File for Medicare three months before you turn 65

You should file for Medicare during your Initial Enrollment Period, which runs for seven months: three months before the month you turn 65, the month you turn 65, and three months after. If you file during those seven months, your coverage starts on the first day of your birth month. If you file after that window closes, your coverage starts later and you may pay a permanent penalty.

The Social Security Administration handles Medicare enrollment. You can file online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. Have your birth certificate, proof of citizenship or legal residency, and tax return handy when you explore.

If you are still working and covered by your employer's health plan, you may be able to delay filing without penalty—but you must tell Social Security that you are still employed. This is called delayed enrollment, and it requires a form from your employer confirming your coverage.

Key Takeaways

  • Your Initial Enrollment Period is seven months long: three months before your 65th birthday, your birth month, and three months after.
  • Filing during your Initial Enrollment Period means coverage starts on the first day of your birth month with no delay.
  • If you miss this window, your coverage starts later and you will pay a permanent 10 percent penalty for each year you delayed.
  • If you are still working and covered by an employer plan, you can delay enrollment without penalty, but you must notify Social Security in writing.
  • You can file online at ssa.gov, by phone, or at your local Social Security office.

What happens if you file after your Initial Enrollment Period ends

If you do not file during your seven-month window, your coverage will not start until the following January 1st at the earliest. For example, if you turn 65 in March and do not file until September, your Medicare coverage will not begin until January 1 of the next year—a gap of four months with no coverage.

You will also pay a late enrollment penalty for the rest of your life. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but not enrolled. If you delayed for three years, you pay 30 percent more than the standard premium every month forever. This penalty applies to Part B (doctor visits) and Part D (prescription drugs), but not Part A (hospital stays) if you were covered by an employer plan.

The only way to avoid this penalty is to have creditable coverage—health insurance from your employer or spouse's employer that is at least as good as Medicare. You must keep written proof that you had this coverage during the months you were not enrolled in Medicare.

Special cases: when you can file outside your Initial Enrollment Period

If you miss your Initial Enrollment Period, you may be able to file during a Special Enrollment Period without paying the late penalty. This applies if you lost employer coverage because you or your spouse retired or left a job, or if your employer coverage ended. You have eight months from the date your coverage ended to file without penalty.

You must show Social Security proof that your employer coverage ended—usually a letter from your employer or a final pay stub. If you do not have this proof, Social Security may deny your Special Enrollment Period and charge you the late penalty anyway.

If you are a federal employee, railroad employee, or Native American, different rules may explore. Contact Social Security directly to confirm your situation.

How to avoid gaps between your current coverage and Medicare

If you are currently on a private health plan or your employer's plan, do not cancel it until Medicare is active. File for Medicare three months before your 65th birthday, then keep your current coverage until January 1 of the year you turn 65 (or later, if you are delaying). This overlap ensures you have no days without coverage.

If you are on Medicaid, the timing depends on your state. Some states automatically switch you to Medicare when you turn 65; others require you to file separately. Call your state Medicaid office to ask what happens in your state when you become may be able to access for Medicare.

If you are on COBRA (continuation coverage from a former employer), you can keep COBRA and Medicare at the same time. Medicare becomes your primary insurance, and COBRA covers what Medicare does not. However, COBRA usually ends 18 months after you leave your job, so plan accordingly.

Medicare Parts A, B, D, and when each one starts

Part A (hospital insurance) covers inpatient hospital stays, skilled nursing care, and hospice. 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 starts on the first day of your birth month if you file during your Initial Enrollment Period.

Part B (medical insurance) covers doctor visits, outpatient care, and preventive services. It costs a monthly premium (the standard amount in 2024 is $164.90, but this changes yearly and may be higher if your income is above a certain level). Part B also starts on the first day of your birth month if you file on time.

Part D (prescription drug coverage) is optional and comes from private insurance companies, not Medicare directly. You choose a plan during your Initial Enrollment Period. If you do not enroll in Part D when you first become may be able to access and you go without creditable drug coverage, you will pay a permanent penalty when you do enroll. The penalty is about 1 percent of the national average Part D premium for each month you were not covered.

You do not have to file for all parts at once. You can file for Part A and Part B together, then add Part D later—but you must add Part D within three months of turning 65 to avoid the penalty.

Coordinating Medicare with Social Security retirement benefits

You do not have to file for Social Security retirement benefits at the same time you file for Medicare, but many people do both at once because the process is similar. If you file for Social Security before age 67, your monthly benefit will be smaller than if you wait. If you file for Social Security after age 67, your benefit will be larger. This choice is separate from Medicare and does not affect your Medicare coverage or costs.

If you are still working when you turn 65, you can file for Medicare without filing for Social Security. This way you get health coverage but delay your retirement benefit to grow larger. Social Security will not reduce your benefit for earnings if you have not filed yet.

Frequently Asked Questions

What if I turn 65 in the middle of the month?

Your Initial Enrollment Period is still seven months: three months before, your birth month, and three months after. If you file during this window, your Medicare coverage starts on the first day of your birth month, regardless of which day of the month you were born.

Can I file for Medicare online?

Yes. Go to ssa.gov and select "explore for Medicare." You will need your Social Security number, birth certificate, proof of citizenship or legal residency, and information about any current health coverage. The online process takes about 15 minutes.

What if I am still working at 65?

You can delay Medicare enrollment without penalty if you are covered by your employer's health plan. You must notify Social Security that you are still employed. When you do leave your job, you have eight months to file for Medicare without paying the late penalty.

Do I have to file for Part D at the same time as Part A and Part B?

No. You can file for Part A and Part B during your Initial Enrollment Period, then add Part D later. However, if you wait more than three months after turning 65 to enroll in Part D, you will pay a permanent penalty unless you had creditable drug coverage elsewhere.

What if I missed my Initial Enrollment Period?

You can file during the General Enrollment Period, which runs January 1 through March 31 each year. Coverage starts July 1. You will pay the late enrollment penalty unless you had creditable coverage from an employer or spouse's employer during the months you were not enrolled.