What Age You Need to Be for Medicare Coverage

Medicare starts at age 65 for most people

You become may be able to access for Medicare the month you turn 65, regardless of whether you are still working. The program is federal health insurance run by the Centers for Medicare & Medicaid Services (CMS), and it covers hospital stays, doctor visits, and prescription drugs once you sign up. You do not have to retire to get it — you only have to reach 65.

If your birthday falls on the first of the month, your coverage begins the month before. If your birthday is any other day, coverage begins the month you turn 65. You will receive a Medicare card in the mail about three months before your 65th birthday.

There is a window to sign up without penalty. If you enroll during the three months before you turn 65, the three months you turn 65, or the three months after, you pay the standard premium. If you wait longer, you may owe a higher premium for the rest of your life.

Key Takeaways

Medicare may be able to access begins the month you turn 65, and you should enroll during the seven-month window around your birthday to avoid permanent premium increases.
You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
Some people under 65 may be may be able to access if they receive Social Security disability benefits or have end-stage renal disease or ALS.
If you are still working at 65 and have health coverage through your employer, you may be able to delay Part B enrollment without penalty.
Medicare has four parts — Part A (hospital), Part B (doctor), Part D (drugs), and Part C (an alternative plan) — and you choose which ones you need.

Who can get Medicare before age 65

A small number of people under 65 become may be able to access early. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you move to Medicare automatically. This happens regardless of your age — someone who became disabled at 30 and received SSDI for two years would be on Medicare at 32.

You are also may be able to access at any age if you have end-stage renal disease (ESRD) — permanent kidney failure that requires dialysis or a transplant. You must have worked long enough to have earned Medicare credits, or be the spouse or child of someone who did. Coverage begins the month your dialysis treatment starts or the month you have a kidney transplant, whichever comes first.

People with ALS (amyotrophic lateral sclerosis) do not have to wait 24 months on SSDI. You become may be able to access for Medicare the same month your SSDI payments begin.

How to sign up when you turn 65

You can enroll online at Medicare.gov starting three months before your 65th birthday. The website walks you through which parts you need — Part A covers hospital care, Part B covers doctor visits and outpatient care, and Part D covers prescription drugs. You choose whether to take Original Medicare (Parts A and B) or a Medicare Advantage plan (Part C), which is an alternative offered by private insurers.

If you do not have internet access or prefer to speak with someone, call 1-800-MEDICARE (1-800-633-4227). Representatives are available seven days a week. You can also visit your local Social Security office in person to enroll.

If you miss the enrollment window, you can still sign up during the General Enrollment Period from January 1 to March 31 each year, but you will owe a 10 percent premium increase for Part B for each year you delayed. The increase is permanent.

What happens if you are still working at 65

You must enroll in Part A (hospital insurance) at 65 even if you are working, because it has no premium and covers hospital stays. You may be able to delay Part B if your employer has 20 or more employees and you are covered under the company health plan. This is called creditable coverage.

If you have creditable coverage through work, you can wait to enroll in Part B without owing a penalty, as long as you sign up within eight months of leaving the job or losing the coverage. After that window closes, the 10 percent penalty applies for each year you delayed.

Tell your employer's benefits administrator that you are turning 65 and ask whether your plan qualifies as creditable coverage. If it does, you can get a written notice confirming it. Keep this notice — you will need it when you enroll in Part B later.

Medicare Advantage and Medigap: what they cost at 65

Once you are on Medicare, you choose how to receive your benefits. Original Medicare (Part A and Part B) is run by the federal government. You pay a monthly premium for Part B, a deductible when you use hospital care, and coinsurance for doctor visits. There is no yearly cap on your out-of-pocket costs.

Medicare Advantage (Part C) is sold by private insurance companies and includes hospital, doctor, and usually prescription drug coverage in one plan. Premiums are often lower than Original Medicare, and there is a yearly cap on out-of-pocket costs. However, you must use doctors and hospitals in the plan's network, and you may need referrals to see specialists.

Medigap is supplemental insurance you buy separately to cover the gaps in Original Medicare — deductibles, coinsurance, and copays. It does not cover prescription drugs, so you also buy Part D separately. Medigap premiums vary widely by plan and location.

Special enrollment periods if you miss the important date

If you miss your initial enrollment window, you may still enroll without penalty during a Special Enrollment Period (SEP) if you have a may have access to life event. Losing employer coverage, moving to a new state, or having a family member become may be able to access can trigger a SEP. You have 60 days from the event to enroll.

If you do not have a may have access to event, the General Enrollment Period runs January 1 to March 31 each year. Coverage begins July 1 of that year. Late enrollment penalties explore unless you have creditable coverage or a SEP.

Frequently Asked Questions

Can I get Medicare before I turn 65?

Yes, if you have been on Social Security Disability for 24 months, have end-stage renal disease, or have ALS. Otherwise, you must wait until 65. Some people with other serious conditions have asked Congress to lower the age, but 65 remains the standard may be able to access age for most beneficiaries.

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

You must enroll in Part A at 65 because it is free and covers hospital care. You can delay Part B if you have creditable employer coverage, but you must sign up within eight months of leaving that job. If you wait longer, you will owe a permanent premium penalty.

Do I have to enroll in all four parts of Medicare?

No. Part A (hospital) is automatic if you receive Social Security. You choose whether to take Part B (doctor visits), Part D (drugs), and whether to use Medicare Advantage instead of Original Medicare. However, if you delay Part B or Part D without creditable coverage, you will owe a penalty when you do enroll.

What if my birthday is on the first of the month?

Your Medicare coverage begins the month before you turn 65. So if you were born on January 1, your coverage would start in December of the year you turn 64. You will still receive your Medicare card about three months before your 65th birthday.

Can my spouse get Medicare at the same time I do?

Only if your spouse is also 65 or older, or meets one of the early may be able to access rules. Your spouse must enroll separately. If your spouse is younger and not disabled, they will need to wait until their own 65th birthday or until they become may be able to access through disability or ESRD.

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.