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When Does Medicare Coverage Start?

Understanding when your Medicare coverage begins can help to ensure proper health coverage. The date your coverage starts depends on when you are automatically enrolled or choose to join. The conditions of your eligibility age or disability also determine when your Medicare health plan becomes active.

Key takeaways:

When does Medicare coverage start?

People eligible for Medicare can join when they turn 65 or older, or younger with certain disabilities. Your start date depends on how you qualify for the program. Generally, people and their spouses satisfy eligibility requirements after paying Medicare taxes for 10 years, or 40 quarters.

If your birthday is on the first day of the month, your coverage will kick in on the first day of the prior month. For instance, if you turn 65 on October 1, your coverage will begin on September 1.

Medicare coverage always begins on the first day of the month.

Time when you enrollTime Medicare coverage begins
Before the month you turn 65.The month of your 65th birthday
The month you turn 65 or three months after.The following month
During the general enrollment period (Jan. 1 – March 31 each year).July 1st
If enrolling into a Medicare Advantage Plan during Medicare Open Enrollment Period aka Annual Enrollment Period (Oct. 15 – Dec. 7 each year).January 1 of the following year
During a special enrollment period.The following month

When turning 65

If you’re automatically enrolled in Medicare, your coverage will commence on the first day of the month of your 65th birthday. This will likely be the case if you receive Social Security retirement benefits before you turn 65.

If you sign up during your Initial Enrollment Period, your coverage will begin on the first day of your 65th birthday month. For example, if you’re turning 65 on October 28, 2035, you can sign up between July 1, 2035, and September 30, 2035, for coverage to start on October 1, 2035.

The Initial Enrollment Period includes the three months after you turn 65. In our example, you can still sign up from October 1, 2035 to January 31, 2036, without incurring late penalties. Your coverage will start the first day of the month after you enroll.

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When getting disability benefits

You can get Medicare coverage at a younger age if you get Social Security Disability Insurance (SSDI) benefits. If you have SSDI, you may have Medicare already or will have it after 24 months.

Individuals living with the following disabilities automatically get Medicare coverage:

  • ALS: (Lou Gehrig’s disease): in the same month that disability benefits begin.
  • ESRD (end-stage renal disease): in the month of admittance to a hospital for a kidney transplant.

Railroad Retirement Board

You may also qualify for early Medicare if you receive Railroad Retirement Board (RRB) benefits. Your Medicare coverage will start either at:

  • The 25th month you get retirement or disability benefits
  • The 30th month after your disability began
Occupational disability annuitants

If you meet the RRB’s special provision for occupational disability annuitants, your Medicare will start the 30th month after being entitled to the annuity.

Federal employment provision

Individuals who meet the special provision for federal employment after December 1992 will obtain Medicare coverage starting either:

  • The 25th month of entitlement to disability or retirement benefits OR.
  • The 30th month after having met both the disability requirement period and the disability earnings requirement period, using federal employment.

When missing the IEP

Individuals who miss the Initial Enrollment Period (IEP) for Medicare can sign up during the yearly General Enrollment Period from January 1 - March 31. Those who wish to join a Medicare Advantage plan can also do so during the General Open Enrollment Period. In both cases, coverage begins on July 1.

Open Enrollment Period

The Medicare Open Enrollment period, aka Annual Enrollment period , October 15 to December 7 each year, is when Medicare Advantage enrollees can change their plans for the following year. Coverage will be effective on January 1 of the following year.

Special Enrollment Period

Medicare allows people to sign up for a limited time without penalty in special situations if they miss other designated enrollment periods. Qualifying circumstances include:

  • Losing Medicaid coverage.
  • Missing Medicare enrollment due to a natural disaster, declared emergency, or other exceptional conditions.
  • Being released from incarceration.
  • Missing a chance to enroll due to inaccurate or misleading information from an employer or health plan.
  • Losing group health plan coverage.

Medicare coverage will begin the month after you sign up.

If you have health insurance from an employer

People over age 65 can delay joining Medicare if they or their spouse have health insurance through a job. They can enroll during a Special Enrollment Period with no penalties. However, if the job is through an employer with less than 20 employees your coverage may decrease, so check with your insurance company. In this situation, you may be better off enrolling in Medicare as you turn 65.

These individuals can still sign up at any time while covered by the employer’s health plan. They can also enroll within eight months after the employment or group health plan ends.

If you sign up for Medicare Part B while you’re still in a group health plan or during the first full month after leaving it, your coverage will start.

On the first day of the month after you enroll.

Discontinuing COBRA or retiree coverage is not a situation that qualifies for a Special Enrollment Period.

How to know if I will automatically enroll in Medicare?

Medicare You will automatically be enrolled in Medicare Part A and B if you are getting Social Security or Railroad Retirement Board benefits. Your coverage starts when you turn 65 or upon your 25th month of disability benefits. You won’t need to pay a premium for Part A, but you’ll need to pay a premium for Part B if you choose to keep it.

People with ALS (Lou Gehrig’s disease) will automatically get Part A and B coverage in the same month their SSDI benefits kick in.

Can I get Medicare before turning 65?

You may be entitled to Medicare coverage before turning 65 if you’ve received SSDI or RRB benefits for 24 months. People with ERSD or Lou Gehrig’s disease (ALS) can also get early coverage.

Medicare benefits may also be available if you’re at least age 50 and a child or the surviving spouse of someone who worked long enough in a Medicare-covered government job or Social Security and meet SSDI requirements.

Timely Medicare coverage is a top priority for many people heading into their older years. For more clarity regarding when your benefits start, contact your employer, Medicare, or Social Security.


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