Turning 65? When to Sign Up for Medicare

You become eligible for Medicare based on age when you turn 65, but you can sign up a few months earlier to ease the transition. You’ll be automatically enrolled in Medicare if you receive Social Security before turning 65.

If you miss your initial enrollment period, you could face permanent late penalties. But you may be able to delay signing up for some parts of Medicare without penalty.

When to sign up for Medicare before turning 65

Medicare initial enrollment period

The span of months around your 65th birthday when you’re eligible to sign up for Medicare is called the initial enrollment period. 

• For most people, the initial enrollment period starts three months before the month you turn 65 and lasts for seven months. If your birthday is July 3, you could sign up starting April 1, and the period would end on the last day of October.

• If your birthday is on the first of the month, your initial enrollment period is a little different. It’s still seven months long, but it starts four months before your birthday month and runs through the end of the second month after you turn 65. If your birthday is July 1, you could sign up starting March 1, and the initial enrollment period would end on the last day of September.

If you sign up before your birthday month, your Medicare benefits start the month you turn 65. If you sign up during or after the month of your birthday, your Medicare benefits start the month after you sign up.

What happens if you miss the initial enrollment period for Medicare?

If you miss your initial enrollment period, you have another chance to sign up every year during the general enrollment period, which runs from Jan. 1 to March 31. Your coverage starts the month after you sign up. Depending on your circumstances and which parts of Medicare you’re signing up for, you might face late enrollment penalties. 

You may also have other opportunities to sign up if you qualify for a special enrollment period. Special enrollment periods generally occur when you move or lose other health coverage.

Automatic enrollment in Medicare

If you’re already receiving Social Security benefits when you turn 65, you’ll be automatically enrolled in Medicare. When this happens, you get Medicare Part A and Part B starting on the first day of the month of your 65th birthday (or the month before, if your birthday is on the first of the month). Your Medicare Part B premiums are automatically deducted from your Social Security payment.

You’ll still need to act if you want to make any of these additions or changes to your Medicare coverage:

• Choosing not to enroll in Medicare Part B.

• Adding Medicare Part D prescription drug coverage.

• Adding a Medicare Supplement Insurance (Medigap) plan to cover out-of-pocket costs.

• Signing up for Medicare Advantage, a bundled alternative to Medicare Part A and B sold by private companies.

How soon before your 65th birthday should you enroll in Medicare?

You can sign up for Medicare starting three months before the month you turn 65 (or four months before if your birthday is on the first day of the month). If you enroll before the month of your 65th birthday, your coverage starts the month you turn 65. If you sign up during the month of your 65th birthday or afterward within your initial enrollment period, your coverage starts the month after you enroll.

Do you automatically get Medicare when you turn 65?

You don't automatically get Medicare when you turn 65 unless you’re already receiving Social Security benefits. In that case, you’ll be automatically enrolled in Original Medicare (Part A and Part B) when you become eligible. If you’re not receiving Social Security benefits, you’ll need to sign up for Medicare yourself when you become eligible.

Even if you're getting Social Security benefits before 65, you may still need to make choices about your Medicare coverage. If you want to wait to enroll in Medicare Part B, you’ll have to send your Medicare card back to the Social Security Administration. If you want to add Medicare Part D prescription drug coverage and/or Medicare Supplement Insurance, you’ll have to do that yourself.

You can also choose to shop for a Medicare Advantage plan instead of Original Medicare.

» MORE: Medicare vs. Medicare Advantage

Is there any reason not to sign up for Medicare at 65?

You're contributing to an HSA

Since most people get Medicare Part A for free, generally there’s no need to delay getting this coverage unless you have employer health coverage and want to contribute to a health savings account (HSA). Once you sign up for Medicare, you can’t save to an HSA. In fact, Medicare Part A has a six-month lookback period, so you should stop contributing to an HSA at least six months before you enroll in Part A.

» MORE: HSAs and Medicare: What you need to know

You're still working

If you have employer health coverage and your company has 20 or more employees, you may be able to wait to enroll in Medicare Part B until that group coverage ends. You won’t have to pay your Part B premium until you sign up for Part B. Once group coverage ends or you stop working, you’ll have eight months to sign up for Medicare Part B before you risk a late enrollment penalty.

If you’ll pay a premium for Part A, you also can delay signing up for Part A if you have health insurance from an employer with 20 or more employees. The same eight-month window applies to signing up once you lose coverage or stop working.

» MORE: When to sign up for Medicare if you’re 65 and still working

What is the first step to sign up for Medicare?

You can start your Medicare application online through the Social Security Administration website. You can also sign up for Medicare over the phone by calling 800-772-1213. You’ll need to have the following information available to apply, according to the SSA:

• Social Security number.

• City, state and country you were born in.

• Email address.

• Your existing Medicare number (if applicable).

• Start and end dates for any current group health plans.

• Start and end dates for any group health plans after age 65.