When you turn 65, you may be considering retirement, prioritizing time with family and navigating how to spend your golden years. But this milestone birthday comes with another important marker: eligibility for Medicare.
Understanding how and when to will allow you to secure health care coverage and avoid late penalties as you enter this new chapter.
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When Are You Eligible for Medicare?
You are generally eligible for coverage if you meet the following criteria:
— You are age 65 or older.
— You are a U.S. citizen or a legal resident who has lived in the United States for at least five continuous years.
— You are eligible for monthly Social Security or Railroad Retirement Board (RRB) benefits.
Eligibility under age 65 if you have a disability
There are exceptions to Medicare eligibility if you meet specific and are under age 65.
| Special Circumstance | Qualification Timeline |
| You have . | You qualify once you have received dialysis for three months or you’ve been admitted to the hospital for a kidney transplant. |
| You have , also known as Lou Gehrig’s disease. | You qualify immediately upon collecting Social Security Disability benefits, with no waiting period. |
| You have another disability. | Generally, qualification kicks in once you’ve received disability benefits for 24 months. |
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When to Sign Up for Medicare
Medicare’s initial enrollment period begins three months before your 65th birthday and ends three months after your birthday month. If you are receiving Medicare based on disability, the enrollment period may vary depending on your disability eligibility.
Key Medicare to know include:
| Enrollment Periods | Details |
| Initial enrollment | The seven-month period when you are first eligible to sign up for Medicare |
| General enrollment | January 1 to March 31 each year, when you can enroll in Medicare parts A or B if you missed initial enrollment |
| Medicare Advantage open enrollment | January 1 to March 31 each year, when those already enrolled in a can switch to another Medicare Advantage plan or return to original Medicare |
| Open enrollment | October 15 to December 7 each year, when you can enroll in Medicare Advantage or switch plans, or add or change coverage |
| Special enrollment period | Based on your personal circumstances, so the timeframe varies. For example, if your employer-sponsored health plan is no longer available, you will receive a special enrollment period to elect original Medicare or a Medicare Advantage plan. |
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How Enrollment Works: Automatic vs. Manual
How you’re enrolled depends on the benefits you do or do not have as you get closer to your birthday.
If you receive Social Security Disability or RRB benefits:
You will receive an information packet a few months before you turn 65 or after your 25th month of SSD or RRB benefits.
This information should cover:
— When your Medicare coverage starts
— What steps, if any, you may need to perform to complete your enrollment
In most cases, however, you’ll be automatically enrolled in original Medicare at least four months before your birthday.
If you do not receive Social Security Disability or RRB benefits:
You’ll need to manually sign up for Medicare by:
— Visiting your local Social Security office
— online for Medicare without retiring at
— Calling 1-800-772-1213, or TTY users can call 1-800-325-0778
You should start preparing for this enrollment before your 65th birthday to or costly penalties. Most people are not automatically enrolled in Medicare, says Scott Maibor, the managing director at Senior Benefits Boston LLC in Massachusetts.
“This is important because if you do not enroll when required, there are lifetime penalties applied for that simple mistake,” he explains.
What Are the Late Penalties If You Don’t Sign Up?
Late penalties for not enrolling in Medicare on time include:
| Medicare Coverage | Late Penalty Qualifications | Cost |
| Medicare Part A late penalty | You will only have a late penalty if you don’t qualify for premium-free Part A because you did not work for at least 10 years and pay Medicare taxes through your employer or self-employment tax. | Your monthly premium will increase by 10% for twice the number of years that you were eligible for Medicare Part A but didn’t sign up. |
| Medicare Part B late penalty | You will only have to pay a late penalty if you don’t qualify for a special enrollment period. | Your monthly premium will increase by 10% for each year that you were eligible for Medicare Part B but didn’t sign up. |
| You will only have to pay a late penalty if you did not have creditable coverage and you don’t qualify for Medicare Extra Help. | Your monthly premium will increase by 1% for each month you were eligible for Medicare Part D and didn’t sign up. |
Medicare With Medicaid or Employer-Sponsored Health Plans
It can be confusing to balance Medicare eligibility with or with employer-sponsored health plans if you are working after age 65.
Medicaid
You might be for both Medicare and Medicaid coverage. Check with your state Medicaid office or a to help answer your questions about dual enrollment.
“They will provide free advice and educational materials. They are really helpful,” says Sharona Hoffman, a Cleveland-based professor of law and bioethics at Case Western Reserve University.
Employer-sponsored health plans
Many older adults assume they cannot enroll in Medicare if they are still working, but Maibor says this is not true. In some instances, Medicare is better than their employer’s group plan, he adds.
If you have questions and are employed, speak with someone in your Human Resources office, advises Hoffman, who is also the co-director of the university’s Law-Medicine Center and author of “Aging With a Plan.”
According to the , most retiree and small employer plans with fewer than 20 employees require their employees to sign up for Medicare Part A and Medicare Part B as soon as they are eligible.
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Update 06/23/26: This story was published at an earlier date and has been updated with new information.
