When Does Medicare Start?
Medicare starts at age 65 for most people.
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You're automatically signed up for Medicare when you turn 65 if you're getting Social Security benefits. If you choose to put off Social Security, you have to sign up for Medicare manually at 65 or wait until Jan. 1 when the general enrollment period starts.
People younger than 65 can get Medicare if they have Lou Gehrig's disease (ALS) or kidney failure. You can also sign up for Medicare at any age if you've gotten Social Security disability benefits for at least two years in a row.
When does Medicare start?
Medicare starts at age 65 for most people.
Typically, the government enrolls you in Original Medicare (Parts A and B) when you start getting Social Security benefits. Your Medicare Part B (coverage for doctor visits) monthly rate automatically comes out of your Social Security payments.
You can choose to delay coverage with no penalty if you or a spouse has health insurance through work. Otherwise, you may end up paying a higher monthly rate if you don't get Social Security at 65 and you forget to sign up for Medicare.
You can enroll in Medicare if you're under the age of 65 if you have Lou Gehrig's disease (ALS), you have kidney failure or you've gotten Social Security disability payments for 24 months in a row.
Medicare enrollment periods
Initial enrollment period (IEP)
General enrollment period (GEP)
Special enrollment period (SEP)
Initial enrollment period (IEP): This is when you can first get Medicare, and it lasts seven months.
The initial enrollment period starts three months before you turn 65, includes your birth month and ends three months after you turn 65.
Initial enrollment period (IEP)
Initial enrollment period (IEP): This is when you can first get Medicare, and it lasts seven months.
The initial enrollment period starts three months before you turn 65, includes your birth month and ends three months after you turn 65.
General enrollment period (GEP)
Special enrollment period (SEP)
Qualified reasons for a special enrollment period include delaying Medicare while you still have coverage from your employer, missing your initial enrollment because of a natural disaster or emergency or losing Medicaid coverage.
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Medicare coverage always starts on the first of the month.
For most people, Medicare starts on the first day of the month you turn 65. You can expect your benefits to begin immediately if you have kidney failure. With Lou Gehrig's disease, coverage starts the same month your Social Security payments begin.
If you're getting Social Security disability benefits, coverage starts after 24 months of uninterrupted payments.
Age
When are you eligible? Age 65
When does Medicare start?
- If you sign up during initial enrollment: Either the month you turn 65 or the month after you sign up
- If you sign up during general enrollment: The month after you sign up
- If you sign up during special enrollment: Depends on what lets you qualify for a special enrollment period
Disability
When are you eligible? After 24 months of getting Social Security disability payments
When does Medicare start?
- If you sign up during initial enrollment: After getting Social Security disability payments for 24 months, you should automatically get coverage for Medicare Parts A and B starting on your 25th month
- If you sign up during general enrollment: The month after you sign up
- If you sign up during special enrollment: Usually the month after you sign up, but it could differ depending on why you're eligible for special enrollment
Kidney failure
When are you eligible? When you have kidney failure and you need regular dialysis or have had a kidney transplant
When does Medicare start?
- If you sign up during initial enrollment: Immediately, and the government may start your coverage up to one year in the past, depending on when your symptoms started
- If you sign up during general enrollment: The month after you sign up
- If you sign up during special enrollment: Special enrollment isn't an option for people with kidney failure
Lou Gehrig’s disease
When do you qualify? The first month you get Social Security disability benefits for ALS
When does Medicare start?
- If you sign up during initial enrollment: As soon as Social Security disability benefits begin
- If you sign up during general enrollment: The month after you sign up
- If you sign up during special enrollment: Usually the month after Social Security gets your request or the first day of the next month, depending on why you qualify for special enrollment
Understanding when to apply based on your situation can help get your Medicare started on time. This will help you avoid late enrollment fees or gaps in health coverage.
At what age does Medicare start?
Medicare starts when you turn 65.
The government automatically enrolls you in Medicare at age 65 if you get Social Security benefits. If you've chosen to delay Social Security payments, you can apply online or by phone with the Social Security Administration. You can also visit your local Social Security office in person.
Generally, your Medicare coverage will start on the first day of the month after you sign up. But, there are two exceptions to this rule.
- If you sign up in the three months before your 65th birthday, your Medicare coverage will start on the first day of your birthday month. For example, your Medicare coverage would start on April 1 if your birthday is April 16 and you enrolled in Medicare on Feb. 3.
- If you qualify for a Medicare special enrollment period because you've lost your Medicaid coverage, you can choose to start Medicare on the day you lost your Medicaid benefits or on the first day of the next month.
When do you have to sign up for Medicare?
You need to sign up for Medicare when you turn 65 if you don't have regular health insurance.
If you don't enroll in Medicare at age 65, you may have to pay a penalty. The size of your penalty depends on how long you wait before you sign up. These penalties only raise rates for certain parts of Medicare.
Medicare late enrollment penalties
- Medicare Part B (doctor visits): You'll pay a 10% late fee on your monthly rate for every year you delayed signing up for Part B coverage. This penalty never goes away.
- Medicare Part D (prescription drugs): You may pay a late enrollment penalty if you wait to get Part D drug coverage, unless you qualify for subsidies if you earn a low income or you had prescription drug coverage that meets certain qualifying conditions. You'll pay an extra 1% of your rate for every month that you delayed coverage. This penalty lasts for as long as you have Part D coverage.
You won't usually get a penalty if you qualify for a Medicare special enrollment period. These are given for events like moving back to the U.S. after living abroad, losing Medicaid coverage or leaving jail or prison.
Medicare Part A late enrollment penalty
You only get a late penalty fee for Medicare Part A (hospital stays) if you haven't paid at least 10 years of Social Security taxes. Part A is free for 99% of Medicare enrollees because it's funded by taxes you pay while you're working.
The remaining 1% of people with Medicare Part A have to pay a monthly premium. If you're in this group, your monthly rate will go up by 10% for twice as many years as you delayed coverage. For example, if you signed up one year late, then you'd have to pay this extra cost for two years.
When to sign up for Medicare before turning 65
Sign up for Medicare during the three months before your 65th birthday if you're not taking Social Security payments.
You can sign up for Medicare before you turn 65 if you have Lou Gehrig's disease (ALS) or kidney failure. You'll also be automatically enrolled in Medicare if you've gotten two years of disability benefits from Social Security or the Railroad Retirement Board. If you miss your initial enrollment or aren't automatically enrolled, you'll need to wait for general enrollment unless you can get a special enrollment period.
- Initial enrollment: In most cases, you automatically get enrolled in Medicare after getting disability benefits for 24 months in a row. Your coverage starts on the first day of the 25th month of disability benefits.
- General enrollment: If the government didn't automatically enroll you during your initial enrollment and you don't qualify for a special enrollment period, you can enroll between Jan. 1 and March 31, called general enrollment. Your Medicare coverage would start the following month. You may pay late enrollment penalties.
- Special enrollment: If you have a disability, you usually become eligible for a special enrollment period if you've lost your workplace health insurance (through your employer or a family member). Your Medicare coverage will start the month after you enroll. If you become eligible for special enrollment for another reason, your start date may differ.
When does Medicare start with kidney failure?
Medicare coverage due to kidney failure usually starts right away.
You can also start your coverage in the past when you first became eligible for Medicare, which is called backdating. That means Medicare will pay for some or all of your existing medical bills. For example, if you qualified for Medicare because of kidney failure in June but didn't sign up until December, your coverage would start from June onward.
When does Medicare start with Lou Gehrig's disease (ALS)?
For patients with Lou Gehrig's disease (ALS), Medicare coverage starts when you start getting Social Security benefits.
Because Lou Gehrig's disease can progress quickly, you can sign up for Medicare immediately if you have ALS. You need to have Social Security or Railroad Retirement benefits to qualify, but you get coverage the first month you have disability benefits.
There's a five-month waiting period for Social Security or Railroad Retirement benefits, and you'll begin getting benefits in the sixth month. At that point, you're eligible for Medicare and your coverage starts right away.
Frequently asked questions
When does Medicare start?
Medicare typically starts when you turn 65. You can get Medicare coverage at any age if you have Lou Gehrig's disease (ALS), you have kidney failure or you've gotten Social Security disability payments for two years in a row.
Do I automatically get Medicare when I turn 65??
Yes, you automatically get Medicare when you turn 65, unless you've delayed getting your Social Security payments. In that case, you need to contact Social Security directly online, over the phone or in a local office to sign up.
Does Medicare start on your birthday?
No, Medicare always starts on the first day of the month. For example, if you turn 65 on April 15, then your Medicare coverage would start on April 1.
Methodology
Information on Medicare enrollment periods, enrollment qualifications, different ways to qualify, eligibility and start dates came from Medicare.gov, CMS.gov, SSA.gov and the U.S. Department of Health and Human Services at HHS.gov.
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