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. If your birthday is the first of the month, coverage begins the previous month. If your birthday is any other day, coverage begins the month after you turn 65. You do not have to retire or stop working to sign up — Medicare runs alongside any job you hold.

There are rare exceptions: you may be able to get Medicare before 65 if you have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease or ALS (amyotrophic lateral sclerosis). Otherwise, 65 is the age when you can enroll.

Key Takeaways

  • Medicare coverage begins the month you turn 65, or the month before if your birthday falls on the first of the month.
  • You must sign up during your enrollment window, which opens three months before the month you turn 65 and closes three months after.
  • If you miss this window and do not have other health coverage, you may pay a penalty for as long as you have Medicare.
  • Some people under 65 can get Medicare if they have received disability benefits for 24 months, or if they have end-stage renal disease or ALS.
  • You can sign up through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

When your enrollment window opens and closes

Your Initial Enrollment Period lasts seven months: it begins three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, you can sign up starting in March and must complete it by September. You can sign up during any of those seven months — there is no advantage to signing up early, and you do not have to wait until the month you turn 65.

If you miss this window, you can still sign up during the General Enrollment Period, which runs January 1 through March 31 each year. However, coverage does not begin until July 1 of that year, and you may owe a penalty on your premiums for every month you were not covered. The penalty is permanent — it stays on your account for as long as you have Medicare.

What happens if you are still working at 65

You can delay signing up for Medicare Part B (which covers doctor visits and outpatient care) if you are still working and covered by your employer's health plan. This is called creditable coverage, and it lets you avoid the enrollment penalty. You must have actual coverage through your employer — coverage through a spouse's employer counts, but coverage through a family member who is self-employed does not.

You still need to sign up for Part A (hospital insurance) when you turn 65, even if you are working. Part A has no premium for most people, and signing up does not affect your employer coverage. When you leave your job or lose the employer coverage, you have eight months to sign up for Part B without a penalty — this is called the Special Enrollment Period.

Signing up through Social Security versus Medicare directly

If you are already receiving Social Security benefits when you turn 65, you are usually signed up for Medicare automatically. You will receive your Medicare card in the mail about two weeks before your 65th birthday. You do not need to do anything unless you want to decline Part B coverage.

If you are not yet receiving Social Security, you must sign up for Medicare yourself. You can do this online at Medicare.gov, by calling 1-800-MEDICARE (1-800-633-4227), or by visiting your local Social Security office in person. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

Medicare Part A versus Part B enrollment

Medicare has different parts, and the age rule applies to both, but they work slightly differently. Part A covers hospital stays, skilled nursing care, and hospice. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. You should sign up for Part A when you turn 65 even if you are still working, because there is no penalty for late enrollment and no premium to worry about.

Part B covers doctor visits, lab tests, and outpatient procedures. Part B has a monthly premium that increases if you delay signing up past your Initial Enrollment Period. If you have creditable coverage through an employer, you can delay Part B without penalty. If you do not have creditable coverage and you miss your enrollment window, you will owe a permanent penalty on top of your regular premium.

What to do if you turned 65 and did not sign up

If you are past your Initial Enrollment Period and did not sign up, you can still enroll during the General Enrollment Period (January 1 through March 31). Coverage will begin July 1 of that year. You will owe a penalty of 10 percent of the Part B premium for each full year you were not covered — this penalty is permanent and will be added to your premium every month.

If you have a valid reason for missing the important date — such as being out of the country for more than six months, or having a medical condition that prevented you from signing up — you may be able to request a Special Enrollment Period. Contact Medicare directly at 1-800-MEDICARE to explain your situation and ask whether an exception applies.

Frequently Asked Questions

Can I get Medicare before I turn 65?

Yes, if you have been receiving Social Security disability benefits for 24 months, you become may be able to access for Medicare at any age. If you have end-stage renal disease or ALS, you may be able to get Medicare regardless of age. Otherwise, you must wait until 65.

Do I have to retire to sign up for Medicare?

No. You can be working full-time and still sign up for Medicare at 65. If your employer provides health coverage, you may be able to delay Part B without penalty, but you should still sign up for Part A.

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

Your Medicare coverage begins the month before you turn 65. For example, if your birthday is June 1, your coverage starts in May. Your enrollment window still opens three months before the month you turn 65.

Will I get a penalty if I miss the sign-up important date?

Yes, for Part B. If you do not sign up during your Initial Enrollment Period and do not have creditable coverage through an employer, you will owe a 10 percent penalty on your Part B premium for every year you were not covered. This penalty is permanent. Part A has no late enrollment penalty.

How do I know if my employer coverage counts as creditable?

Ask your employer's benefits office directly whether your plan is creditable coverage under Medicare rules. If it is, you can delay Part B without penalty. When you lose the coverage, you have eight months to sign up for Part B without owing a penalty.