Sign up for Medicare in the three months before you turn 65

You can enroll in Medicare starting three months before the month you turn 65. If you were born on June 15, you can sign up beginning in March. The enrollment window stays open for three months after your birthday month — so you have a total of seven months to enroll without penalty.

The exact important date depends on your birth month. If you miss this window, you will pay a higher premium for as long as you have Medicare, unless you have a valid reason for the delay. 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.

Key Takeaways

  • You can sign up three months before you turn 65, during the month you turn 65, or three months after — a seven-month window with no penalty.
  • If you are still working and covered by your employer's health plan, you may be able to delay Part B enrollment without penalty, but you must tell Medicare about your coverage.
  • Sign up through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
  • Missing your important date triggers a permanent 10 percent premium increase on Part B unless you have documented proof of a valid delay reason.
  • Part A (hospital insurance) has no premium for most people, but Part B (doctor visits) does, and the penalty applies only to Part B.

What happens if you miss the important date

If you do not enroll during your seven-month window and you do not have a valid reason for the delay, Medicare will add a penalty to your Part B premium. This penalty is permanent — it does not go away after a few years. You will pay it every month for the rest of your life.

A valid reason for delay includes being covered by an employer health plan while you are still working, or being a federal employee covered by the Federal Employees Health Benefits Program. If you have one of these situations, you must report it to Medicare when you do eventually enroll, and bring proof of your coverage dates.

Enrolling while you are still working

If you are still employed and your employer offers health insurance, you do not have to enroll in Medicare Part B right away. You can delay Part B enrollment without penalty as long as your employer has 20 or more employees and you are actively working. Part A (hospital insurance) is still available to you at 65, but you can delay Part B.

When you do leave your job or lose your employer coverage, you have eight months from the date your coverage ends to enroll in Part B without penalty. Report your employment status and coverage dates to Medicare when you sign up, and bring your employer's benefits paperwork as proof.

How to sign up

You can enroll through three routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online enrollment is fastest — you can complete it in about 10 minutes if you have your Social Security number and information about any current health coverage.

By phone, a Medicare representative will walk you through the same questions. The call usually takes 15 to 20 minutes. In person, bring your Social Security card, proof of citizenship or legal residency, and proof of your current address. Social Security offices have walk-in hours, but you can also make an appointment ahead of time.

What to have ready before you enroll

Gather your Social Security number, date of birth, and citizenship or legal residency documents before you start. If you are currently covered by an employer health plan, have that policy number and the name of your employer. If you receive Veterans benefits, have your VA claim number.

You will also need to choose between Original Medicare (Part A and Part B) and Medicare Advantage (Part C), which is an alternative way to get your hospital and doctor coverage through a private insurance company. If you choose Original Medicare, you can also add prescription drug coverage (Part D) and supplemental insurance (Medigap) during this enrollment window.

Timing for prescription drug and supplemental coverage

If you enroll in Part B, you can also sign up for Part D (prescription drug coverage) and Medigap (supplemental insurance) during the same window without penalty. Part D has its own important date: you can enroll anytime during your Initial Enrollment Period, which is the same seven-month window as Part B. If you miss it and you do not have other creditable drug coverage, you will pay a penalty on your Part D premium.

Medigap enrollment also has a important date. You have six months from the date your Part B coverage starts to buy a Medigap policy without the insurance company asking about your health history. After six months, insurers can deny you or charge more based on pre-existing conditions.

Special situations that change your important date

If you are a federal employee, your important date is different. Federal employees can enroll in Medicare Part B up to one year after they retire or lose their Federal Employees Health Benefits coverage. If you are a railroad retiree, you may have different rules under the Railroad Retirement Board.

If you are a non-citizen with a green card, you can enroll in Medicare at 65 just like a citizen. If you are a non-citizen without a green card, you cannot enroll in Medicare, even at 65. If you are a spouse of a U.S. citizen or permanent resident, contact Social Security to learn whether you meet the requirements.

Frequently Asked Questions

Can I enroll in Medicare before I turn 65?

You can enroll starting three months before your 65th birthday. You cannot enroll earlier unless you are on disability or have end-stage renal disease. If you are on Social Security disability, you are automatically enrolled in Medicare two years after your disability benefits start.

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

Your enrollment window is based on the month you turn 65, not the specific date. If you turn 65 on June 15, your window opens in March and closes in September. You can enroll anytime during those seven months.

Do I have to enroll in Part A if I do not want Part B?

Part A (hospital insurance) has no monthly premium for most people, so there is no penalty for delaying it. However, if you wait to enroll in Part A after your Initial Enrollment Period ends, you may have to pay a premium surcharge. It is usually best to enroll in Part A even if you delay Part B.

What happens if I miss my important date but I am still working?

If you miss your important date and you are still covered by an employer plan, you can enroll without penalty within eight months of losing that coverage. You must report your employment status and bring proof of your employer coverage dates when you enroll.

Can I change my mind after I enroll?

You have a limited time to change your coverage choices. If you enroll in Original Medicare and then want to switch to Medicare Advantage, you have until March 31 of the year after you first enroll. Changes to Medigap or Part D have different important date depending on your situation.