How to Sign Up for Medicare When You Turn 65

You sign up during your Initial Enrollment Period, which starts three months before the month you turn 65

Your Initial Enrollment Period lasts seven months total: it begins on the first day of the third month before your 65th birthday and ends on the last day of the month after you turn 65. For example, if you turn 65 in June, your period runs from March 1 through July 31. You can sign up anytime during those seven months, but signing up early matters because coverage does not start the same day you enroll.

Most people sign up online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. You do not need to wait until your birthday month — you can start the process as soon as your Initial Enrollment Period opens. If you miss this window, you may face a permanent penalty on your premiums, so the timing is worth getting right.

Key Takeaways

• Your Initial Enrollment Period is seven months long, starting three months before you turn 65, and you can sign up anytime during it.
• You will need your Social Security number, birth date, citizenship or immigration status, and information about current health coverage when you sign up.
• Medicare Part A (hospital insurance) is usually free if you or your spouse paid Medicare taxes for at least 10 years; Part B (medical insurance) has a monthly premium.
• You choose between Original Medicare (Parts A and B) plus a separate drug plan, or a Medicare Advantage plan that bundles hospital, medical, and drug coverage.
• If you sign up late without a valid reason, you will pay a higher premium for as long as you have Medicare.

What documents and information you need before you start

Gather your Social Security number, birth date, and citizenship or immigration status before you open an application. You will also need the name and phone number of your current health insurance provider if you have coverage through an employer or union — Medicare needs to know whether your current plan is still active so it can coordinate benefits correctly.

If you are signing up online at Medicare.gov, you can create an account using your email address and a password, then return to finish the application later if you need to. If you are calling 1-800-MEDICARE, a representative will walk you through the questions and can answer them as you go. Either way, the process takes 15 to 30 minutes.

Choosing between Original Medicare and Medicare Advantage

You will make your first major choice during enrollment: Original Medicare (Part A for hospital care and Part B for doctor visits and outpatient services) or a Medicare Advantage plan (Part C, which is a private insurance plan that covers hospital, medical, and usually drug services all in one). This choice shapes your costs, your doctors, and your coverage for the rest of the year.

Original Medicare lets you see any doctor or hospital that accepts Medicare, with no referrals required. You pay a monthly premium for Part B (the amount changes yearly), a deductible when you use services, and coinsurance (a percentage of the cost). You also need a separate prescription drug plan (Part D) unless you have coverage elsewhere. Medicare Advantage plans have lower or zero monthly premiums in many cases, but they limit you to a network of doctors and hospitals, require referrals for specialists, and may have higher out-of-pocket costs when you use services. Both options cover the same basic services; the difference is how you pay and which providers you can use.

You do not have to decide right now which is better for you — you can change your choice during the Annual Enrollment Period (October 15 through December 7 each year) if you change your mind after you start.

Signing up for Part D (prescription drug coverage) if you choose Original Medicare

If you enroll in Original Medicare, you must also choose a Part D prescription drug plan during your Initial Enrollment Period, or you will pay a penalty if you sign up later. Part D is sold by private insurance companies, not by Medicare directly, so you will see a list of plans available in your area and their costs for the drugs you take.

Medicare.gov has a tool called the Prescription Drug Plan Finder where you can enter the medications you take and see which plans cover them and at what cost. The plans change every year, so even if you had Part D before, you should check the current options during your enrollment period. You can enroll in Part D at the same time you enroll in Parts A and B, or separately — either way, it must happen during your Initial Enrollment Period to avoid a penalty.

What happens after you sign up

After you submit your application, Medicare will send you a confirmation letter in the mail within two weeks. This letter tells you your Medicare number, which coverage you chose, and when your coverage starts. Your coverage start date depends on when you signed up: if you enroll between the first and 15th of any month, coverage starts on the first day of the next month; if you enroll between the 16th and the end of the month, coverage starts on the first day of the month after that.

You will receive your Medicare card in the mail before your coverage starts. Keep it with you when you see a doctor or go to a hospital. If you chose Original Medicare, your Part D insurance company will also send you a separate card. If you chose Medicare Advantage, your plan will send you an insurance card that replaces your Medicare card for most purposes.

What to do if you miss your Initial Enrollment Period

If you do not sign up during your seven-month Initial Enrollment Period and you do not have a valid reason for the delay, you will pay a permanent penalty on your Part B and Part D premiums for as long as you have Medicare. The penalty is 10 percent of the Part B premium for each full year you were not enrolled, and 1 percent of the Part D premium for each month you were not enrolled. These penalties do not go away even if you sign up later.

A valid reason for late enrollment includes being covered by an employer or union health plan while you were still working, being a federal employee with federal health benefits, or being a non-citizen who was not yet a permanent resident. If you have one of these reasons, you can sign up without a penalty during a Special Enrollment Period. Call 1-800-MEDICARE to explain your situation and ask whether you may have access to.

Frequently Asked Questions

Can I sign up before I turn 65?

Yes. Your Initial Enrollment Period starts three months before your birthday, so you can sign up as early as then. Signing up early is a good idea because it gives you time to receive your Medicare card before your coverage starts and to ask questions if something is unclear.

Do I have to sign up online, or can I do it by phone or in person?

You can sign up any way that works for you. Medicare.gov is the fastest if you are comfortable online. Calling 1-800-MEDICARE connects you to a representative who can answer questions as you go. Your local Social Security office can also help you sign up in person if you prefer to do it face-to-face.

What if I am still working and have health insurance through my job?

You can delay signing up for Part B without a penalty as long as your employer coverage is active and you are still working. When you leave your job or lose that coverage, you have eight months to sign up for Part B without a penalty. You still need to sign up for Part A during your Initial Enrollment Period, even if you delay Part B.

Can I change my mind after I sign up?

Yes, but timing matters. During your Initial Enrollment Period, you can change your choice of Original Medicare or Medicare Advantage as many times as you want. After that, you can change plans only during the Annual Enrollment Period (October 15 through December 7) or if you may have access to for a Special Enrollment Period because of a major life change.

What if I am not a U.S. citizen?

You must be a U.S. citizen or a permanent resident (green card holder) who has lived in the United States for at least five years to sign up for Medicare. When you apply, you will need to provide proof of your immigration status. If you are not yet a permanent resident, you may still be able to sign up if you have been lawfully present in the United States for at least five years — call 1-800-MEDICARE to discuss your specific situation.