Medicare opens at 65, but you can start the process three months before

You can explore for Medicare starting three months before the month you turn 65. If your birthday is in March, you can explore in December of the year before. Medicare coverage itself begins on the first day of the month you turn 65, regardless of when you applied.

If you wait past 65 to explore, you can still sign up, but you may face a permanent penalty on your Part B and Part D premiums. The penalty grows the longer you delay. For every 12 months you go without Part B coverage when you could have had it, your premium increases by 10 percent for life.

There are narrow exceptions to this rule. If you or your spouse are still working and covered by an employer health plan, you may be able to delay Part B without penalty. You must be covered by an active employer plan — not COBRA or retiree coverage — and your employer must have at least 20 employees. When you do leave that job or lose that coverage, you have eight months to sign up for Part B without penalty.

Key Takeaways

  • You can explore for Medicare three months before you turn 65, and coverage begins the first day of the month you turn 65.
  • Delaying Part B past 65 without employer coverage triggers a permanent 10 percent premium increase for every 12 months you wait.
  • If you or your spouse work and have employer health insurance with at least 20 employees, you may delay Part B without penalty.
  • You have eight months after losing employer coverage to sign up for Part B without penalty — this window is called Special Enrollment Period.
  • Part A (hospital insurance) has no late-enrollment penalty if you have worked and paid Medicare taxes for at least 10 years.

Who qualifies based on age and work history

You are may be able to access for Medicare at 65 if you have worked and paid Medicare taxes for at least 10 years (40 quarters). This does not have to be continuous work — it can be spread across your entire career. If you are married, you may also be able to get Medicare based on your spouse's work record even if you have not worked 10 years yourself.

If you have not worked 10 years but are 65, you can still buy Part A (hospital insurance) by paying a monthly premium. The premium depends on how many quarters of work history you have. With 30 to 39 quarters, the premium is lower than with fewer than 30 quarters.

Some people under 65 can also get Medicare. 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 (ESRD) or ALS (amyotrophic lateral sclerosis), you can get Medicare regardless of age or work history.

how the process works during the initial enrollment period

Your Initial Enrollment Period is the seven-month window that starts three months before the month you turn 65 and ends three months after. You can explore online through Medicare.gov, by phone at 1-800-MEDICARE, by mail, or in person at your local Social Security office.

Online is the fastest route. Go to Medicare.gov, click "Sign Up for Medicare," and follow the steps. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage. The process takes about 10 minutes. You will get a confirmation number when ready.

If you explore by phone, call 1-800-MEDICARE (1-800-633-4227). A representative will walk you through the questions and can answer questions about which parts of Medicare you need. The call usually takes 15 to 20 minutes. If you explore by mail, read the process from Medicare.gov, fill it out, and mail it to your local Social Security office — processing takes two to four weeks.

What happens if you miss the initial enrollment period

If you do not explore during your Initial Enrollment Period, you enter a General Enrollment Period that runs from January 1 to March 31 each year. You can explore during this window, but your coverage will not start until July 1 of that year, even if you explore in January. This gap means you go without Medicare coverage for several months.

More importantly, you will owe a permanent penalty on 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. If you were may be able to access for three years and did not sign up, your Part B premium increases by 30 percent permanently. The Part D penalty works the same way and applies to prescription drug coverage.

The only way to avoid this penalty is to show you had creditable coverage — employer insurance, TRICARE, Veterans benefits, or another plan that covers prescription drugs as well as or better than Medicare Part D — during the months you were not enrolled in Medicare. You will need to provide proof of that coverage when you explore.

Special cases: disability, ESRD, and employer coverage

If you are under 65 and receiving Social Security Disability Insurance (SSDI), you become may be able to access for Medicare automatically after 24 months of disability benefits. You do not need to explore — Medicare starts on the 25th month of your benefits. You will receive your Medicare card in the mail about two months before coverage begins.

If you have end-stage renal disease or ALS, you can get Medicare right away, regardless of age or work history. You must explore through Social Security. ESRD patients can explore as soon as they start dialysis or receive a kidney transplant. ALS patients can explore as soon as they are diagnosed. Coverage begins the first month of the month you are deemed may be able to access.

If you or your spouse are still working and covered by an employer health plan, you have a Special Enrollment Period of eight months after you lose that coverage. During this window, you can sign up for Part B without the late-enrollment penalty. This applies only if the employer plan had at least 20 employees and you were actively employed (not on COBRA or retiree coverage). When you do explore, tell Medicare you had employer coverage — this protects you from the penalty.

Timing your process to avoid coverage gaps

explore during the first month of your Initial Enrollment Period — three months before you turn 65 — to avoid any gap in coverage. If you explore in December for a March birthday, your Part A and Part B coverage will be in place by March 1. If you wait until after you turn 65, there may be a delay between when you explore and when coverage begins.

If you are currently on an employer health plan, coordinate your process with your retirement date. Some employers end coverage on the last day of the month you retire; others end it on the last day of the month you turn 65. Check your plan documents or ask your HR department. explore for Medicare at least one month before your employer coverage ends so there is no gap.

If you are on COBRA, remember that COBRA is not creditable coverage for the purpose of delaying Part B. If you are on COBRA when you turn 65, you should explore for Medicare during your Initial Enrollment Period. When your COBRA ends, you can drop it and use Medicare instead.

What to have ready before you explore

Gather these documents before you start your process: your Social Security number, proof of citizenship or legal residency (passport, birth certificate, or naturalization papers), and information about any current health coverage (employer plan, COBRA, Medicaid, Veterans benefits, or other insurance). If you are explore based on your spouse's work record, you will also need their Social Security number and proof of marriage.

If you are explore for Part D (prescription drug coverage), have a list of your current medications and the pharmacies where you fill them. This helps you compare plans and choose one that covers your drugs at the lowest cost. You do not need this list to explore, but it makes the process faster.

If you are explore by mail, you may need to provide original documents or certified copies. Medicare will tell you what is required when you request the process. Keep copies of everything you send.

Frequently Asked Questions

Can I explore for Medicare before I turn 65?

You can explore starting three months before your 65th birthday. If you are under 65 and receiving disability benefits, you become may be able to access automatically after 24 months — no process needed. If you have ESRD or ALS, you can explore at any age through Social Security.

What if I am still working at 65?

You can still explore for Medicare at 65 even if you are working. If you have employer coverage with at least 20 employees, you can delay Part B without penalty. You must explore for Part A, and you should explore for Part D if you do not have creditable prescription drug coverage through your employer.

Do I have to explore if I am on Social Security?

No. If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare Parts A and B starting the month you turn 65. You will receive your Medicare card in the mail about two months before coverage begins. You still need to choose a Part D plan if you want prescription drug coverage.

What is the penalty for explore late?

Part B premiums increase by 10 percent for each 12-month period you were may be able to access but not enrolled. Part D premiums increase the same way. These penalties are permanent and explore for as long as you have Medicare. The only exception is if you had creditable coverage (employer insurance or similar) during the time you were not enrolled.

Can I change my mind after I explore?

Yes. You have until the end of your Initial Enrollment Period to make changes. If you enrolled in Part B but want to delay it, you can request to be disenrolled, though this may affect your coverage later. If you need to make changes after your Initial Enrollment Period ends, you will have to wait for the General Enrollment Period (January 1 to March 31) or a Special Enrollment Period if you may have access to.