Topics on this page:
- If You Are Approaching or at Age 65
- If You Are Younger than Age 65 with a Disability
- If You Have End-Stage Renal Disease (ESRD)
- If You Have Amyotrophic Lateral Sclerosis (ALS)
- If You Delay Enrolling in Part B
1. If You Are Approaching or at Age 65
If you are approaching age 65 and you already receive Social Security or Railroad Retirement benefits through early retirement, you will be automatically enrolled in Medicare Parts A (hospital insurance) and B (medical insurance) when you turn 65. Approximately 3 months prior to your 65th birthday, Medicare will send you an initial enrollment package containing general information about Medicare, a questionnaire and your red-white-and-blue Medicare card.
If you receive the initial enrollment package and you want both Medicare Part A (hospital insurance) and Part B (medical insurance), simply sign your Medicare card and keep it in your wallet.
If you are approaching age 65 and you’re not receiving early retirement Social Security or Railroad Retirement benefits, you can apply for Medicare during your 7-month initial enrollment period (IEP). Your IEP begins 3 months before you turn 65, includes the month of your birthday and ends 3 months later. Note: To apply for Medicare Parts A and B, you must contact the Social Security Administration at ssa.gov or 1-800-772-1213. You will also need to sign up separately for a Part D plan to cover your prescription drug benefits. Learn more about Medicare Part D.
2. If You Are Younger than Age 65 with a Disability
If you are younger than age 65 and receive disability benefits under Social Security Disability Insurance (SSDI) or Railroad Retirement, you will automatically be enrolled in Medicare Parts A and B in the 25th month of your disability payments, or sooner if you have either end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). You will need to sign up separately for a Part D plan to cover your prescription drug benefits.
During the 24th month of your SSDI payments, Medicare will send you an initial enrollment package containing general information, a questionnaire and your Medicare card.
If you want both Medicare Part A (hospital insurance) and Part B (medical insurance), simply sign your Medicare card and keep it in your wallet.
3. If You Have End-Stage Renal Disease (ESRD)
If you have end-stage renal disease (ESRD), also known as permanent kidney failure, you can get Medicare Parts A and B within 3 months of your first dialysis treatment. If you are unable to work, you will need to file for SSDI to receive monthly payments. You can also get Medicare if you are not receiving SSDI benefits if you meet one of the following conditions:
- You have worked long enough under Social Security (40 quarters), the Railroad Retirement Board or as a Medicare-qualified government employee.
- You are receiving or are eligible for Social Security, Railroad Retirement or Office of Personnel Management benefits.
- You are the spouse or dependent child of a person who has worked the required amount of time under Social Security, the Railroad Retirement Board or as a Medicare-qualified government employee, or who is receiving Social Security, Railroad Retirement or federal retirement benefits.
You will need to sign up separately for a Part D plan to cover your prescription drug benefits. See our fact sheet: Medicare and People with End-Stage Renal Disease (ESRD) (PDF).
4. If You Have Amyotrophic Lateral Sclerosis (ALS)
If you have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, you will be automatically enrolled in Medicare Parts A and B when you begin receiving SSDI payments (congress waived the 24-month waiting period for people with this condition). You will need to sign up separately for a Part D plan to cover your prescription drug benefits.
5. If You Delay Enrolling in Part B
If you do not want Part B coverage because you are actively employed and covered by the employer plan and you automatically received Medicare’s initial enrollment package, sign the included form and check the box next to “I do not want medical insurance.” Return the form to the Social Security Administration in the provided envelope before the date listed so you won’t owe a monthly premium.
If you turn down Part B and don’t have other coverage due to active employment, but later decide you want Part B coverage, you can only enroll during the annual General Enrollment Period (GEP), which is January 1 through March 31. Your Part B benefits will not be effective until July 1 of that year. You may also be required to pay a late enrollment penalty of 10% of the current Part B premium for each 12-month period you could have had Part B coverage, but did not take it.
For beneficiaries age 65 and older, this penalty is for life, and you will always pay more for your Part B coverage than other people.
If you are younger than age 65, have Medicare because of a disability and are charged the Part B penalty, it will be waived when you turn 65 and qualify for Medicare based on age.
Note: If you or your spouse is actively employed and you or your spouse are covered by the employer’s group health plan, you may not need Part B or Part D. When your employer coverage or employment ends (whichever is earlier), you will have a Special Enrollment Period (SEP) for Part B and a Special Election Period for Part D, and will not be penalized for late enrollment if you sign up for:
- Part B within 8 months
- Part D within 2 months
Learn more about Medicare & Other Health Insurance Coverage.
Note: If you have ESRD, you do not have the same SEP for Part B. See our fact sheet: Medicare and People with End-Stage Renal Disease (ESRD) (PDF)
