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 are still working. If your birthday falls on the first of the month, your coverage begins the month before. For any other birthday, coverage starts the first day of the month you turn 65. You do not have to retire or stop working to use Medicare — the two are separate.

The enrollment window opens three months before the month you turn 65 and closes three months after. This seven-month window is called your Initial Enrollment Period. If you miss this window, you will face late enrollment penalties that increase your premiums permanently, so the timing matters even if you do not plan to use Medicare right away.

Key Takeaways

  • You become may be able to access for Medicare at 65, and your enrollment window opens three months before that birthday and closes three months after.
  • If you are still working and have employer health insurance, you may be able to delay Part B enrollment without penalty if your employer has 20 or more employees.
  • You can enroll online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • Missing your enrollment window triggers permanent premium increases unless you have a may have access to life event that reopens your window.
  • Some people become may be able to access before 65 if they receive Social Security Disability Insurance or have end-stage renal disease.

Enrolling Before You Turn 65

You should enroll in Medicare during your Initial Enrollment Period even if you do not plan to use it when ready. The enrollment itself takes about 10 minutes and costs nothing. You can enroll online at Medicare.gov, call 1-800-MEDICARE, or visit your local Social Security office in person.

When you enroll, you will choose between Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C). Original Medicare is run by the federal government and covers hospital stays and doctor visits. Medicare Advantage is run by private insurance companies and often includes prescription drug coverage and dental or vision benefits, though with different costs and networks. You do not have to decide everything at once — you can enroll in Part A and delay Part B if you meet certain conditions.

Have your Social Security number and information about any current health insurance ready when you enroll. If you are already receiving Social Security benefits, Medicare will enroll you automatically in Part A and Part B, though you can decline Part B if you are still covered by an employer plan.

Delaying Part B If You Have Employer Coverage

If you are still working at 65 and your employer has 20 or more employees, you can delay enrolling in Part B without penalty. This is called the working exception. Your employer's health insurance becomes your primary coverage, and Medicare becomes secondary. You must enroll in Part B within eight months of leaving your job or losing the employer coverage, or you will face permanent penalties.

You still need to enroll in Part A at 65 — only Part B can be delayed. Part A is hospital insurance and has no premium for most people, so there is no reason to skip it. When you do leave your job, contact Medicare within the eight-month window to add Part B. If you miss that important date, you will pay a 10 percent penalty on your Part B premium for each year you were may be able to access but not enrolled.

Becoming may be able to access Before Age 65

Some people can use Medicare before turning 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare regardless of age. The 24 months starts from the month your disability benefits began, not from when you applied. Once you reach 65, your disability benefits convert to regular retirement benefits, but your Medicare coverage continues without interruption.

If you have end-stage renal disease (permanent kidney failure requiring dialysis or a transplant), you can use Medicare when ready, even at any age. You will need documentation from your doctor or dialysis center. If you have ALS (amyotrophic lateral sclerosis), you become may be able to access for Medicare the month your Social Security Disability Insurance begins, with no 24-month waiting period.

What Happens If You Miss Your Enrollment Window

If you do not enroll during your Initial Enrollment Period and do not have a may have access to reason to delay, you will pay a permanent penalty. For Part B, the penalty is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. If you were may be able to access at 65 and enroll at 68, you owe three years of penalties — and those penalties stay on your bill for life.

You can only avoid this penalty if you have a may have access to life event that reopens your enrollment window. These events include losing employer coverage, moving out of your Medicare Advantage plan's service area, or having a change in your Medicaid status. When a may have access to event happens, you get a two-month window to enroll without penalty. Keep documentation of the event — a letter from your employer, proof of the move, or a Medicaid notice — because Medicare will ask for it.

Coordinating Medicare With Other Coverage

If you have retiree health insurance from a former employer, check whether it coordinates with Medicare or replaces it. Some retiree plans are primary at 65, meaning they pay first and Medicare pays second. Others end at 65 and Medicare becomes your only coverage. Call your former employer's benefits department to find out which applies to you before you turn 65.

If you have Medicaid (state health insurance for low-income people), Medicare becomes your primary insurance at 65, and Medicaid becomes secondary. You keep both. If you have Veterans health benefits through the VA, Medicare and VA coverage work separately — you can use either one, and they do not coordinate. You do not need to choose between them.

Enrollment Methods and important date

You can enroll in Medicare three ways: online at Medicare.gov (the fastest option, usually takes 10 minutes), by phone at 1-800-MEDICARE (available 24 hours, seven days a week), or in person at your local Social Security office. Online enrollment is available year-round. Phone and in-person enrollment follow the same hours as Social Security offices, which are typically Monday through Friday, 9 a.m. to 4 p.m.

Your Initial Enrollment Period is seven months long: three months before the month you turn 65, the month you turn 65, and three months after. Mark your calendar three months before your birthday to start the process. If your birthday is January 15, your window opens October 1 and closes April 30. You do not need an appointment — you can enroll any time during this window.

Frequently Asked Questions

Can I delay Medicare if I am still working?

You can delay Part B if your employer has 20 or more employees and you are covered by their health plan. Part A cannot be delayed — you should enroll at 65 because it is usually free. You must enroll in Part B within eight months of leaving your job, or you will face permanent penalties.

What if I miss my enrollment window?

You will pay a permanent 10 percent penalty on your Part B premium for each year you were may be able to access but not enrolled. The only way to avoid this is a may have access to life event, such as losing employer coverage or moving. If a may have access to event happens, you get a two-month window to enroll without penalty.

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

No, you can delay Part B if your employer has 20 or more employees. You still must enroll in Part A. When you leave your job or lose the employer coverage, you have eight months to enroll in Part B without penalty.

Can I use Medicare before age 65?

Yes, if you have been receiving Social Security Disability Insurance for 24 months, you become may be able to access for Medicare at any age. If you have end-stage renal disease or ALS, you may become may be able to access sooner. Contact Social Security to confirm your may be able to access.

What is the difference between Original Medicare and Medicare Advantage?

Original Medicare is federal coverage for hospital and doctor visits. Medicare Advantage is private insurance that often includes prescription drugs, dental, and vision, but with different costs and provider networks. You choose one or the other during enrollment, and you can switch during the annual open enrollment period.