Register for Medicare at 65, or Earlier if You Have Certain Conditions

You become may be able to access for Medicare the month you turn 65, and that is when most people register. If you are already receiving Social Security benefits, Medicare enrollment happens automatically the month you turn 65 — you do not need to do anything. If you are not yet taking Social Security, you must register yourself during your enrollment window or face late penalties that last for life.

Some people under 65 can register earlier: those with end-stage renal disease (permanent kidney failure requiring dialysis or transplant), amyotrophic lateral sclerosis (ALS), or those who have been receiving Social Security Disability Insurance (SSDI) for 24 months. If any of these explore to you, you become may be able to access for Medicare two years after your disability benefits began, or when ready if you have ALS.

Key Takeaways

  • You can register for Medicare starting three months before the month you turn 65, and you should do so during this window to avoid penalties.
  • If you are already receiving Social Security at 65, Medicare enrollment is automatic and requires no action on your part.
  • Missing your initial enrollment window triggers a permanent 10 percent monthly premium increase for Part B and a similar increase for Part D, lasting as long as you have Medicare.
  • People under 65 with end-stage renal disease, ALS, or 24 months of SSDI benefits can register early and should contact Social Security to begin the process.
  • Your enrollment window is seven months long: three months before the month you turn 65, the month itself, and three months after.

The Initial Enrollment Window: Seven Months to Register

Your Initial Enrollment Window is a seven-month period centered on the month you turn 65. It begins three months before your birthday month and ends three months after. For example, if you turn 65 in June, your window runs from March through September.

You should register during the first three months of this window — before or during the month you turn 65 — to have coverage start on the first day of the month you turn 65. If you register in the last three months of your window, your coverage will start later, sometimes as much as three months after you register. Waiting until the last month of your window means you could have a gap in coverage.

What Happens If You Miss Your Enrollment Window

If you do not register during your seven-month Initial Enrollment Window, you will face a late enrollment penalty on your Part B premium (the part that covers doctor visits and outpatient care). The penalty is 10 percent of the standard Part B premium for each full 12-month period you were may be able to access but not enrolled. This penalty stays on your bill for as long as you have Medicare — it does not go away after a few years.

The same 10 percent penalty applies to Part D (prescription drug coverage) if you go without creditable drug coverage for more than 63 days after your Initial Enrollment Window closes. "Creditable coverage" means drug coverage that is at least as good as Medicare's standard plan. If your employer or former employer offers retiree drug coverage, that usually counts as creditable, but you need to verify this before your window closes.

The only way to avoid these penalties is to register during your Initial Enrollment Window or to have a Special Enrollment Period that applies to your situation. Special Enrollment Periods are triggered by specific life events — losing employer coverage, moving out of your plan's service area, or may have access to for Medicaid, among others.

Special Enrollment Periods: When You Can Register Outside Your Window

A Special Enrollment Period gives you extra time to register for Medicare without penalty if you experience certain may have access to events. The most common trigger is losing health coverage through an employer or union when you turn 65 or after. If your employer coverage ends, you have eight months from the date it ends to register for Medicare without penalty.

Other may have access to events include moving out of your current plan's service area, losing Medicaid coverage, or having your employer coverage wrongly terminated. If you are still working at 65 and covered by your employer's health plan, you do not have to register for Medicare right away — you can delay Part B registration without penalty as long as you are still employed and covered. Once you leave that job or the coverage ends, you have eight months to register.

To use a Special Enrollment Period, you will need to show proof of the may have access to event — a letter from your employer stating when coverage ended, a notice from your health plan, or a Medicaid termination letter. Contact Social Security or Medicare directly to discuss your situation and confirm you have a may have access to event.

How to Register: Three Main Routes

You can register for Medicare through Social Security, Medicare directly, or your local Social Security office. The easiest route for most people is online at ssa.gov (Social Security's website) or medicare.gov (Medicare's official site). Both let you create an account and submit your registration without leaving home.

If you prefer to register by phone, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Have your Social Security number, birth certificate, and proof of citizenship or legal residency ready. You can also visit your local Social Security office in person — find the nearest one at ssa.gov/locator.

If you are registering for Medicare because you have end-stage renal disease or ALS, contact Social Security to start the process. These conditions have different enrollment rules, and Social Security will walk you through the steps specific to your situation.

Part A, Part B, and Part D: What You Are Registering For

Part A covers hospital stays, skilled nursing facility care, and some home health services. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Part A is automatic when you register, and you should not decline it unless you have other coverage that is at least as good.

Part B covers doctor visits, outpatient care, and medical equipment. Part B has a monthly premium (the standard amount in 2024 is $164.90, but this changes yearly and varies by income). You can decline Part B if you are still covered by an employer plan, but you must register for it within eight months of losing that coverage or face a penalty. Many people delay Part B while still working, which is allowed — just do not miss the eight-month window after your coverage ends.

Part D is prescription drug coverage offered by private insurance companies approved by Medicare. You do not have to register for Part D when you turn 65, but if you go without it for more than 63 days after your Initial Enrollment Window closes, you will pay a penalty. If you have drug coverage through an employer or union that is at least as good as Medicare's standard plan, you can skip Part D without penalty — but confirm this with your plan before your window closes.

Frequently Asked Questions

Do I have to register if I am still working at 65?

No. If you are still employed and covered by your employer's health plan, you can delay registering for Part B and Part D without penalty. You should still register for Part A since it has no premium and covers hospital care. Once you leave your job or your coverage ends, you have eight months to register for Part B and Part D.

What if I turn 65 while living outside the United States?

You can still register for Medicare, but coverage rules differ for people living abroad. Part A covers you anywhere in the world, but Part B generally does not cover care outside the U.S. Contact Medicare at 1-800-633-4227 to discuss your situation and learn what coverage makes sense for where you live.

Can I change my mind after I register?

Yes, during your Initial Enrollment Window you can change your Part B or Part D choices. After your window closes, you can make changes only during the annual Open Enrollment Period (October 15 to December 7 each year) or if you have a may have access to life event. Changes made during Open Enrollment take effect January 1.

What if Social Security says I do not may have access to for Part A without a premium?

If you or your spouse did not pay Medicare taxes for 10 years, you can still register for Part A but will pay a monthly premium. The premium amount depends on how many years of Medicare taxes were paid. You can register anyway and pay the premium, or explore other coverage options — discuss this with Social Security when you register.

Do I need to register in person, or can I do it all online?

You can register entirely online through ssa.gov or medicare.gov, by phone, or in person. Online registration is fastest and requires no appointment. If you have questions about your specific situation, calling Social Security at 1-800-772-1213 lets you speak with someone who can answer them before you submit your registration.