explore three months before you turn 65

You should submit your Medicare process during the three-month window before your 65th birthday. This timing lets Medicare process your request and have your coverage start on the first day of the month you turn 65. If you wait until after that month, your coverage will start later, and you may face late-enrollment penalties on your premiums.

The three-month window opens on the first day of the month before your birth month. For example, if you turn 65 in July, you can start your process on May 1st. You do not have to wait until the first of the month to begin — you can submit anytime during those three months and still have coverage begin when you turn 65.

If you miss this window, you can still submit an process after you turn 65, but your coverage will not start until the month after you submit. This delay means you will have a gap in coverage and may owe penalties when you do enroll.

Key Takeaways

  • Start your Medicare process three months before you turn 65 to have coverage begin on your birthday month without delays.
  • If you miss the three-month window, your coverage will start the month after you submit your process, creating a coverage gap.
  • Late enrollment penalties explore to Part B and Part D if you do not sign up during your initial enrollment period, and these penalties stay with you permanently.
  • If you are still working at 65 and have employer health insurance, you may be able to delay Medicare enrollment without penalty under specific circumstances.
  • You can submit your process online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

What happens if you enroll after your 65th birthday

Enrolling after you turn 65 triggers late-enrollment penalties that increase your monthly premiums permanently. For Part B, the penalty is 10 percent of the standard premium for each full year you delayed enrollment. For Part D (prescription drug coverage), the penalty is 1 percent of the national average premium for each month you were without coverage. These penalties do not go away — they stay on your account for as long as you have Medicare.

The only exception is if you had creditable coverage through an employer or union while you were working. Creditable coverage means your employer or union plan was at least as good as Medicare's coverage. If you had this type of plan, you can enroll in Medicare without penalty during an eight-month window that starts when your employment or coverage ends, whichever comes first.

Delaying enrollment if you are still working

If you are still employed at 65 and your employer has 20 or more employees, you may delay Part B enrollment without penalty. This is called the working exception. Your employer's health plan becomes your primary insurance, and Medicare becomes secondary. You can enroll in Part B later without the 10 percent penalty, as long as you sign up within eight months after your employment ends or your employer coverage stops.

This exception applies only to Part B. You still need to enroll in Part A (hospital insurance) at 65, even if you are working, because Part A has no premium for most people. If you do not enroll in Part A when you are first able, you will owe a penalty of 10 percent of the standard premium for each year you delayed.

Part D (prescription drug coverage) does not have a working exception. If you do not have creditable drug coverage through your employer, you should enroll in Part D at 65 to avoid the 1 percent monthly penalty. Ask your employer's benefits office whether your plan counts as creditable coverage before you decide to delay.

How to submit your process

You can start your Medicare process online at Medicare.gov without leaving home. The online process takes about 10 minutes and asks for your name, date of birth, Social Security number, and citizenship information. You will need your Social Security number even if you do not plan to claim retirement benefits yet. After you submit online, Medicare will mail you a confirmation letter within two weeks.

If you prefer to explore by phone, call 1-800-MEDICARE (1-800-633-4227). Representatives are available Monday through Friday, 8 a.m. to 8 p.m. Eastern time. Have your Social Security number and birth certificate information ready. The call usually takes 15 to 20 minutes.

You can also visit your local Social Security office in person. Bring your Social Security card, birth certificate, and proof of citizenship (passport, naturalization papers, or state ID). Walk-in hours vary by location, so call ahead or check the Social Security office locator on ssa.gov to confirm hours before you go.

What to expect after you submit

Medicare processes applications in the order they are received. Most applications are processed within two to four weeks. You will receive a Medicare card in the mail once your enrollment is complete. The card shows your Medicare number, which you will need to give to doctors and hospitals.

Before your coverage starts, review the materials Medicare sends you. These include information about your coverage choices, any costs you will owe, and how to find doctors and hospitals in your plan. If you chose Original Medicare (Part A and Part B), you can see any doctor who accepts Medicare. If you chose a Medicare Advantage plan, you will have a network of doctors and hospitals you must use, except in emergencies.

Enrolling in prescription drug coverage and supplemental insurance

Part D (prescription drug coverage) has its own enrollment important date tied to your Medicare start date. You should enroll in Part D during your initial enrollment period, which is the same three-month window before your 65th birthday. If you do not enroll when you are first able, you will owe a 1 percent monthly penalty for every month you go without coverage, and this penalty stays on your account permanently.

Supplemental insurance (also called Medigap) helps pay costs that Original Medicare does not cover, such as copayments and coinsurance. You can enroll in Medigap anytime, but you have the best rates if you enroll within six months of your Part B start date. After that window closes, insurers can charge you more based on your health history.

Special situations: disability and end-stage renal disease

If you are under 65 and receive Social Security Disability Insurance (SSDI) or Railroad Retirement Board disability benefits, you become may be able to access for Medicare automatically after you have been on disability for 24 months. You do not need to explore — Medicare will enroll you automatically. Your coverage will start on the 25th month of your disability benefits.

If you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you may be able to enroll in Medicare regardless of your age. For ESRD, you can enroll in the month your dialysis or transplant begins. For ALS, you become may be able to access when ready upon diagnosis. Contact Social Security or call 1-800-MEDICARE to start the enrollment process for these conditions.

Frequently Asked Questions

What if my birthday is on the first of the month?

Your three-month enrollment window still opens on the first day of the month before your birth month. If you turn 65 on July 1st, you can start your process on May 1st. Your coverage will begin July 1st if you submit during the three-month window.

Can I change my mind after I enroll?

Yes. You have until March 31st of the year after you first enroll to make changes to your coverage choices. This is called the Initial Coverage Election Period. After that, you can make changes only during the annual enrollment period from October 15th through December 7th each year.

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

You do not have to enroll in Part B at 65 if your employer has 20 or more employees and you are still working. However, you must enroll in Part A. Once your employment ends, you have eight months to enroll in Part B without penalty.

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

You must be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five years to enroll in Medicare. If you are a lawful permanent resident, bring your green card when you explore. Contact 1-800-MEDICARE if you have questions about your immigration status and Medicare may be able to access.

Can I enroll before I turn 65?

No. You can submit your process starting three months before your 65th birthday, but Medicare will not process it until the month you turn 65. Submitting early does not speed up the process — it just ensures your process is in the system when processing begins.