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 or stop working to enroll — you can keep your job and still sign up for Medicare at 65.

The month you turn 65, you enter your Initial Enrollment Period, a seven-month window that runs from three months before your birthday month through three months after. During this window, you can sign up for Medicare without waiting or paying a penalty. If you miss this window, you may face higher costs for the rest of your life.

Some people become may be able to access before 65. If you have received Social Security Disability Insurance (SSDI) for 24 months, or if you have End-Stage Renal Disease (ESRD) or ALS, you may be able to enroll in Medicare earlier. Otherwise, age 65 is when your coverage can begin.

Key Takeaways

  • You become may be able to access for Medicare at age 65, and you have a seven-month enrollment window centered on your birthday month to sign up without penalty.
  • If you are still working and have employer health insurance at 65, you may be able to delay Medicare Part B without penalty, but you must enroll in Part A.
  • Missing your Initial Enrollment Period can result in a permanent 10 percent increase to your Part B premium for each year you delayed.
  • A small number of people under 65 — those on SSDI for 24 months, those with ESRD, or those with ALS — may be able to enroll in Medicare earlier.
  • You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

How the enrollment window works and why timing matters

Your Initial Enrollment Period is seven months long and always centers on the month you turn 65. It begins three months before your birthday month and ends three months after. For example, if you turn 65 in June, your enrollment period runs from March through September.

You should enroll during this window because missing it triggers a late enrollment penalty. For Part B (medical insurance), the penalty is 10 percent of the standard premium for each full year you delayed. This penalty is permanent — it stays on your premium for as long as you have Medicare. If you delayed for three years, your Part B premium will be 30 percent higher than the standard rate, and you will pay that extra amount every month for the rest of your life.

Part A (hospital insurance) does not usually carry a late penalty if you have worked and paid Medicare taxes. However, if you do not enroll in Part A when you first become may be able to access, you cannot enroll later unless you are still working and covered by an employer plan. Waiting to enroll in Part A can close the door to coverage you may need.

Working past 65 and employer health insurance

If you are still employed and your employer offers health insurance, you may be able to delay Part B without penalty — but only under specific conditions. Your employer must have 20 or more employees, and you must be enrolled in the employer plan based on your current employment. This exception is called the Special Enrollment Period.

Even if you may have access to for this exception, you must still enroll in Part A at 65. Part A does not conflict with employer coverage and does not trigger penalties. You enroll in Part B later, when you leave your job or lose the employer coverage, and you have eight months from that date to sign up without penalty.

If your employer has fewer than 20 employees, you cannot use this exception. You must enroll in Part B at 65 or accept the late penalty. Check with your employer's benefits office about the size of your company and whether you may have access to for the Special Enrollment Period before you turn 65.

Medicare for people under 65

Most people cannot enroll in Medicare before 65, but three groups can. If you have received SSDI for at least 24 consecutive months, you become may be able to access for Medicare automatically at the end of your 24th month of benefits. You do not have to explore — Social Security will enroll you in both Part A and Part B.

If you have End-Stage Renal Disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you may be able to enroll in Medicare when ready, regardless of age. You will need documentation from your doctor or dialysis center. Similarly, if you are diagnosed with ALS (amyotrophic lateral sclerosis), you become may be able to access for Medicare right away without waiting for any benefit period.

If you fall into one of these categories, contact Social Security or Medicare directly to confirm your may be able to access and enrollment status. Do not assume you are automatically enrolled — verify your coverage before you need medical care.

What happens if you miss your enrollment important date

If you do not enroll during your Initial Enrollment Period, you enter a situation where penalties explore and your coverage options narrow. For Part B, you will pay a 10 percent premium penalty for each year you delayed, and this penalty is permanent. You can still enroll in Part B during the General Enrollment Period, which runs from January 1 through March 31 each year, but your coverage will not start until July 1 of that year.

This means if you miss your Initial Enrollment Period in June and do not enroll until February of the following year, you will have no Part B coverage from July of the first year through June of the second year — a full year without medical insurance. During that gap, you are responsible for all doctor visits, tests, and treatments out of pocket.

The only way to avoid this penalty is to have a may have access to life event that opens a Special Enrollment Period. Losing employer coverage, moving to a new state, or changes in your Medicaid status can may have access to. If you believe you have a may have access to event, contact Medicare at 1-800-MEDICARE to ask whether you can enroll without penalty.

How to enroll when you turn 65

You have three ways to enroll in Medicare. The easiest is online through Medicare.gov — you can create an account and submit your enrollment process without leaving home. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) and speak with a representative who will walk you through the process. The line is open Monday through Friday, 8 a.m. to 8 p.m. Eastern time, and Saturday 9 a.m. to 1 p.m. Eastern time. Have your Social Security number and insurance information ready.

A third option is to visit your local Social Security office in person. You can find the nearest office on Social Security's website. Bring your Social Security card, proof of citizenship or legal residency, and information about any current coverage. Staff can enroll you on the spot, and you will receive confirmation before you leave.

Understanding Medicare Parts A, B, C, and D

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. It has no monthly premium if you or your spouse paid Medicare taxes for at least 10 years. Most people enroll in Part A automatically when they turn 65.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. It has a monthly premium that changes each year — in 2024 the standard premium is $164.90 per month, but your actual premium may be higher or lower depending on your income. You must actively enroll in Part B; it does not happen automatically.

Part C, also called Medicare Advantage, is an alternative to Parts A and B offered by private insurance companies. It combines hospital and medical coverage and usually includes prescription drug coverage. You can choose Part C instead of Part A and B, but you must be enrolled in Part A and Part B first.

Part D covers prescription drugs. It is optional but recommended — if you do not enroll when you first become may be able to access, you may pay a penalty for as long as you have Medicare. You can enroll in Part D through a standalone plan or through a Part C plan that includes drug coverage.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

Only if you have received SSDI for 24 months, have End-Stage Renal Disease, or have ALS. Otherwise, you must wait until age 65. If you have one of these conditions, contact Social Security or Medicare to confirm your may be able to access and enrollment status.

What if I turn 65 but I am still working and have health insurance through my job?

You must enroll in Part A at 65 with no penalty. You may be able to delay Part B if your employer has 20 or more employees and you are enrolled in the employer plan. When you leave your job or lose coverage, you have eight months to enroll in Part B without penalty. Confirm with your employer's benefits office that you may have access to for this exception.

How much does Medicare cost at age 65?

Part A has no monthly premium for most people. Part B costs vary by income — the standard premium in 2024 is $164.90 per month, but higher earners pay more. Part C and Part D have their own premiums that vary by plan. You will receive a notice showing your exact costs before your coverage begins.

What happens if I do not enroll in Medicare at 65?

You will face a permanent 10 percent premium penalty on Part B for each year you delayed. You can still enroll during the General Enrollment Period (January 1 through March 31), but coverage will not start until July 1, leaving you uninsured for months. Enroll during your Initial Enrollment Period to avoid these gaps and penalties.

Can I change my Medicare plan after I enroll?

Yes, during the Annual Enrollment Period from October 15 through December 7 each year, you can switch between Part C and Part A/B, change your Part C plan, or change your Part D plan. Changes take effect January 1 of the following year. You can also make changes if you have a may have access to life event like moving or losing coverage.