Medicare may be able to access 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. You do not have to retire or stop earning income. If your birthday falls on the first of the month, your coverage begins the month before. For any other birthday, coverage begins the month you turn 65.

Some people become may be able to access before 65. You may may have access to at any age if you have received Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). These three conditions bypass the age requirement entirely.

Your may be able to access does not depend on your income, savings, or employment status. It depends only on age or on one of those three medical conditions. You do not need to have worked a certain number of years, though most people do need a work history to receive Medicare Part A without a premium.

Key Takeaways

  • Medicare may be able to access begins the month you turn 65, or earlier if you have received SSDI for 24 months, have ESRD, or have ALS.
  • You must sign up during your Initial Enrollment Period, which runs three months before your 65th birthday through three months after, or face a permanent penalty on Part B premiums.
  • If you are still working and covered by employer health insurance at 65, you can delay Part B enrollment without penalty if your employer has 20 or more employees.
  • Part A (hospital insurance) is usually free if you or your spouse paid Medicare taxes for at least 10 years; Part B (medical insurance) costs a monthly premium based on your income.
  • You must enroll through Social Security, Medicare.gov, or by phone at 1-800-MEDICARE; enrollment does not happen automatically.

How the Initial Enrollment Period works

Your Initial Enrollment Period is a seven-month window: three months before you turn 65, the month you turn 65, and three months after. You must enroll during this window or pay a permanent penalty on your Part B premium for as long as you have Medicare.

The penalty is 10 percent of the standard Part B premium for each full year you delayed enrollment. If you wait one year past your Initial Enrollment Period, your premium increases by 10 percent permanently. If you wait five years, it increases by 50 percent. This penalty does not go away.

The only exception is if you were covered by an employer health plan when you turned 65. If your employer has 20 or more employees and you are covered through that employer or your spouse's employer, you can delay Part B without penalty. You have eight months after your employment or coverage ends to enroll without penalty.

When you must enroll if you receive disability benefits

If you receive SSDI, you become may be able to access for Medicare automatically after 24 months of receiving benefits. You do not need to do anything — Medicare Part A and Part B coverage begins automatically. Your coverage starts on the 25th month of your SSDI may be able to access.

You will receive your Medicare card in the mail before your coverage begins. If you do not receive it within a reasonable time, contact Social Security at 1-800-772-1213 to confirm your coverage has started.

If you have ESRD or ALS, you must enroll yourself. You cannot wait for automatic enrollment. Contact Medicare at 1-800-MEDICARE or visit Medicare.gov to enroll as soon as you receive your diagnosis.

Part A and Part B may be able to access requirements

Part A (hospital insurance) is usually free if you or your spouse paid Medicare taxes for at least 10 years while working. If you do not meet this requirement, you can still purchase Part A, but you will pay a monthly premium. The premium is higher if you have fewer than 30 quarters of Medicare tax payments.

Part B (medical insurance) requires a monthly premium for everyone. The amount depends on your income from two years prior. If your income was below a certain threshold, you pay the standard premium. If your income was higher, you pay an income-related monthly adjustment amount (IRMAA) on top of the standard premium.

You are not required to enroll in Part B when you turn 65 if you are still working and covered by your employer's health plan. However, you must enroll within eight months of losing that coverage, or you will face the permanent Part B penalty.

How to enroll when you become may be able to access

You can enroll through three routes: Social Security, Medicare.gov, or by phone. If you already receive Social Security benefits, you may be able to enroll online at ssa.gov without contacting Medicare directly. If you do not yet receive Social Security, you must enroll through Medicare.

Visit Medicare.gov and select "Enroll in Medicare" to start an online process. You will need your Social Security number, proof of citizenship or legal residency, and information about any current health coverage. The online process takes about 10 minutes.

You can also call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. Representatives are available seven days a week. Have your Social Security number and current insurance information ready. Enrollment by phone takes about 15 minutes.

If you prefer to enroll in person, visit your local Social Security office. Bring your Social Security card, proof of citizenship, and any current insurance documents. You can find your local office at ssa.gov.

What happens after you enroll

After you enroll, Medicare processes your process and mails you a Medicare card. This usually takes two to four weeks. Your coverage begins on the first day of the month you turn 65 (or the month before if your birthday is the first of the month).

You will receive information about your Part B premium and when it will be deducted from your Social Security check. If you do not receive Social Security, Medicare will bill you directly by mail or set up automatic payments from your bank account.

Once you have your Medicare card, you can use it at any hospital, doctor's office, or pharmacy that accepts Medicare. Keep your card with you whenever you receive medical care.

Special situations that affect your may be able to access date

If you are a federal employee or railroad retiree, your may be able to access may differ. Federal employees who are covered under the Federal Employees Health Benefits Program (FEHB) have different enrollment rules. Railroad retirees are covered under the Railroad Retirement Board, not Social Security, and should contact that agency directly.

If you are a non-citizen, you must have been a lawful permanent resident (green card holder) for at least five years to be may be able to access for Medicare at 65. If you do not meet this requirement, you cannot enroll in Medicare, even if you are working and paying Medicare taxes.

If you are still working past 65 and your employer offers health insurance, you can delay Part B enrollment. However, you must enroll within eight months of retiring or losing coverage. Delaying Part B does not delay Part A if you are may be able to access for it.

Frequently Asked Questions

Do I have to enroll in Medicare when I turn 65 if I am still working?

You must enroll in Part A (hospital insurance) when you turn 65, even if you are still working. However, you can delay Part B (medical insurance) if your employer has 20 or more employees and you are covered by their health plan. You have eight months after you leave that job to enroll in Part B without penalty.

What happens if I miss my Initial Enrollment Period?

If you miss your seven-month Initial Enrollment Period and you are not covered by an employer health plan, you will pay a permanent 10 percent penalty on your Part B premium for each year you delayed. You can still enroll, but the penalty stays with you for life. The only way to avoid this penalty is to enroll during a General Enrollment Period (January 1 through March 31 each year), but your coverage will not begin until July 1.

Can I enroll in Medicare before I turn 65?

You can enroll up to three months before your 65th birthday. This is the earliest you can start the enrollment process. Your coverage will not begin until the month you turn 65 (or the month before if your birthday is the first of the month).

Do I need to have worked to be may be able to access for Medicare?

Most people need a work history to receive Part A without a premium — specifically, 10 years of Medicare tax payments (40 quarters). However, if you are married, your spouse's work history may allow you to receive Part A for free. If you do not meet the work requirement, you can still purchase Part A with a monthly premium.

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

You must be a U.S. citizen or a lawful permanent resident who has held a green card for at least five years to be may be able to access for Medicare at 65. If you do not meet this requirement, you cannot enroll in Medicare, even if you have worked and paid Medicare taxes in the United States.