How Do I Sign Up for Medicare?

As you approach 65, you may wonder how to sign up for Medicare. Enrollment is automatic if you get Social Security. Otherwise, you need to apply.
Dec 15, 2021
How Do I Sign Up for Medicare?

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You’ll be automatically enrolled in Medicare at age 65 if you’re already receiving Social Security. If you aren’t receiving those benefits, you can enroll in one of three ways:

The online application typically takes less than 10 minutes. (The Social Security Administration has suspended face-to-face service in local offices due to the COVID-19 pandemic, so no in-person visits are possible at this time.)

Medicare eligibility

Medicare is available to all U.S. adults age 65 or older. It's also available to younger people who get Social Security disability benefits. Usually, they’re enrolled in Medicare automatically after 24 months of disability benefit eligibility.

People who have ALS, also known as Lou Gehrig’s disease, automatically receive Medicare coverage the same month that they get their first disability check. People with kidney failure (end-stage renal disease) can apply for Medicare, with coverage typically starting on the first day of the fourth month of dialysis treatments.

When to sign up for Medicare

If you’re not enrolled automatically, you should sign up in the three months before your 65th birthday. That way, coverage will start on the first day of your birthday month (unless you were born on the first day of the month, in which case coverage begins on the first day of the prior month).

You technically have seven months around your birthday to enroll: the three months before your birthday month, your birthday month and the three months after. If your birthday is the first of the month, your enrollment period includes the four months before your birthday month and two months after.

But your coverage could be delayed if you wait until your birthday month or the three months afterward to apply for Medicare. If you miss your initial window, there are several Medicare open enrollment periods that may apply to your situation.

Medicare parts

People who are enrolled automatically are generally enrolled in both Medicare Part A, which covers hospitals, and Medicare Part B, which covers doctor visits. Part A normally doesn’t have premiums, but Part B does.

People who enroll themselves generally choose both Part A and Part B, although some delay signing up for Part B because they have other coverage. There could be penalties for delaying, so make sure you understand the rules.

Prescription drug coverage is available through a Medicare Part D plan. There may be penalties if you go without Part D or other acceptable drug coverage for too long, so make sure you understand these rules as well.

You also can opt for additional coverage from private insurance companies. Many people buy Medicare supplement insurance or “Medigap” to cover copays, deductibles and other expenses Medicare doesn’t cover. You have a six-month period after starting Part B to select a supplemental policy with “guaranteed issue,” meaning the insurer can’t turn you down or charge you more for preexisting conditions or other issues. After that, a Medigap policy might cost more or you may not be able to get one at all, depending on your health situation.

Another private insurance option to consider is Medicare Advantage, also known as Part C. These plans include all the benefits offered by Medicare Part A and Part B, as well as additional coverage.

Medicare late enrollment penalties

If you’re not automatically enrolled in Medicare and you don’t apply on time, you may face late enrollment fees:

  • Medicare Part A: If you must buy Part A and you don’t purchase it during your initial enrollment period, you may owe 10% more than the monthly premium for twice the time period you didn’t sign up.

  • Medicare Part B: If you don’t sign up for Part B during your initial enrollment period, your monthly premium may see a 10% bump for each 12-month period that you went without Part B coverage. You’ll usually pay this penalty as long as you have Part B.

  • Medicare Part D: If you go without Medicare drug coverage or other creditable prescription drug coverage for 63 or more days once your initial enrollment period ends, you may pay a penalty for as long as you have Medicare drug coverage. The penalty is calculated as 1% of the “national base beneficiary premium” multiplied by the number of full months you weren’t covered. This is rounded to the nearest 10 cents, and it’s recalculated each year.

What happens after you sign up for Medicare

After you sign up for Medicare, you’ll be mailed information about how Medicare works and how to shop for additional coverage. You’ll also get your red, white and blue Medicare card. (Don’t throw it away — it’s not junk mail.)

The date your coverage starts will depend on when you sign up for Medicare:

When you sign up

When your Medicare coverage starts

Before the month of your 65th birthday*.

The month you turn 65.

The month you turn 65.

The next month.

One month after you turn 65.

Two months after you sign up.

Two or three months after you turn 65.

Three months after you sign up.

During a general enrollment period, which runs Jan. 1 to March 31 each year.

July 1.

During a special enrollment period.

The next month.

*If your birthday is on the first of the month, your coverage will start on the first day of the month before your birthday month. For example, if you turn 65 on August 1, your coverage will start on July 1.

Coverage always starts on the first day of the month. If you’re unsure of when you can sign up for Medicare, check your specific situation with Medicare directly.

What Medicare covers

Medicare covers a lot of things — but not everything. Find out where Medicare stands in the following areas:

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