Medicare starts at age 65 for most people

You become may be able to access for Medicare the month you turn 65, regardless of whether you have retired or are still working. The program does not require you to stop working, and your may be able to access does not depend on your income. If your birthday falls on the first of the month, your coverage begins the month before.

You do not have to sign up on your 65th birthday — you have a window of time to enroll. However, waiting past that window can cost you in higher premiums for the rest of your life, so the timing of your enrollment matters even if the timing of your coverage start does not.

Some people become may be able to access before 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease or ALS, you may start Medicare earlier. These are the only circumstances that move your start date forward.

Key Takeaways

  • Medicare may be able to access begins the month you turn 65, and you have a seven-month window to enroll without penalty.
  • If you miss your enrollment window, you will pay a permanent increase to your Part B and Part D premiums for as long as you have Medicare.
  • You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • If you are still working at 65 and have health coverage through your employer, you may be able to delay Part B enrollment without penalty under certain conditions.
  • People receiving SSDI for 24 months, or those with end-stage renal disease or ALS, become may be able to access before age 65.

The seven-month enrollment window and what happens if you miss it

Your enrollment window opens three months before the month you turn 65 and closes three months after. If you turn 65 in June, you can enroll from March through September. During this time, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance) without any penalty.

If you do not enroll during this window, you will pay a late enrollment penalty on your Part B premium. The penalty is 10 percent of the standard Part B premium amount for each full 12 months you delayed enrollment. That increase stays with you permanently — it does not go away after a few years. If you also delay Part D (prescription drug coverage), you will pay a similar permanent penalty on that premium.

The only exception is if you have health coverage through a current employer and you are still working. If your employer has 20 or more employees, you can delay Part B without penalty as long as you are employed and covered. You must enroll within eight months of losing that coverage or retiring, whichever comes first. This is called the Special Enrollment Period, and it is the only way to avoid the late penalty after your initial window closes.

How to enroll and what documents you need

You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online enrollment is the fastest route — you can complete it in about 10 minutes if you have your information ready.

You will need your Social Security number, date of birth, and citizenship or immigration status. If you are enrolling by phone or in person, bring your birth certificate or passport as proof of identity. If you are already receiving Social Security benefits, much of your information is already on file, which speeds up the process.

If you are delaying Part B because you have employer coverage, you will need to provide proof of that coverage — usually a letter from your employer's benefits department or a copy of your health plan card. Keep this documentation; you will need it when you enroll in Part B later.

Part A versus Part B: which one starts when

Medicare Part A (hospital insurance) and Part B (medical insurance) have different rules about when they start. Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and home health services. Part B covers doctor visits, outpatient services, and preventive care.

Most people become may be able to access for both at the same time — the month they turn 65. However, you can enroll in Part A without enrolling in Part B if you are still working and have employer coverage. Many people do this because Part A is usually free (you have already paid for it through payroll taxes), while Part B has a monthly premium.

If you delay Part B because of employer coverage, you must enroll in Part B within eight months of losing that coverage. If you wait longer, the late enrollment penalty applies. Part A does not have the same penalty structure, but you should still enroll when your employer coverage ends to avoid gaps in coverage.

What happens if you are still working at 65

Working past 65 does not delay your Medicare may be able to access — you still become may be able to access the month you turn 65. However, you have options about when to enroll. If your employer has 20 or more employees and you are covered under their health plan, you can delay enrolling in Part B without penalty.

Many people in this situation enroll in Part A only (since it is usually free) and keep their employer coverage as primary. When you eventually retire or lose that coverage, you have eight months to enroll in Part B. If you miss that important date, the 10 percent monthly penalty applies.

If your employer has fewer than 20 employees, Medicare becomes your primary insurance when you turn 65, even if you are still working. In this case, you should enroll in both Part A and Part B during your initial window to avoid penalties.

Early may be able to access: SSDI, end-stage renal disease, and ALS

If you have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months, you become may be able to access for Medicare at that point, regardless of your age. This means someone who started receiving SSDI at age 40 would become may be able to access for Medicare at age 42. Your Medicare coverage begins the 25th month of your SSDI may be able to access.

If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you may become may be able to access for Medicare when ready upon diagnosis or the start of dialysis, depending on your situation. Similarly, if you are diagnosed with amyotrophic lateral sclerosis (ALS), you become may be able to access for Medicare right away, without waiting for age 65 or any other condition.

If you fall into one of these categories, contact Social Security or Medicare directly to confirm your may be able to access date. The enrollment process is the same as for people turning 65, but your window opens based on your actual may be able to access date, not your age.

Enrollment through Social Security versus Medicare directly

If you are already receiving Social Security retirement or disability benefits when you turn 65, you will be enrolled in Medicare automatically. You do not need to do anything — Part A and Part B coverage will start the month you turn 65. You will receive a Medicare card in the mail about two weeks before your coverage begins.

If you are not yet receiving Social Security benefits, you must enroll in Medicare yourself. You can do this through Medicare.gov, by calling 1-800-MEDICARE, or at your local Social Security office. Do not wait for Social Security to contact you — they will not. You are responsible for enrolling during your seven-month window.

Some people delay Social Security benefits past 65 to receive a higher monthly payment later. If this is your situation, you still need to enroll in Medicare separately during your initial window. Delaying Social Security does not delay your Medicare enrollment important date.

Frequently Asked Questions

What if I turn 65 while I am still working full-time?

You still become may be able to access for Medicare at 65. If your employer has 20 or more employees and covers you under their health plan, you can delay enrolling in Part B without penalty. You should still enroll in Part A since it is usually free. When you retire or lose coverage, you have eight months to enroll in Part B.

Can I enroll in Medicare before I turn 65?

No, you cannot enroll before your may be able to access date. Your enrollment window opens three months before the month you turn 65. If you try to enroll earlier, the system will reject your process. The only exception is if you may have access to early due to SSDI, ESRD, or ALS.

What is the penalty for enrolling late?

The late enrollment penalty for Part B is 10 percent of the standard monthly premium for each full 12 months you delayed. This penalty is permanent and stays on your premium for life. Part D has a similar penalty structure. The only way to avoid it is to enroll during your initial window or may have access to for a Special Enrollment Period.

Do I have to enroll in Part D when I turn 65?

You do not have to enroll in Part D at 65 if you do not take prescription drugs. However, if you go without creditable drug coverage for more than 63 days and then enroll later, you will pay a permanent penalty. If you think you might need prescriptions in the future, it is usually cheaper to enroll when you are first may be able to access.

What if I am a non-citizen or permanent resident?

You must be a U.S. citizen or permanent resident (green card holder) to be may be able to access for Medicare. Permanent residents must have held their green card for at least five years. If you are not yet a permanent resident, you cannot enroll in Medicare. Contact your local Social Security office if you have questions about your immigration status and Medicare may be able to access.