Medicare starts at age 65 for most people

You become may be able to access for Medicare at age 65, regardless of your work history or income. This is the standard age set by federal law. You do not have to retire at 65 to sign up — you can keep working and still enroll in Medicare.

The enrollment window opens three months before the month you turn 65 and closes three months after. If you miss this window, you may face a permanent penalty on your premiums, so timing matters. You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

Key Takeaways

  • You become may be able to access for Medicare at age 65, and you have a seven-month window to enroll without penalty.
  • 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 late outside your initial window triggers a permanent increase to your Part B and Part D premiums.
  • You must be a U.S. citizen or lawful permanent resident for at least five years to may have access to.

Who can enroll before age 65

Three groups of people under 65 may be may be able to access for Medicare. The first group includes people who have received Social Security Disability Insurance (SSDI) for at least 24 consecutive months. The second group includes people diagnosed with end-stage renal disease (permanent kidney failure requiring dialysis or transplant). The third group includes people with ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease) — they become may be able to access when ready without waiting.

If you fall into one of these categories, you should contact Social Security to confirm your may be able to access and enroll. Social Security will notify you automatically if you may have access to through SSDI, but you still need to complete the enrollment process yourself. For end-stage renal disease or ALS, your doctor or dialysis center can help you start the process.

Citizenship and residency requirements

You must be a U.S. citizen or a lawful permanent resident to enroll in Medicare. If you are a lawful permanent resident, you must have held that status for at least five consecutive years. This means you cannot enroll based on temporary visa status, even if you have worked and paid taxes in the United States.

If you are a citizen or permanent resident living outside the United States, you can still enroll in Medicare at 65. However, Medicare coverage generally does not work outside U.S. borders, so you would need to understand what services are and are not covered before you move abroad.

How your work history affects enrollment

Your work history does not determine whether you can enroll in Medicare at 65 — age alone is the deciding factor. However, your work history affects what you pay. If you or your spouse paid Medicare taxes for at least 10 years (40 quarters), you pay no premium for Part A (hospital insurance). If you have fewer than 10 years of work history, you may still enroll but will pay a monthly premium for Part A.

Part B (medical insurance) and Part D (prescription drug coverage) require monthly premiums for everyone, though the amount varies based on your income. You do not need any work history to enroll in these parts — age and citizenship are the only requirements.

What happens if you miss your enrollment window

Your initial enrollment window is seven months long: three months before you turn 65, the month you turn 65, and three months after. If you do not enroll during this window and you do not have other coverage (such as employer health insurance), you will face a late enrollment 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 not enrolled. This penalty is permanent — it stays on your premiums for as long as you have Medicare. For Part D, the penalty is 1 percent of the national average premium for each month you were not enrolled. You can avoid this penalty if you had creditable coverage (employer insurance or other may have access to coverage) during the time you were not enrolled in Medicare.

Enrolling after you turn 65

If you miss your initial window, you can still enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. Coverage begins July 1 of that year. This means if you enroll in February, your coverage does not start until July — a five-month gap.

Some people have a second chance to enroll without penalty through a Special Enrollment Period. This applies if you had employer coverage and lost it, or if you were working and did not enroll because you were covered through your job. You have eight months from the date you lose that coverage to enroll in Medicare without penalty. You will need to provide proof that you had other coverage.

Delaying enrollment if you are still working

You can delay enrolling in Medicare Part B if you are still working and covered by your employer's health plan. You have until eight months after you leave your job or lose your employer coverage to enroll without penalty. This is called the Special Enrollment Period for working beneficiaries.

However, you should still enroll in Part A (hospital insurance) at 65 even if you delay Part B, because Part A has no monthly premium if you have 10 years of work history. Delaying Part A does not save you money and only delays your coverage. Part D (prescription drug) works differently — delaying it can trigger a permanent penalty, so ask your employer whether your drug coverage counts as creditable before you decide to delay.

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 three months before your 65th birthday to begin the enrollment process.

What if I am still working at 65?

You can enroll in Medicare and keep working. If your employer offers health insurance, you may be able to delay Part B without penalty as long as you enroll within eight months of leaving your job or losing coverage. Always enroll in Part A at 65 if you are may be able to access.

Do I lose Medicare if I move to another country?

You keep your Medicare enrollment, but coverage does not work outside the United States. Medicare only pays for emergency care in Canada and Mexico under specific circumstances. If you move abroad permanently, contact Medicare to discuss your options.

What is the penalty for enrolling late?

For Part B, you pay 10 percent more per month for each year you delayed, and this penalty is permanent. For Part D, the penalty is 1 percent per month. You can avoid both penalties if you had other may have access to coverage during the time you were not enrolled.

Can I enroll in Medicare online?

Yes, you can enroll through Medicare.gov, or you can call 1-800-MEDICARE to enroll by phone. You can also visit your local Social Security office in person. All three methods take you through the same enrollment process.