Medicare may be able to access starts at age 65 for most people

You become may be able to access for Medicare on the first day of the month in which you turn 65, or the month after, depending on your birthday. If you turn 65 on the first of any month, your coverage begins that same month. If you turn 65 on any other day, coverage begins the first day of the following month.

You do not have to be retired to sign up. You do not have to stop working. Medicare is available to you at 65 regardless of your employment status or income. The only requirement is that you or your spouse paid Medicare taxes for at least 10 years (40 quarters) during your working life.

Some people become may be able to access before 65. If you have received Social Security Disability Insurance (SSDI) for 24 months, you may have access to for Medicare even if you are younger than 65. If you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you may be may be able to access when ready, without waiting.

Key Takeaways

  • Most people become may be able to access for Medicare the month they turn 65, whether or not they are working.
  • You must have paid Medicare taxes for at least 10 years to be may be able to access based on age; your spouse's work history can also may have access to you.
  • People under 65 who have received SSDI for 24 months, or who have ESRD or ALS, may be may be able to access before reaching 65.
  • You should sign up during your Initial Enrollment Period, which runs three months before and three months after the month you turn 65, to avoid late penalties.
  • If you are still working and have health insurance through your employer, you may be able to delay Part B enrollment without penalty.

How your work history determines may be able to access

Medicare may be able to access is based on your own work record or your spouse's work record. You need 40 quarters of coverage, which means you paid Medicare taxes in at least 10 years of work. A quarter is roughly three months; you can earn up to four quarters per year, so 10 years of work typically gives you the 40 quarters you need.

If you did not work long enough yourself, you may still be may be able to access based on your spouse's work history. If you are married, divorced (and the marriage lasted at least 10 years), or widowed, you can use your spouse's or ex-spouse's earnings record. You do not need your spouse's permission, and using their record does not reduce their benefits.

If neither your record nor your spouse's record has 40 quarters, you are not may be able to access for Medicare based on age. You would need to explore other coverage options, such as the Affordable Care Act marketplace or Medicaid, depending on your state and income.

may be able to access before age 65

You can receive Medicare before 65 if you have been on SSDI for 24 consecutive months. The 24-month waiting period begins the month your SSDI payments start, not the month you applied. Once you have been receiving SSDI for 24 months, Medicare Part A (hospital insurance) begins automatically the 25th month.

If you have end-stage renal disease (ESRD)—permanent kidney failure requiring dialysis or a transplant—you are may be able to access for Medicare when ready, without an age requirement or waiting period. The same applies if you have been diagnosed with amyotrophic lateral sclerosis (ALS, also called Lou Gehrig's disease). You should contact Social Security to report your diagnosis and begin the enrollment process.

If you are under 65 and may be able to access through SSDI, ESRD, or ALS, you still need to sign up for Part B (medical insurance) if you want it. Part B is not automatic; you must enroll during your Initial Enrollment Period to avoid late penalties.

Your Initial Enrollment Period and why it matters

Your Initial Enrollment Period is a seven-month window: it starts three months before the month you turn 65 and ends three months after. For example, if you turn 65 in June, your period runs from March through September. During this window, you can sign up for Medicare Part A and Part B without penalty, regardless of whether you need the coverage right away.

If you miss this window, you may face a late enrollment penalty. For Part B, the penalty is 10 percent of the standard premium for each 12-month period you were may be able to access but did not sign up. This penalty is permanent—you pay it for as long as you have Part B. The penalty for Part D (prescription drug coverage) works similarly and also lasts for life.

There is one exception: if you have health insurance through a current employer (yours or your spouse's), you may be able to delay Part B enrollment without penalty. This is called the Special Enrollment Period. You must have "creditable coverage"—coverage that is at least as good as Medicare Part B—and you must sign up within eight months of losing that coverage or retiring, whichever comes first.

Enrollment through Social Security or Medicare

Most people sign up for Medicare through Social Security. If you are already receiving Social Security benefits, Medicare enrollment happens automatically three months before you turn 65. You will receive your Medicare card in the mail about two weeks before your coverage begins. You do not need to do anything.

If you are not yet receiving Social Security, you must sign up for Medicare yourself. You can do this online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. You will need your Social Security number, proof of citizenship or legal residency, and proof of age (such as a birth certificate).

If you are under 65 and may be able to access through SSDI, ESRD, or ALS, Social Security will contact you about Medicare enrollment. Read any notices carefully and follow the instructions to enroll in Part B if you want it.

What happens if you delay enrollment

If you miss your Initial Enrollment Period and do not have a may have access to reason (such as creditable employer coverage), you will have to wait until the next General Enrollment Period, which runs January 1 through March 31 each year. Coverage would not begin until July 1 of that year. During the months you are uninsured, you are responsible for all medical costs.

When you do enroll late, the late penalty applies. For Part B, you pay 10 percent more than the standard premium for each year you were may be able to access but not enrolled. For Part D, the penalty is 1 percent of the national average premium for each month you were without coverage. Both penalties are permanent.

The only way to avoid a late penalty is to have had creditable coverage through an employer or union, or to may have access to for a Special Enrollment Period for another reason. If you believe you have a may have access to reason, contact Social Security or Medicare to discuss it before enrolling late.

may be able to access for your spouse or family members

Your spouse can become may be able to access for Medicare at 65 based on their own work record or on yours, even if you are not yet 65. They follow the same enrollment process and timeline as you do. If your spouse is younger than 65 and you are already on Medicare, they will need to explore other coverage options until they turn 65.

Children do not become may be able to access for Medicare based on a parent's age. However, children under 19 (or up to 26 if they are full-time students) may be covered under a parent's health insurance plan if the parent has employer coverage. Once they turn 26 or finish school, they will need their own coverage through the Affordable Care Act marketplace, Medicaid, or an employer plan.

If you are divorced and your marriage lasted at least 10 years, you can use your ex-spouse's work record to become may be able to access for Medicare at 65, even if your ex-spouse has not yet signed up. You do not need their consent or involvement.

Frequently Asked Questions

Do I have to sign up for Medicare at 65 if I am still working?

You do not have to sign up for Part B if you have health insurance through your current employer. However, you should still sign up for Part A (hospital insurance) at 65 unless you are covered under a group health plan through current employment. If you delay Part B, sign up within eight months of retiring or losing your employer coverage to avoid a late penalty.

What if I worked in another country—does that count toward the 40 quarters?

Work in most countries does not count toward Medicare may be able to access. However, work in certain countries with Social Security agreements may count. Contact Social Security to discuss your specific situation. If you do not have 40 quarters, you may still be able to use a spouse's or ex-spouse's work record.

Can I get Medicare if I am not a U.S. citizen?

You must be a U.S. citizen or a lawful permanent resident (green card holder) who has lived in the United States for at least five years to be may be able to access for Medicare. If you are not yet a permanent resident, contact Social Security to learn what documentation you will need when you explore.

What if I turned 65 but did not sign up—can I still enroll?

Yes, but you may face a late penalty. You can enroll during the General Enrollment Period (January 1 through March 31) each year, with coverage beginning July 1. If you had creditable coverage through an employer, you may be able to enroll without penalty. Contact Medicare or Social Security to discuss your situation.

Does my income affect my Medicare may be able to access?

Income does not affect whether you can enroll in Medicare at 65. However, income does affect how much you pay for Part B and Part D premiums. Higher income means higher premiums. Your income also affects whether you are may be able to access for Medicaid or other information programs that help pay Medicare costs.