When Does Medicare Start?
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Your Medicare coverage start date depends on when you sign up, but most people first get coverage at age 65.
Medicare usually starts on the first of the month after you enroll, but that timeframe may differ depending on why you're eligible for Medicare. When you're eligible for Medicare and when Medicare starts are two different things, but they both affect when your coverage starts. Most people are eligible because of their age, but you may get coverage sooner if you have a disability, Lou Gehrig’s Disease or kidney failure.
When does Medicare start?
Your Medicare start date depends on when you apply for coverage and why you're eligible for Medicare. Most people are eligible at age 65.
Medicare groups the times you can enroll into three enrollment periods.
- Initial enrollment period (IEP): This is when you are first eligible for Medicare, and it lasts seven months. If you qualify for Medicare because of your age, your 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): Between Jan. 1 and March 31 each year, anyone who is eligible for Medicare can enroll. You'll typically pay late enrollment penalties if you enroll during general enrollment instead of your initial enrollment period.
- Special enrollment period (SEP): These periods allow you to enroll after your initial enrollment without facing late penalties. Examples of a special enrollment period include delaying Medicare while you still have coverage from your employer, missing your initial enrollment due to a natural disaster or emergency, or losing Medicaid coverage on or after Jan. 1, 2023.
Medicare coverage always starts on the first of the month.
The specifics of when your coverage starts depend on why you're eligible and when you enroll.
Age
Disability
Kidney failure
Lou Gehrig’s Disease
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 why you qualify for a special enrollment period
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 why you qualify for a special enrollment period
Disability
When are you eligible? After 24 months of receiving Social Security disability payments
When does Medicare start?
-
If you sign up during initial enrollment: The 25th month of receiving Social Security disability payments
- 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 vary based on why you qualify 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 coverage can be backdated up to 12 months
- If you sign up during general enrollment: The month after you sign up
- If you sign up during special enrollment: There is no special enrollment period for people with kidney failure
Lou Gehrig’s Disease
When are you eligible? The first month you receive 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
Medicare effective dates can be confusing. Understanding when to apply based on your situation can help get your Medicare started on time so you avoid late enrollment fees or gaps in health coverage.
At what age does Medicare start?
Medicare starts the month you turn 65 or the month after, depending on when you sign up.
You're automatically enrolled in Medicare at age 65 if you are getting Social Security benefits. If you are not receiving Social Security, you must sign up manually. You can apply online or by phone with the Social Security Administration, or you can visit your local Social Security office.
- Initial enrollment: If you're eligible for Medicare because of your age, your initial enrollment period begins three months before you turn 65, includes the month you were born and ends three months after you turn 65. If you sign up before your birthday, your coverage will start on the first of the month that you turn 65. If you sign up during or after your birth month, your coverage starts on the first of the next month.
- General enrollment: If you enroll in Medicare during the annual general enrollment period, your coverage starts on the first of the month after you've signed up. You may pay late enrollment penalties.
- Special enrollment: Your Medicare start date will depend on why you qualified for a special enrollment period. For example, if you use a special enrollment period because a natural disaster caused you to miss your other changes to sign up, your Medicare will start on the first of the month after you enroll. But if you qualify for a special enrollment period because you've lost your Medicaid coverage, you can choose to either start your coverage the day you lose Medicaid or the first day of the next month.
When does Medicare start for those with disabilities?
If you qualify for Medicare because of a disability, coverage starts after you've received Social Security disability benefits for two years.
You'll be automatically enrolled in Medicare if you get 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 or qualify for a special enrollment period.
- Initial enrollment: In most cases, you're automatically enrolled in Medicare after you've received disability benefits for 24 consecutive months. Your coverage starts on the first day of the 25th month of disability benefits.
- General enrollment: If you weren't automatically enrolled during your initial enrollment and you don't qualify for a special enrollment period, you can enroll during general enrollment between Jan. 1 and March 31. Your Medicare coverage would start the following month. You may pay late enrollment penalties.
- Special enrollment: If you have a disability, you usually qualify for a special enrollment period if you've lost employer coverage you had yourself or through a family member. Your Medicare coverage will start the month after you enroll. If you qualify for special enrollment for another reason, your state date will vary.
When does Medicare start with kidney failure?
Medicare coverage due to kidney failure usually starts right away.
Qualifying for Medicare for kidney failure (also called End-Stage Renal Disease or ESRD) is a bit different than other qualifications. If you're eligible and don't sign up immediately, you can backdate your coverage to when you were first eligible. For example, if you became eligible in June but didn't sign up until December, you could backdate your coverage to June.
- Initial enrollment: Your Medicare start date during this period varies based on the type of treatment you need. For example, if you're on dialysis, your coverage will usually start on the first day of the fourth month of treatment. In some cases, you may qualify for immediate coverage, but remember that Medicare coverage for kidney failure patients can be backdated.
- General enrollment: If you don't enroll in Medicare when you are first eligible, you must wait for general enrollment and possibly pay late enrollment penalties. Your Medicare would start on the first of the month following enrollment.
- Special enrollment: Because Medicare for kidney failure operates a bit differently than it does for other qualifications, there's no specific special enrollment period for it.
To qualify for Medicare based on kidney failure, you must meet strict requirements. You must have ESRD, and you have to need continuing dialysis or have had a kidney transplant. One of the following factors also has to apply:
- You must also have worked the amount of time required by either Social Security, the Railroad Retirement Board or for the government.
- You already get or are eligible to get Social Security or Railroad Retirement benefits.
- You're married to or a dependent child of someone who meets one of those requirements.
When does Medicare start with Lou Gehrig's Disease?
For patients with Lou Gehrig's Disease, also called ALS, Medicare coverage starts as soon as Social Security benefits do.
Because Lou Gehrig's Disease can progress quickly, there is no waiting period for ALS patients to sign up for Medicare. You must be receiving Social Security or Railroad Retirement benefits to qualify, but you're eligible for coverage the first month you get disability benefits.
- Initial enrollment: Medicare coverage begins as soon as disability benefits take effect. 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 begins right away.
- General enrollment: If you wait for the general enrollment period, your Medicare starts on the first of the month following your enrollment. You may pay late enrollment penalties.
- Special enrollment: The start date of your Medicare coverage will vary based on why you qualify for special enrollment. If you continue working after your ALS diagnosis, for example, you could enroll in Medicare under a special enrollment period when your employer coverage ends. Your coverage would begin on the first of the month after you enroll.
Frequently asked questions
Does Medicare automatically start at age 65?
Yes, Medicare automatically starts at age 65 if you contributed to Social Security while working and received benefits for at least four months. Your application for Social Security benefits is also your application for Medicare, and you should receive a notice in the mail when you are automatically enrolled. If you have applied for Social Security benefits, you can still apply for Medicare when you turn 65.
Will Medicare start at 62?
You can get Medicare at age 62 only if you qualify because of a disability, Lou Gehrig's Disease or kidney failure. If you are only eligible based on your age, Medicare starts at age 65.
Does Medicare start on your birthday?
No, Medicare always starts on the first of the month. Say you qualify because of your age and sign up during your initial enrollment period. If you enroll in the three months before your birth month, coverage will start the first of the month that you turn 65. If your birthday is on the first day of the month, your coverage starts on the first of the previous month. If you sign up during or after your birth month, coverage starts on the first of the month after you enroll.
Methodology
Information on Medicare enrollment periods, enrollment qualifications, different ways to qualify, eligibility and start dates was obtained from Medicare.gov, CMS.gov, SSA.gov and the U.S. Department of Health and Human Services at HHS.gov.
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