Medicare starts at age 65 for most people, but you can claim it earlier if you have a disability or end-stage renal disease

You become may be able to access for Medicare the month you turn 65, regardless of whether you have retired. If you were born on the first of the month, your coverage begins the month before. Most people sign up during their initial enrollment period, which runs for seven months: three months before the month you turn 65, the month itself, and three months after.

You do not have to wait until 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months—Medicare begins automatically in your 25th month of disability payments. Similarly, if you have end-stage renal disease (permanent kidney failure requiring dialysis or transplant), you become may be able to access when ready upon diagnosis, regardless of age.

If you miss your initial enrollment period, you can still sign up during the general enrollment period (January 1 through March 31 each year), but you may face a permanent penalty on your Part B premiums. The penalty is 10 percent for each full 12-month period you delayed, added to your monthly bill for as long as you have Medicare.

Key Takeaways

  • You become may be able to access for Medicare the month you turn 65, and your initial enrollment period spans seven months centered on that birthday.
  • If you receive SSDI, Medicare begins automatically 24 months after your disability payments start, with no action required on your part.
  • People with end-stage renal disease become may be able to access when ready upon diagnosis, even before age 65.
  • Missing your initial enrollment window means a permanent 10 percent penalty on Part B premiums for each year you delay.
  • You can enroll during the general enrollment period (January through March) if you miss your initial window, but the penalty still applies.

How the initial enrollment period works

Your initial enrollment period is a seven-month window that gives you time to sign up without penalty. It begins three months before the month you turn 65 and ends three months after. If your birthday is June 15, for example, your enrollment period runs from March through September.

You do not have to enroll on your birthday itself. Many people sign up two or three months before turning 65 so their coverage is in place on day one. You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, by mail, or in person at your local Social Security office.

If you are still working and covered by an employer health plan at 65, 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. You will need to show proof of employer coverage when you do enroll, and you should enroll within eight months of leaving that job or losing the coverage.

Medicare may be able to access through disability before age 65

If you have been receiving SSDI for 24 consecutive months, you automatically become may be able to access for Medicare in your 25th month of payments. You do not need to explore separately or reach age 65. Your Medicare coverage begins the first day of the month you become may be able to access, and Social Security will send you information about your coverage options.

The 24-month waiting period is a federal rule that applies regardless of your age. Someone who starts receiving SSDI at age 30 will become may be able to access for Medicare at age 32 (or whenever their 25th month of payments occurs). You will receive Part A (hospital insurance) and Part B (medical insurance) automatically unless you decline them in writing.

If you receive Railroad Retirement Board (RRB) benefits instead of Social Security, the same 24-month rule applies. Your Medicare may be able to access date will be listed in your RRB benefit letter.

End-stage renal disease and when ready may be able to access

People diagnosed with end-stage renal disease become may be able to access for Medicare when ready, even if they are under 65 and have never worked long enough to earn Social Security credits. This includes anyone who needs dialysis or a kidney transplant to survive.

Your may be able to access begins the first day of the month in which you are diagnosed, or the month you start dialysis or have a transplant, whichever comes first. You should notify Social Security or your dialysis center so they can help you enroll. Medicare will cover your dialysis, transplant surgery, and related care, though you will still have copayments and deductibles.

If you already have Medicare through age or disability, your coverage continues without change. If you are newly may be able to access through ESRD, you will receive both Part A and Part B automatically.

What happens if you miss your enrollment important date

If you do not enroll during your initial enrollment period, you can still sign up during the general enrollment period, which runs January 1 through March 31 each year. Your coverage will begin July 1 of that year. However, you will pay a permanent penalty on your Part B premiums.

The penalty is 10 percent of the standard Part B premium amount for each full 12-month period you delayed enrollment. If you were may be able to access at 65 but did not enroll until age 68, you delayed for three years, so your penalty would be 30 percent of the standard premium. This penalty stays with you for life, even if you switch plans or move to a different state.

There are narrow exceptions to this penalty. If you had creditable coverage through an employer or union plan while you were still working, you may not owe a penalty. You will need to provide proof of that coverage when you enroll. If you were receiving Medicaid, that does not count as creditable coverage for this purpose.

Enrollment for people still working at 65

If you are still employed and covered by your employer's health plan when you turn 65, you have options. If your employer has 20 or more employees, you can delay Part B enrollment without penalty. Your employer plan will be primary (pay first), and Medicare will be secondary.

You must enroll in Part A (hospital insurance) even if you delay Part B, because Part A has no penalty for late enrollment. Part A is usually free if you or your spouse paid Medicare taxes for at least 10 years.

Once you leave your job or lose employer coverage, you have eight months to enroll in Part B without penalty. This is your special enrollment period. If you wait longer than eight months, the standard late-enrollment penalty applies. You should enroll as soon as you lose coverage to avoid any gap in protection.

How to enroll in Medicare

You can enroll through several methods. The easiest for most people is online at Medicare.gov, where you can create an account and submit your process. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage.

You can also call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. Representatives are available Monday through Friday, 8 a.m. to 8 p.m. Eastern time. If you are deaf or hard of hearing, you can use TTY at 1-877-486-2048.

In person, you can visit your local Social Security office to enroll. Bring your Social Security card, proof of citizenship or legal residency, and proof of age. You can find your nearest office at ssa.gov. Some people also enroll through their employer's benefits office if the employer offers that service.

Frequently Asked Questions

Can I delay Medicare past 65 without penalty?

You can delay Part B without penalty only if you have creditable coverage through an employer plan with 20 or more employees, or through your spouse's employer plan. You must still enroll in Part A. If you do not have employer coverage, delaying past your initial enrollment period triggers a permanent penalty on Part B premiums.

What if I turn 65 while still working?

You should still enroll in Part A during your initial enrollment period, because it has no late-enrollment penalty and is usually free. If your employer has 20 or more employees, you can delay Part B. Once you leave that job, you have eight months to enroll in Part B without penalty.

Do I have to enroll in Part D (prescription drug coverage) at 65?

You do not have to enroll in Part D at 65, but if you go without creditable drug coverage for more than 63 days, you will pay a permanent penalty when you do enroll. The penalty is about 1 percent of the national average Part D premium for each month you were without coverage. If you do not take prescription drugs, you may not need Part D, but check your situation carefully.

What if I am not a U.S. citizen?

You must be a U.S. citizen or a lawful permanent resident (green card holder) to enroll in Medicare. Lawful permanent residents must have held that status for at least five years. If you do not meet these requirements, you will not be able to enroll, even if you are 65 or older.

Does my Medicare start the day I turn 65?

Your coverage begins the first day of the month you turn 65, unless you were born on the first of the month—then it begins the first day of the month before. You do not need to wait for your birthday itself. If you enroll during your initial enrollment period, your coverage will be in place by the time your may be able to access month arrives.