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Nerdy takeaways
- Most people can sign up for Medicare at age 65.
- If you're living with a disability or with certain conditions, Medicare can start sooner.
- If you get health insurance from an employer with 20 or more workers, you may be able to delay Medicare.
- There are penalties for missing enrollment dates.
For most people, Medicare starts at age 65. If you're living with a disability or with certain conditions, Medicare can start sooner. If you’re working past 65, you may be able to delay Medicare.
There are penalties for missing enrollment dates, so it’s important to understand the timeline.
Your Medicare initial enrollment period (IEP)
For most, this is the best time to sign up for Medicare. It's a seven-month window around your 65th birthday that includes:
3 months before your birthday month.
Your 65th birthday month.
3 months after your birthday month.
The 1st of the month birthday exception:
If your birthday is on the first of the month, your seven-month enrollment window shifts back by one full month. It starts four months before your 65th birthday month and ends two months after your birthday month.
When does Medicare start?
Medicare usually starts when you’re 65, depending on your Medicare eligibility. But it doesn’t necessarily start on your birthday. Medicare coverage always kicks in on the first day of the month.
Your Medicare coverage start date depends on when you sign up:
| If you sign up... | Your Medicare coverage starts |
|---|---|
| Before the month of your 65th birthday.* | The first day of the month you turn 65. |
| The month you turn 65 or during the three months after. | The first day of the next month. |
| During the general enrollment period, which runs Jan. 1 to March 31 each year. | The first day of the month after you sign up. |
| During a special enrollment period. | The first day of 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 Aug. 1, your coverage will start July 1. | |
Medicare vs. Social Security age
You don’t have to be retired to get Medicare. While the full retirement age is 67 for most people, Medicare starts at age 65.
Shopping for Medicare plans? We have you covered.
Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
- States available48 states and Washington, D.C.
- Members in high-rated plansMedium (50% to 84%)
- Member satisfactionAverage
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- States available46 states and Washington, D.C.
- Members in high-rated plansLow (49% or less)
- Member satisfactionAbove average
(855) 432-0512 / TTY 711
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
Get a quote
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Do you automatically get Medicare when you turn 65?
If you’ve applied for Social Security benefits or Railroad Retirement Board benefits, you’ll automatically get Medicare Part A when you become eligible for Medicare. If you’ve been getting benefits for at least four months, you’ll get Part A and Part B when you turn 65. You can choose whether to keep Part B.
If you haven't applied for Social Security, you’ll have to sign up for Medicare yourself. You should enroll in the three months before your birthday to avoid any coverage gap.
» MORE: Medicare and Social Security
When does Medicare start for people living with a disability?
If you’re under 65, you can qualify for Medicare based on disability or specific health conditions. Here’s when your Medicare coverage starts:
- Social Security Disability Insurance (SSDI) recipients: People who get disability benefits from Social Security automatically receive Medicare coverage after 24 months.
- People who have ALS (Lou Gehrig’s disease): You automatically receive Medicare coverage the same month that disability benefits start.
- People who have end-stage renal disease (ESRD): You can usually apply for Medicare starting on the first day of the fourth month of dialysis treatments. If you’re getting a kidney transplant, Medicare coverage can start the month you’re admitted to a hospital for the transplant, if the transplant happens that month or within the next two months. Transplant delays may move Medicare’s starting date out, too. Get more information on ESRD and Medicare on Medicare.gov.
Understanding Medicare enrollment periods: IEP, GEP and SEP
Most people start Medicare during their initial enrollment period, but your window may be different depending on your work status and whether you’ve missed previous deadlines.
Medicare initial enrollment period (IEP): Turning 65
This is the seven-month window that includes the three months before your birthday month, your 65th birthday month and the three months after. If you were born on June 17, your enrollment window would be March 1 through Sept. 30. Aim to sign up before June, and your coverage will start June 1.
If your birthday is on the first of the month, your enrollment period shifts back one month. If you were born on June 1, your enrollment window would be Feb. 1 through Aug. 30. Aim to sign up before May, and your coverage will start May 1.
» MORE: How do I sign up for Medicare?
Medicare general enrollment period (GEP): If you missed your window
If you miss your initial enrollment period, you can sign up for premium-free Medicare Part A any time. But you must wait until Medicare’s general enrollment period, Jan. 1 to March 31, to sign up for the other parts of Medicare. Coverage starts the month after you sign up. Those who miss the initial enrollment period for Medicare Part B and Part D usually have to pay permanently higher premiums due to penalties.
You may be able to enroll outside of this window — and potentially avoid penalties — if you qualify for a special enrollment period.
Medicare special enrollment period (SEP): Working past 65 and other special circumstances
You can qualify for a special enrollment period and avoid penalties if you’re working past 65 and have creditable coverage through your employer. Your special enrollment period begins when your employment or coverage ends. (Note: COBRA and retiree health coverage do not extend this clock.)
You then have two months to enroll in Medicare Advantage or Part D, and eight months to enroll in Medicare Part B. (Though if you enroll in a Medicare Advantage plan, you’ll have to enroll in Part B at that time.) If you apply using a special enrollment period and your application is approved, your coverage starts the first day of the following month.
Other things that might qualify you for a SEP include missing a chance to sign up because you were affected by a natural disaster or missing a chance to enroll because a health plan or employer gave you incorrect information. To apply for a SEP, fill out the Application for Medicare Part A and Part B Special Enrollment Period and fax or mail to your local Social Security office.
What happens if I miss my Medicare start date?
If you don’t sign up for Medicare when you first become eligible, you could end up facing permanent late enrollment penalties, unless you’re still working and have creditable coverage from your employer.
Here are the Medicare late enrollment penalties:
| If you miss this deadline... | You will pay this penalty: |
|---|---|
| Part A | 10% premium increase for twice the number of years you were late. |
| Part B | 10% increase for every 12-month period delayed. This penalty is for life. |
| Part D | Permanent monthly penalty based on how long you went without drug coverage. |
If you’re unsure when you can sign up for Medicare, check your specific situation with Medicare directly.
» MORE: Best Medicare Advantage plans
If you need additional guidance, you can get free, unbiased Medicare counseling through your State Health Insurance Assistance Program, or SHIP. Visit shiphelp.org to find yours.
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- 1. Centers for Medicare & Medicaid Services. When does Medicare coverage start?. Accessed Mar 2, 2026.
- 2. Social Security Administration. Medicare. Accessed Mar 2, 2026.
- 3. Social Security Administration. Medicare information. Accessed Mar 2, 2026.
- 4. Centers for Medicare & Medicaid Services. End-State Renal Disease (ESRD). Accessed Mar 2, 2026.
- 5. Centers for Medicare & Medicaid Services. Avoid late enrollment penalties. Accessed Mar 2, 2026.
- 6. Centers for Medicare & Medicaid Services. Special Enrollment Periods. Accessed Mar 2, 2026.
