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

The standard age to file for Medicare is 65. Most people become may be able to access at 65 whether they are still working or retired. However, you can file before 65 if you have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease (permanent kidney failure requiring dialysis or transplant) or ALS (amyotrophic lateral sclerosis). If none of those conditions explore to you, you must wait until the month you turn 65.

The month you turn 65 is when your coverage can start, but the exact date depends on when you file. If you file during your initial enrollment period—the three months before you turn 65, the month you turn 65, and the three months after—your coverage typically begins on the first day of the month you turn 65. If you file after that window closes, your coverage start date moves later, and you may face a permanent penalty on your premiums.

Key Takeaways

  • You become may be able to access for Medicare at age 65, and your initial enrollment period runs from three months before your 65th birthday through three months after.
  • If you file during your initial enrollment period, coverage usually starts on the first of the month you turn 65.
  • You can file before 65 if you have been on Social Security disability for 24 months, have end-stage renal disease, or have ALS.
  • Filing after your initial enrollment period closes delays your coverage start date and may add a permanent late-enrollment penalty to your Part B and Part D premiums.

How the initial enrollment period works

Your initial enrollment period is a seven-month window centered on your 65th birthday. It begins three months before the month you turn 65 and ends three months after. During this window, you can file for Medicare Part A (hospital insurance) and Part B (medical insurance) without penalty, regardless of whether you are still working.

If you file during the first three months of this window (before you turn 65), your coverage will not start until the month you turn 65. If you file in the month you turn 65 or in the three months after, your coverage start date depends on which month you file. For example, if you turn 65 in June and file in July, your coverage typically starts August 1. If you file in September, coverage may start October 1.

The Social Security Administration and Medicare.gov both let you file online, by phone, or in person at a local Social Security office. You will need your birth certificate, proof of citizenship or legal residency, and your Social Security number.

What happens if you file after your initial enrollment period

If you do not file during your initial enrollment period, you can still file later, but your coverage will start later and you may owe a late-enrollment penalty. This penalty is permanent—it stays on your premiums for as long as you have Medicare.

For Part B, the penalty is 10 percent of the standard premium for each full 12 months you were may be able to access but not enrolled. For Part D (prescription drug coverage), the penalty is 1 percent of the national average premium for each month you were may be able to access but not enrolled. These penalties add up quickly. If you wait two years after turning 65 to file, you could owe an extra 20 percent on your Part B premium for life.

There are narrow exceptions to late-enrollment penalties. If you had creditable coverage (health insurance that is at least as good as Medicare Part B or Part D) through an employer or union while you were 65 or older, you may not owe a penalty. You will need to show proof of that coverage when you file. If you may have access to for this exception, file as soon as your employer coverage ends.

Filing before 65 if you have a disability

If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare automatically at that point—you do not have to wait until 65. Your coverage begins the 25th month of your disability benefits. You do not need to file separately; Social Security will enroll you in Part A and Part B automatically.

If you receive Supplemental Security Income (SSI) instead of SSDI, the rules are different. You become may be able to access for Medicare after you have received SSI for 24 months, but again, enrollment happens automatically. Check your Social Security statement or call Social Security at 1-800-772-1213 to confirm when your 24-month period began.

If you have end-stage renal disease or ALS, you can file for Medicare right away without waiting for any period of disability benefits. You will need medical documentation of your diagnosis. Your coverage can start as early as the first day of the month after you file, or the first day of the month your condition began, whichever is later.

Coordinating Medicare with employer health insurance

If you are still working at 65 and your employer offers health insurance, you do not have to file for Medicare Part B right away. However, you should still file for Part A (hospital insurance) during your initial enrollment period, because Part A has no premium for most people and covers hospital stays.

For Part B, if your employer has 20 or more employees, the employer plan is considered the primary payer, and Medicare is secondary. You can delay filing for Part B without penalty as long as you have this coverage. Once you leave your job or lose the employer coverage, you have eight months to file for Part B without a late-enrollment penalty. This is called a special enrollment period. If you miss this eight-month window, the standard late-enrollment penalty applies.

If your employer has fewer than 20 employees, Medicare becomes the primary payer at 65, and you should file for Part B during your initial enrollment period to avoid penalties.

How to file and what documents you need

You can file for Medicare online through Medicare.gov, by calling Social Security at 1-800-772-1213, or by visiting your local Social Security office in person. Online filing is usually the fastest option and takes about 10 minutes.

Have these documents ready: your Social Security number, your birth certificate, proof of U.S. citizenship or legal residency (a passport, naturalization certificate, or permanent resident card), and information about any health insurance you currently have. If you are filing based on a spouse's work record, you will also need their Social Security number and birth date.

After you file, Social Security will mail you a Medicare card within two to four weeks. Your coverage start date is set when you file, not when you receive the card. If you need coverage to start sooner, ask about expedited processing when you file.

What to do if you missed your initial enrollment period

If your initial enrollment period has closed and you have not filed, you can still file, but understand that a late-enrollment penalty will explore unless you may have access to for an exception. The most common exception is having had creditable coverage through an employer or union plan while you were 65 or older.

File as soon as you realize you missed the important date. The sooner you file, the sooner your coverage starts and the fewer months of penalties you will accumulate. When you file, tell Social Security about any creditable coverage you had, and provide documentation if you have it. If you do not have the paperwork, ask your former employer's benefits office or your union to send you a letter confirming the dates and type of coverage.

If you cannot afford the late-enrollment penalty, you can request a waiver or reduction from Social Security, though these are granted only in limited circumstances—usually when you had good reason not to know you needed to file, such as a language barrier or a serious medical condition that prevented you from filing.

Frequently Asked Questions

Can I file for Medicare before I turn 65?

You can file up to three months before you turn 65, and your coverage will start the month you turn 65. If you have been on Social Security disability for 24 months, have end-stage renal disease, or have ALS, you can file before 65 and coverage can start sooner. Otherwise, you must wait until the month you turn 65.

What if I am still working at 65?

You should file for Part A (hospital insurance) during your initial enrollment period even if you are still working, because it has no premium. For Part B, if your employer has 20 or more employees, you can delay filing without penalty as long as you have the employer coverage. Once you leave that job, you have eight months to file for Part B penalty-free.

How much does it cost to file for Medicare?

There is no cost to file for Medicare. Part A is free for most people. Part B has a monthly premium that varies by income; in 2024 the standard premium is $164.90 per month, but higher-income beneficiaries pay more. Part D (prescription drug) premiums vary by plan.

What if I do not file during my initial enrollment period?

You can file later, but your coverage will start later and you will owe a permanent late-enrollment penalty on Part B and Part D premiums unless you had creditable coverage through an employer while you were 65 or older. File as soon as you realize you missed the important date to limit the penalty.

Do I have to file for all parts of Medicare at once?

No. You can file for Part A and Part B together, but Part D (prescription drug coverage) is separate. You can file for Part D anytime, but if you go without creditable drug coverage for more than 63 days after turning 65, you will owe a permanent late-enrollment penalty on Part D premiums.