Medicare starts at 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. If you are already receiving Social Security retirement benefits when you turn 65, Medicare enrollment happens automatically — you do not need to do anything. If you have not yet claimed Social Security, you will need to sign up for Medicare separately.

The month you turn 65 is when your coverage can begin, but the exact timing depends on when you enroll. If you sign up during your Initial Enrollment Period — which runs for seven months, starting three months before the month you turn 65 — your coverage will start on the first day of the month you turn 65. If you miss this window, your coverage will start later, and you may owe a penalty for the months you were uninsured.

Key Takeaways

  • You are may be able to access for Medicare at age 65, and enrollment is automatic if you are already receiving Social Security retirement benefits.
  • Your Initial Enrollment Period lasts seven months: three months before you turn 65, the month you turn 65, and three months after.
  • If you delay enrollment past your Initial Enrollment Period without a valid reason, you will pay a permanent monthly penalty on your premiums.
  • Some people under 65 may be may be able to access if they receive Social Security Disability Insurance (SSDI) for at least 24 months or have end-stage renal disease or ALS.

When to enroll if you are turning 65

You should enroll in Medicare during your Initial Enrollment Period, which is seven months long. It begins three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, your enrollment period runs from March through September.

You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. The Social Security Administration handles Medicare enrollment, even though Medicare is a separate program. If you are already receiving Social Security retirement benefits, you will be enrolled automatically in Medicare Part A (hospital insurance) and Part B (medical insurance) when you turn 65, unless you have asked them not to enroll you.

If you are still working at 65 and have health insurance through your employer, you may be able to delay Part B enrollment without penalty — but only if your employer has 20 or more employees. This is called the special enrollment period for group health plan coverage. You will still need to enroll in Part A, since it has no work-related exception.

Penalties for missing your enrollment window

If you do not enroll in Medicare Part B during your Initial Enrollment Period and you do not have a valid reason for the delay, you will pay a late enrollment penalty for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full 12-month period you were may be able to access but not enrolled. This penalty is added to your monthly premium and does not go away.

Part A (hospital insurance) also has a late enrollment penalty if you wait to sign up and do not have group health plan coverage through work. The penalty is 10 percent of the standard Part A premium for twice the number of years you were may be able to access but not enrolled. For example, if you were may be able to access for two years and did not enroll, you would pay a 20 percent penalty.

The only way to avoid these penalties is to enroll during your Initial Enrollment Period or to have a valid reason for the delay — such as active group health plan coverage through an employer with 20 or more workers, or coverage through a spouse's employer plan.

may be able to access before age 65

Most people cannot enroll in Medicare until 65, but some younger people are may be able to access. If you have been receiving Social Security Disability Insurance (SSDI) for at least 24 months, you become may be able to access for Medicare regardless of your age. This means you could be 30, 40, or 50 and still may have access to if you have been on disability long enough.

You are also may be able to access for Medicare at any age if you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant. Similarly, if you have been diagnosed with ALS (amyotrophic lateral sclerosis), you are may be able to access for Medicare when ready, without waiting for any length of time on disability benefits.

If you fall into one of these categories, you will receive a notice from Social Security explaining your Medicare may be able to access. You still need to enroll during your Initial Enrollment Period to avoid penalties, even though your period may start at a different age than 65.

Medicare Part A versus Part B enrollment

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working for at least 10 years. Part B has a monthly premium that changes each year.

You must enroll in both Part A and Part B during your Initial Enrollment Period to avoid penalties. If you are automatically enrolled through Social Security, both parts are activated at the same time. If you are enrolling manually, make sure you sign up for both unless you have a specific reason to delay Part B (such as active employer coverage).

Some people choose to add Part D (prescription drug coverage) or a Medigap or Medicare Advantage plan during enrollment as well. These have their own enrollment periods and rules, but your Initial Enrollment Period for Part A and Part B is the most critical important date to meet.

What happens if you are still working at 65

If you are still working and covered by your employer's health plan at 65, you do not have to enroll in Medicare Part B right away — but you must still enroll in Part A. Part A has no work-related exception, so you should sign up during your Initial Enrollment Period to avoid the late enrollment penalty.

For Part B, you can delay enrollment without penalty as long as your employer has 20 or more employees and you are actively working. Once you leave your job or lose your employer coverage, you have eight months to enroll in Part B without penalty. This is called the special enrollment period. If you miss this eight-month window, the late enrollment penalty applies.

You should contact Medicare or Social Security before you retire to confirm your options. Employer coverage rules are complex, and the difference between being covered and being uninsured can cost you thousands in penalties over time.

How to enroll in Medicare at 65

You have three main ways to enroll: online, by phone, or in person. The easiest method for most people is online through Medicare.gov. You can create an account, review your may be able to access, and complete enrollment in one session. You will need your Social Security number and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. A representative can walk you through the process and answer questions about your specific situation. This is helpful if you are unsure whether you need Part B right away or if you have questions about penalties.

If you prefer to enroll in person, visit your local Social Security office. You can find the nearest office at ssa.gov or by calling 1-800-772-1213. Bring your Social Security card, proof of citizenship or legal residency, and information about any current health coverage. If you are already receiving Social Security benefits, you may not need to do anything — check your Social Security statement or call to confirm.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

You can begin the enrollment process up to three months before you turn 65, and your coverage will start on the first day of the month you turn 65. You cannot enroll earlier than that unless you are under 65 and may be able to access due to disability, ESRD, or ALS. Contact Medicare at 1-800-MEDICARE to start the process.

What if I miss my Initial Enrollment Period?

You can still enroll after your Initial Enrollment Period ends, but you will owe a late enrollment penalty on your premiums for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each 12-month period you were may be able to access but not enrolled. Enroll as soon as possible to limit the total penalty you will pay.

Do I have to enroll in Part B if I have employer coverage?

If your employer has 20 or more employees and you are actively working, you can delay Part B enrollment without penalty. However, you must still enroll in Part A. When you leave your job, you have eight months to enroll in Part B without penalty. After that window closes, late enrollment penalties explore.

Will I be automatically enrolled in Medicare?

If you are already receiving Social Security retirement benefits when you turn 65, you will be automatically enrolled in Medicare Part A and Part B. You will receive a notice in the mail before your coverage starts. If you are not yet receiving Social Security, you must enroll manually during your Initial Enrollment Period.

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

You must enroll in Part A at 65 to avoid penalties, even if you are working. For Part B, you can delay if your employer has 20 or more employees. When you retire or lose coverage, you have eight months to enroll in Part B without penalty. Talk to your employer's benefits department to understand your options before you turn 65.