Medicare starts at 65 for most people, but the exact date depends on your birth month and whether you sign up on time

If you turn 65, you become may be able to access for Medicare the first day of that month. If you were born on the first of any month, your coverage begins the month you turn 65. If you were born on any other day, coverage starts the first day of the month after you turn 65. For example, if you turn 65 on March 15, your Medicare coverage begins April 1.

You do not automatically receive Medicare when you turn 65. You must sign up during your Initial Enrollment Period, which runs for seven months: three months before the month you turn 65, the month you turn 65, and three months after. If you miss this window, you may face a permanent penalty on your premiums, even if you sign up later.

Some people become may be able to access before 65. If you have received Social Security Disability Insurance (SSDI) for 24 months, you may have access to for Medicare at any age. If you have End-Stage Renal Disease (ESRD) or ALS (amyotrophic lateral sclerosis), you may may have access to regardless of age or work history.

Key Takeaways

  • Medicare begins the first day of the month you turn 65, or the first day of the month after you turn 65 if you were not born on the first of the month.
  • You must sign up during your seven-month Initial Enrollment Period (three months before, the month of, and three months after you turn 65) to avoid permanent premium penalties.
  • If you are still working and have employer health coverage, you may delay Part B enrollment without penalty if your employer has 20 or more employees.
  • People on SSDI for 24 months, those with ESRD, and those with ALS become may be able to access for Medicare before age 65.
  • You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

How your birth month affects your start date

Medicare uses your birth month to set your coverage start date. The Social Security Administration (SSA) considers you to reach a given age on the day before your birthday for Medicare purposes. This means if you were born on January 15, you are considered to turn 65 on January 14, and your coverage begins January 1 of that year. If you were born on January 1, your coverage also begins January 1.

If your birthday falls between the 2nd and 31st of any month, your coverage starts on the 1st of the following month. This rule applies regardless of which month you were born in. The key is to know your exact birth date and count forward to find your Initial Enrollment Period, which opens three months before the month you turn 65.

What happens if you miss your enrollment important date

If you do not sign up during your Initial Enrollment Period and you do not have a may have access to reason for the delay, you will face a late enrollment penalty. For Part B, this penalty is 10 percent of the standard premium for each full 12-month period you were may be able to access but not enrolled. This penalty is permanent—it stays on your premiums for as long as you have Medicare.

For Part D (prescription drug coverage), the penalty is 1 percent of the national base beneficiary premium for each month you were may be able to access but not enrolled. Like the Part B penalty, this is permanent. The only way to avoid these penalties is to sign up during your Initial Enrollment Period or to have a may have access to life event that opens a Special Enrollment Period.

may have access to life events include losing employer coverage, moving out of your plan's service area, or becoming a U.S. citizen. If you experience one of these events, you have a two-month window (in most cases) to sign up without penalty. You will need to provide documentation of the event when you enroll.

Delaying Part B if you are still working

If you are still working at 65 and your employer offers health coverage, you may be able to delay Part B enrollment without penalty. This is called the Special Enrollment Period for Working Individuals. To use it, your employer must have 20 or more employees, and you must be covered under the employer's group health plan based on your current employment.

When you eventually leave your job or lose the employer coverage, you have eight months to sign up for Part B without penalty. You will need to provide proof of your employer coverage (usually a letter from your employer's benefits department) when you enroll. Part A (hospital insurance) has no penalty for delay if you have employer coverage, but you should still sign up for it when you become may be able to access.

Signing up for Medicare before your coverage starts

You can sign up for Medicare online at Medicare.gov, by calling 1-800-MEDICARE (1-800-633-4227), or by visiting your local Social Security office. Online signup is available starting three months before the month you turn 65. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

If you sign up online or by phone, your enrollment is usually processed within two weeks. If you sign up in person at a Social Security office, staff can often complete the process the same day. Your Medicare card will arrive in the mail about two weeks before your coverage begins. If you do not receive it by the time your coverage starts, you can use your Social Security number as proof of coverage at hospitals and doctors' offices.

Medicare may be able to access before age 65

You do not have to wait until 65 to get Medicare if you meet one of three conditions. If you have been receiving SSDI for 24 consecutive months, you become may be able to access for Medicare the month after your 24-month period ends. Your age does not matter—you could be 30 or 50 and still may have access to.

If you have ESRD and need dialysis or a kidney transplant, you may may have access to for Medicare regardless of age or work history. Coverage typically begins the month your dialysis treatments start or the month of your transplant. If you have ALS, you become may be able to access for Medicare when ready upon approval of your SSDI claim, without waiting 24 months. In all three cases, you still need to sign up; coverage does not begin automatically.

What to expect after you sign up

Once you sign up, Medicare Part A and Part B coverage begins on the date determined by your birth month. You will receive a Medicare card in the mail showing your Medicare number and coverage details. Your card will indicate which parts of Medicare you have enrolled in. Keep this card with you when you visit doctors, hospitals, or pharmacies.

You will also receive a Welcome to Medicare packet in the mail, which includes information about your coverage, preventive services, and how to choose a plan. If you have not chosen a Part D plan (prescription drug coverage) or a Medicare Advantage plan by your coverage start date, you will be automatically enrolled in a plan chosen by Medicare. You can change your plan during the annual Open Enrollment Period (October 15 to December 7 each year).

Frequently Asked Questions

Can I sign up for Medicare before I turn 65?

Yes. You can sign up starting three months before the month you turn 65. This is the safest approach because it ensures your coverage begins on time and you avoid any enrollment delays. You can sign up at Medicare.gov, by phone, or in person at a Social Security office.

What if I was born on the first day of the month?

If you were born on the 1st of any month, your Medicare coverage begins on the 1st of the month you turn 65. Your Initial Enrollment Period still runs for seven months (three months before, the month of, and three months after), so you should sign up as soon as the enrollment window opens.

Do I have to sign up for Part B if I am still working?

If your employer has 20 or more employees and you are covered under their group health plan, you can delay Part B without penalty. You have eight months after you leave the job or lose coverage to sign up. You should still sign up for Part A when you turn 65, as it has no penalty for delay.

What happens if I miss my enrollment important date?

You will face a permanent late enrollment penalty on your Part B and Part D premiums. The Part B penalty is 10 percent of the standard premium for each 12-month period you were may be able to access but not enrolled. This penalty stays with you for life, so it is important to sign up during your Initial Enrollment Period or within a may have access to Special Enrollment Period.

Can I get Medicare if I am under 65?

Yes, if you have received SSDI for 24 months, have ESRD requiring dialysis or transplant, or have ALS. In these cases, you become may be able to access regardless of age. You still need to sign up; coverage does not begin automatically. Contact Social Security or Medicare to learn about your specific situation.