Turning 65 is a big milestone. And one of the most important things you need to do is sign up for Medicare. But the process can feel confusing if you’ve never done it before.
Don’t worry. Signing up for Medicare is easier than you think. This guide walks you through every step in plain, simple language.
Are You Automatically Enrolled?
Some people are automatically enrolled. Others need to sign up themselves. Here’s how to tell:
You ARE automatically enrolled if:
- You are already receiving Social Security benefits when you turn 65
- You are already receiving Railroad Retirement Board benefits when you turn 65
If you’re automatically enrolled, your Medicare card will arrive in the mail about 3 months before your 65th birthday. You’ll be enrolled in both Part A and Part B. You don’t need to do anything.
You are NOT automatically enrolled if:
- You have not started receiving Social Security benefits yet
- You are still working and haven’t claimed Social Security
- You are under 65 and becoming eligible through disability
If you’re not automatically enrolled, you must sign up yourself. Keep reading for exactly how to do it.
When to Sign Up
You need to sign up during your Initial Enrollment Period (IEP). This is a 7-month window around your 65th birthday:
- Starts: 3 months before the month you turn 65
- Includes: Your birthday month
- Ends: 3 months after the month you turn 65
Example: If you turn 65 in July 2026, your window runs from April 2026 through October 2026.
Sign up in the first 3 months if possible. This ensures your coverage starts the month you turn 65. If you wait until later in the window, your coverage start date gets pushed back.
For a complete breakdown of all enrollment deadlines and periods, read our detailed guide.
How to Sign Up: 3 Easy Options
Option 1: Online (Fastest)
This is the easiest way. Takes about 10-15 minutes.
- Go to ssa.gov/medicare
- Click “Apply for Medicare Only” (or “Apply for Medicare and Social Security” if you want both)
- Fill in your personal information — name, date of birth, Social Security number
- Answer the questions about your current coverage
- Review and submit
That’s it. You’ll receive a confirmation and your Medicare card will arrive by mail.
You can apply online up to 4 months before you want coverage to start. The website is available 24/7.
Option 2: By Phone
Call Social Security at 1-800-772-1213. They’ll walk you through the process over the phone.
- Hours: Monday through Friday, 8am to 7pm local time
- TTY: 1-800-325-0778
- Best time to call: early morning or late afternoon (shorter wait times)
Have this information ready when you call:
- Your Social Security number
- Your date of birth
- Information about your current health insurance (if any)
- Information about your employer (if you’re still working)
Option 3: In Person
Visit your local Social Security office. Bring the same information listed above plus a photo ID.
Find your nearest office at ssa.gov/locator or call 1-800-772-1213 to find the closest location.
Tip: Make an appointment before going. Walk-in visits can have long wait times.
What You’re Signing Up For
When you sign up for Medicare, you’re enrolling in Original Medicare:
Part A (Hospital Insurance):
- Covers hospital stays, skilled nursing, hospice, home health care
- $0 per month for most people
- You should always enroll in Part A — there’s no reason not to
Part B (Medical Insurance):
- Covers doctor visits, outpatient care, preventive services
- $202.90 per month in 2026
- You need this unless you have qualifying employer coverage
You’ll choose Part A only or Part A and Part B together during the sign-up process. Most people should sign up for both.
What Happens After You Sign Up
Your Medicare Card Arrives
After you sign up, you’ll receive your red, white, and blue Medicare card in the mail. This card shows:
- Your Medicare number
- Whether you have Part A, Part B, or both
- When your coverage starts
Keep this card safe. You’ll need it at every doctor visit and hospital stay.
Choose Your Additional Coverage
Original Medicare (Part A + Part B) is a great start. But it doesn’t cover everything. After signing up, you need to decide on additional coverage:
Part D — Prescription Drug Plan You need this for prescription medications. Without it, you pay full price for drugs AND face a late penalty later. Sign up for Part D at the same time as Part A and Part B.
Medigap — Medicare Supplement Plan This covers the 20% coinsurance and deductibles that Original Medicare doesn’t pay. Your Medigap Open Enrollment Period starts the month you turn 65 and have Part B. This is the best time to buy Medigap — guaranteed acceptance regardless of health.
OR
Medicare Advantage — Part C Instead of Original Medicare + Medigap + Part D, you can choose a Medicare Advantage plan that bundles everything together. Many plans charge $0 extra per month and include dental, vision, and hearing.
You must choose one path or the other:
- Path 1: Original Medicare + Part D + Medigap
- Path 2: Medicare Advantage (replaces everything)
Read our Medicare Advantage vs Medigap comparison to decide which is right for you.
What If You’re Still Working at 65?
If you’re still working and have health insurance through your employer, you have options:
If your employer has 20 or more employees:
- Sign up for Part A (it’s free — no reason not to)
- You can delay Part B without penalty as long as you have employer coverage
- When you retire or lose employer coverage, you get a Special Enrollment Period — 8 months to sign up for Part B penalty-free
- Get written confirmation from your employer that your coverage is “creditable” — save this document
If your employer has fewer than 20 employees:
- Sign up for both Part A and Part B during your Initial Enrollment Period
- Medicare becomes your primary insurance
- Your employer plan becomes secondary
- Failing to sign up for Part B means your employer plan may not cover you properly
If your spouse’s employer covers you, the same rules apply based on the employer’s size.
When in doubt, call Social Security at 1-800-772-1213 and explain your situation. They’ll tell you exactly what to do.
Common Mistakes to Avoid
Mistake 1: Waiting Too Long
The biggest mistake is missing your Initial Enrollment Period. If you don’t sign up on time and don’t have qualifying employer coverage, you’ll pay a late enrollment penalty — 10% higher Part B premium for every year you were late. This penalty lasts forever.
Mistake 2: Assuming You’re Automatically Enrolled
If you’re not receiving Social Security at 65, you are NOT automatically enrolled. You must sign up yourself. Don’t assume it happens on its own.
Mistake 3: Forgetting Part D
Many people sign up for Part A and Part B but forget about Part D (prescriptions). If you don’t sign up for Part D when first eligible and don’t have other drug coverage, you’ll pay a penalty when you eventually do sign up.
Mistake 4: Not Buying Medigap During Open Enrollment
Your Medigap Open Enrollment Period is the only time you’re guaranteed acceptance into a Medigap plan regardless of health. Miss it, and you may be denied or charged more later.
Mistake 5: Not Checking Employer Coverage Rules
If you’re still working, talk to your HR department AND Social Security before making any decisions. The rules about employer coverage and Medicare are complicated. One wrong move could leave you uninsured or paying penalties.
Mistake 6: Signing Up for Medicare Advantage Without Comparing
Don’t just pick the first Medicare Advantage plan you see. Compare multiple plans. Check that your doctors are in network. Check that your medications are covered. Use Medicare.gov Plan Finder to compare options.
Step-by-Step Checklist
Here’s your complete checklist for signing up for Medicare:
6 months before you turn 65:
- Start researching Original Medicare vs Medicare Advantage
- Make a list of your current doctors
- Make a list of your current medications
- Talk to your employer’s HR department if you’re still working
3 months before you turn 65:
- Sign up for Medicare Part A and Part B at ssa.gov/medicare or call 1-800-772-1213
- Compare Part D plans at Medicare.gov
- If choosing Medigap, compare plans from 3-4 insurance companies
- If choosing Medicare Advantage, compare plans at Medicare.gov
The month you turn 65:
- Confirm your Medicare card has arrived
- Enroll in Part D or Medicare Advantage
- Enroll in Medigap if you’re going that route — your Open Enrollment starts now
Within 3 months after you turn 65:
- Make sure all enrollment is complete
- Schedule your free Annual Wellness Visit with your new Medicare coverage
- Set up automatic premium payments if desired
Documents You Might Need
Have these ready when you sign up:
- Social Security number
- Date of birth
- Proof of citizenship (birth certificate or passport) if applying for the first time
- Current health insurance information (employer plan, COBRA, etc.)
- Employment information if you’re still working
- Bank information if you want to set up automatic premium payments
Frequently Asked Questions
How long does it take to get my Medicare card? After signing up, your card typically arrives within 4-6 weeks. If you signed up online, you may be able to print a temporary card from your MyMedicare.gov account.
Can I sign up for Medicare if I’m under 65? Only if you have a qualifying disability and have received SSDI for 24 months, or you have end-stage renal disease or ALS.
What if I missed my enrollment period? You can sign up during the General Enrollment Period from January 1 to March 31 each year. Coverage starts July 1. But you’ll pay the late enrollment penalty.
Can I sign up for Part A only? Yes. Part A is free for most people and there’s no penalty for having it. Some people enroll in Part A only while they keep employer coverage, then add Part B when they retire.
Do I need to sign up for Part D separately? Yes. Part D is not included in Original Medicare. You must enroll in a standalone Part D plan or a Medicare Advantage plan that includes drug coverage.
Can I change my mind after signing up? You can switch between Original Medicare and Medicare Advantage during Open Enrollment (October 15 to December 7). You can also change your Part D plan during this time.
What if I can’t afford Part B? If your income is limited, Medicare Savings Programs can pay your Part B premium. Contact your state Medicaid office to see if you qualify.
What to Do Right Now
- If you’re turning 65 in the next 3-6 months, go to ssa.gov/medicare and start the sign-up process. Don’t wait.
- If you’re already 65 and haven’t signed up, call 1-800-772-1213 immediately to find out your options and any penalties.
- If you’re still working with employer coverage, talk to your HR department about how Medicare coordinates with your plan. Get written confirmation that your coverage is creditable.
- If you need free help, call SHIP at 1-877-839-2675. They walk you through the entire process at no cost.
- After signing up, don’t forget to enroll in Part D and consider Medigap or Medicare Advantage.
Signing up for Medicare is one of those things that seems complicated until you actually do it. It takes 15 minutes online. Don’t overthink it — just sign up on time and you’re covered.