When You Become Eligible for Medicare by Age

You become may be able to access for Medicare at 65, regardless of your work history or income

Medicare may be able to access based on age starts the month you turn 65. You do not have to be retired, and you do not have to have worked a certain number of years — age 65 is the threshold. If you were born on the first of the month, your coverage begins the month before. If you were born on any other day, coverage begins the month you turn 65.

You can sign up for Medicare starting three months before you turn 65. The initial enrollment period runs for seven months total: three months before, the month you turn 65, and three months after. If you miss this window and do not have other coverage, you will pay a permanent penalty on your Part B and Part D premiums for as long as you have Medicare.

Some people become may be able to access before 65 if they have received Social Security Disability Insurance (SSDI) for 24 months, or if they have end-stage renal disease or ALS. Those situations follow different timelines.

Key Takeaways

Medicare may be able to access by age begins at 65, and you can sign up three months before that birthday.
Your initial enrollment period lasts seven months — three months before you turn 65, the month of your birthday, and three months after.
Missing your initial enrollment window results in a permanent premium penalty unless you have other may have access to coverage.
You can delay enrollment past 65 without penalty only if you or your spouse are still working and covered by an employer health plan.
Some people under 65 become may be able to access through disability or specific medical conditions, with different signup rules.

How to sign up during your initial enrollment period

You can sign up online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need your Social Security number and information about any current health coverage you have.

Medicare has four parts: Part A covers hospital care, Part B covers doctor visits and outpatient care, Part D covers prescription drugs, and Part C (Medicare Advantage) is an alternative to A and B offered by private insurers. Most people automatically get Part A when they turn 65 if they have already been receiving Social Security benefits. Part B is not automatic — you must choose to enroll.

If you are still working at 65 and covered by your employer's health plan, you can delay Part B enrollment without penalty as long as you are actively employed and your employer has 20 or more employees. When you do leave that job, you have eight months to sign up for Part B without penalty. This is called a Special Enrollment Period.

What happens if you miss your enrollment window

If you do not sign up during your initial seven-month enrollment period and you do not have a may have access to reason for delay, you will owe a permanent penalty. For Part B, the penalty is 10 percent of the standard premium for each full 12 months you were not enrolled. For Part D, the penalty is 1 percent of the national average premium for each month you were not enrolled.

These penalties stay with you for life, even if you sign up later. The only way to avoid them is to enroll during your initial period or to have had other may have access to coverage (such as an employer plan or TRICARE) that delayed your need for Medicare.

If you realize you missed the important date, you can still sign up during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage would begin July 1 of that year. But the penalty will explore unless you had a may have access to reason to delay.

Delaying Medicare past 65 if you are still working

If you and your spouse are both working and covered by an employer health plan with 20 or more employees, you can delay Medicare enrollment past 65 without penalty. This is one of the few situations where delaying is penalty-free.

When you leave that job or lose the employer coverage, you have a Special Enrollment Period of eight months to sign up for Medicare without penalty. You must sign up within that window or face the permanent premium penalty.

If you are self-employed or work for a small employer with fewer than 20 employees, you cannot use this exception. You should enroll in Medicare at 65 even if you are still working.

Medicare may be able to access before age 65

You may become may be able to access for Medicare before 65 if you have been receiving SSDI for 24 months. Once you have been on disability for two years, Medicare coverage begins automatically — you do not have to sign up. The same applies if you receive Railroad Retirement Board disability benefits.

If you have end-stage renal disease (ESRD) requiring dialysis or a kidney transplant, you become may be able to access for Medicare regardless of age. You must sign up within specific timeframes related to your treatment start date. If you have ALS (amyotrophic lateral sclerosis), you become may be able to access when ready upon diagnosis without waiting periods.

These early may be able to access pathways have their own enrollment rules and important date. Contact Social Security or Medicare directly to understand your specific situation.

How Social Security and Medicare enrollment connect

If you are already receiving Social Security retirement benefits when you turn 65, you are automatically enrolled in Medicare Part A and Part B. You will receive your Medicare card in the mail about three months before your 65th birthday. You do not have to do anything unless you want to decline Part B, which you can do in writing.

If you have not yet claimed Social Security, you can sign up for Medicare separately at 65 without claiming Social Security benefits. This is useful if you want to delay Social Security to get a higher monthly payment later. Delaying Social Security does not delay Medicare — they are independent programs.

If you are not yet receiving Social Security at 65, you must sign up for Medicare yourself. Do this online, by phone, or at your local Social Security office during your initial enrollment period.

Frequently Asked Questions

Can I sign up for Medicare before I turn 65?

Yes, you can sign up starting three months before your 65th birthday. Your coverage will not begin until the month you turn 65 (or the month before if you were born on the first of the month), but signing up early ensures you do not miss the important date.

What if I am still working at 65 and do not want Medicare yet?

If you are covered by an employer health plan with 20 or more employees, you can delay Part B without penalty. Part A is automatic if you are receiving Social Security, but you can decline it in writing. When you leave your job, you have eight months to enroll in Part B penalty-free.

Do I have to take Social Security when I turn 65 to get Medicare?

No. You can sign up for Medicare at 65 without claiming Social Security. This lets you delay Social Security to age 70 for a higher monthly benefit while still getting Medicare coverage at 65.

What is the penalty for signing up late?

For Part B, you pay 10 percent extra on your premium for each year you were not enrolled. For Part D, you pay 1 percent extra for each month. These penalties are permanent and stay with you for life.

Does my spouse's age affect when I can get Medicare?

No. Your Medicare may be able to access is based on your own age, not your spouse's. However, if your spouse is still working and you are covered under their employer plan, you may be able to delay your Part B enrollment without penalty.

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.