be able to access for Medicare automatically — you do not have to explore separately, though you should confirm your enrollment.

The second group is people with end-stage renal disease (ESRD), which means permanent kidney failure requiring dialysis or a transplant. You can enroll in Medicare as soon as you start dialysis or receive a transplant, regardless of age. The third group is people diagnosed with ALS (amyotrophic lateral sclerosis). You become may be able to access for Medicare the month your ALS diagnosis is made, with no waiting period.

What happens if you miss your enrollment window

If you do not enroll during your Initial Enrollment Period and you do not have a valid reason for the delay, you will pay a late enrollment penalty for the rest of your life. For Part B (medical insurance), the penalty is 10 percent of the standard premium for each full 12-month period you were not enrolled. For Part D (prescription drug coverage), the penalty is 1 percent of the national average premium for each month you were not enrolled.

These penalties add to your monthly premium and do not go away. The only way to avoid them is to enroll during your Initial Enrollment Period or to have what Medicare calls a "may have access to event" — such as losing employer coverage, moving out of your plan's service area, or experiencing a major life change like divorce or death of a spouse. If you think you have a may have access to reason, contact Social Security or Medicare directly to ask whether it applies to your situation.

Employer coverage and delayed enrollment

If you are still working at 65 and your employer offers health insurance, you may not have to enroll in Medicare right away. If your employer has 20 or more employees, you can usually stay on the employer plan and delay Medicare enrollment without penalty. This is called creditable coverage.

However, you must enroll in Medicare Part A (hospital insurance) within eight months of leaving your job or losing employer coverage, or you will face a late enrollment penalty. Part B (medical insurance) has the same eight-month window. If you are unsure whether your employer plan counts as creditable coverage, ask your employer's benefits department or contact Medicare before you turn 65.

How to enroll when you are ready

You can enroll in Medicare 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 is the fastest option and takes about 10 minutes. You will need your Social Security number and information about any current health coverage you have.

If you are already receiving Social Security benefits, Medicare will enroll you automatically in Part A and Part B starting the month you turn 65. You do not have to do anything. If you are not yet receiving Social Security, you will need to enroll in Medicare separately, even if you have already set up a Social Security account online.

Medicare Parts A, B, C, and D: what each covers

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Part B covers doctor visits, outpatient care, and medical equipment. Part B has a monthly premium that changes each year.

Part C, also called Medicare Advantage, is an alternative to Original Medicare (Parts A and B). Private insurance companies offer Part C plans, which bundle hospital and medical coverage and usually include prescription drug coverage. Part D is prescription drug coverage you add to Original Medicare if you want it. You can choose a Part D plan during your enrollment period, or you will pay a late enrollment penalty if you go without drug coverage and enroll later.

Special enrollment periods and life changes

If you miss your Initial Enrollment Period but experience a may have access to life event, you may get a second chance to enroll without penalty. may have access to events include losing employer coverage, moving out of your plan's service area, getting married, getting divorced, or having a significant drop in income.

You usually have two months from the date of the event to enroll. For example, if you lose your job on June 15, you have until August 15 to enroll in Medicare without penalty. Contact Social Security or Medicare to report the event and ask about your options. Having documentation of the event — such as a termination letter from your employer or a divorce decree — will speed up the process.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65 if I am still working?

Only if you receive SSDI for 24 months, have end-stage renal disease, or have ALS. If you are working but do not fall into one of these groups, you must wait until 65. However, if your employer coverage ends before 65, you may be able to enroll early under a special circumstance — contact Medicare to ask.

What if I turn 65 while I am traveling or living abroad?

You can still enroll in Medicare during your Initial Enrollment Period. You can enroll online at Medicare.gov or by phone at 1-800-MEDICARE from anywhere. If you are living outside the United States, you can enroll in Part A and Part B, but some Medicare Advantage and Part D plans may not be available to you.

Do I have to enroll in Part D when I turn 65?

You do not have to enroll in Part D at 65, but if you go without prescription drug coverage and enroll later, you will pay a permanent penalty. The only exception is if you have other creditable drug coverage through an employer or union plan. If you do not take any prescription medications, you can skip Part D, but you cannot go back without penalty.

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

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

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.