You can enroll in Medicare starting the month you turn 65

Medicare may be able to access begins the first day of the month in which you turn 65, regardless of your employment status. You do not have to be retired to enroll. The enrollment window opens three months before your 65th birthday and closes three months after, giving you a total of seven months to sign up without penalty.

If you delay enrollment past this window, you will pay a higher monthly premium for Part B (medical insurance) for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but did not enroll. This penalty is permanent and does not go away.

There are narrow exceptions: if you are still working and covered by your employer's health plan, you may be able to delay enrollment without penalty, but you must meet specific conditions. If you are a federal employee, a railroad retiree, or covered under a group health plan through your or your spouse's current employment, contact your employer's benefits office to confirm your situation before your 65th birthday.

Key Takeaways

  • You become may be able to access for Medicare on the first day of the month you turn 65, and you have seven months to enroll without penalty.
  • Delaying enrollment past your initial window costs you 10 percent more per month on Part B premiums for life.
  • If you are still working and have employer coverage, you may may have access to for a special exception, but you must verify this with your employer before age 65.
  • You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

What happens if you enroll before age 65

You cannot enroll in Medicare before the month you turn 65, even if you want to. Medicare.gov will not accept an process, and Social Security will not process one. The system is built around the age 65 threshold, and there is no early enrollment option for people in good health or those who straightforward prefer to start sooner.

The only exception is if you have been receiving Social Security Disability Insurance (SSDI) for 24 months. In that case, Medicare begins automatically two years after your disability benefits started, regardless of your age. You will receive your Medicare card in the mail without having to explore. If you are on SSDI and approaching age 65, your Medicare will straightforward continue under the standard program rather than switching to a disability-based version.

Enrolling during your initial enrollment period

Your initial enrollment period is seven months long: three months before the month you turn 65, the month you turn 65, and three months after. You can enroll online at Medicare.gov by selecting "Sign up for Medicare" and following the process. You will need your Social Security number, date of birth, and citizenship or immigration status.

If you prefer not to use the website, call 1-800-MEDICARE (1-800-633-4227) and speak to a representative. They can walk you through the enrollment process over the phone and answer questions about which parts of Medicare you need. The phone 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.

You can also visit your local Social Security office in person. Bring your Social Security card, proof of citizenship or legal residency, and proof of age. An employee will help you complete the process on the spot. Many offices allow you to schedule an appointment online through Social Security's website to avoid waiting.

Understanding Part A and Part B enrollment

Medicare has two main parts that cover different services. Part A covers hospital stays, skilled nursing care, hospice, and some home health services. Part B covers doctor visits, outpatient care, lab tests, and medical equipment. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. Part B has a monthly premium that changes each year.

When you enroll, you are automatically signed up for both Part A and Part B unless you decline Part B in writing. If you are still working and have employer coverage, you can decline Part B to avoid paying the premium while you are covered by your job. You will need to sign a form stating that you are declining Part B due to current employment. Keep a copy for your records.

If you decline Part B and later want to enroll, you can do so during the General Enrollment Period (January 1 through March 31 each year), but you will pay a 10 percent penalty on your Part B premium for each full year you were may be able to access but did not enroll. The exception is if you have employer coverage — in that case, you can enroll in Part B without penalty within eight months of losing that coverage or retiring, whichever comes first.

What to do if you miss your enrollment window

If you do not enroll during your initial seven-month window, you can still enroll during the General Enrollment Period, which runs from January 1 through March 31 each year. Coverage begins July 1 of that year. This means if you miss your initial window and enroll in February, you will not have Medicare coverage until July.

During this delayed enrollment, you will pay a 10 percent penalty on your Part B premium for each full year you were may be able to access but did not enroll. This penalty is permanent — it does not expire or decrease over time. If you were may be able to access at 65 and did not enroll until age 68, you owe a 30 percent penalty for life.

The only way to avoid this penalty after missing your initial window is to show that you had creditable coverage (such as employer insurance or COBRA) during the time you were not enrolled in Medicare. You will need to provide documentation from your previous insurance plan. Contact Medicare at 1-800-MEDICARE to discuss your specific situation and what documents you need to gather.

Special situations: working past 65 and employer coverage

If you are still working at age 65 and your employer has 20 or more employees, you can decline Part B without penalty as long as you have health insurance through your job. Your employer's plan is considered primary, meaning it pays first, and Medicare becomes secondary. You must enroll in Medicare within eight months of retiring or losing your employer coverage to avoid the permanent penalty.

If your employer has fewer than 20 employees, Medicare becomes primary when ready at age 65, even if you have employer coverage. In this case, you should enroll in both Part A and Part B when you turn 65 to avoid gaps in coverage. Part A has no monthly premium for most people, so there is no cost to enrolling.

Federal employees, railroad retirees, and certain other groups have different rules. If you fall into one of these categories, contact your benefits office or union representative before your 65th birthday to understand how your coverage transitions to Medicare.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

No, you cannot enroll before the month you turn 65. The only exception is if you have been on Social Security Disability Insurance for 24 months — in that case, Medicare begins automatically two years after your disability benefits started, regardless of your age.

What happens if I turn 65 while I'm still working?

You can still enroll in Medicare at 65. If your employer has 20 or more employees and you have health coverage through your job, you can decline Part B without penalty. You must enroll within eight months of retiring or losing that coverage. If your employer has fewer than 20 employees, enroll in both Part A and Part B at 65 because Medicare becomes primary.

How much does Medicare cost at age 65?

Part A has no monthly premium for most people. Part B has a monthly premium that changes each year — in 2024 it was $164.90 for most people, but it varies based on your income. You may also choose to buy Part D (prescription drug coverage) or a Medigap or Medicare Advantage plan, which have their own costs.

What if I miss the enrollment important date?

You can enroll during the General Enrollment Period (January 1 through March 31), but coverage does not start until July 1. You will pay a 10 percent penalty on your Part B premium for each full year you were may be able to access but did not enroll, and this penalty is permanent. The only exception is if you had creditable coverage during the time you were not enrolled.

Do I have to retire to enroll in Medicare?

No. You can enroll in Medicare at 65 whether you are working or retired. If you are still working and have employer coverage, you may be able to decline Part B without penalty, but you must meet specific conditions based on your employer's size and your coverage type.