When can I sign up for Medicare?

The best time to sign up for Medicare isn’t the same for everyone. While most people are eligible to enroll around their 65th birthday, the ideal time to sign up for Medicare varies based on your personal circumstances. For example, you may have coverage from your employer or your spouse’s employer that you’d like to keep. Or you may want to sign up for parts of Medicare at different times. In this section, we’ll walk through how sign-up timing works, as well as other factors you may want to consider. 

Initial Enrollment Period

If you’re turning 65 and don’t have other qualifying coverage, you should sign up for Medicare during your Initial Enrollment Period (IEP). Your IEP is simply the first time you can sign up for Medicare. It spans a period of 7 months:

  • Three months before your 65th birthday month
  • Your birthday month
  • Three months after your 65th birthday month


Birthday cake with 65 candles & illustrations of the 7-month Medicare Initial Eligibility Period.


If your birthday doesn’t land on the first day of the month, your coverage begins the first day of your birthday month. As an example, let’s assume that you will turn 65 on July 18, 2018. Your coverage will begin July 1, 2018 if you sign up in April, May or June.

If your birthday is on the first day of the month, your coverage begins the first day of the prior month. If you turn 65 on July 1, 2018, and sign up in March, April or May, your coverage will kick in June 1, 2018.  Signing up after your birthday, in the second half of your IEP, will delay your coverage by 1-3 months. Your coverage delay will increase by 1 month for every month that passes after your birthday month. For example, if your birthday is in July, but you don’t enroll until September, your coverage will be delayed by three months.

If you’re eligible for Medicare and turning 65, use your IEP to sign up for Parts A & B if:

  • You’re retired or not working; or
  • You or your spouse don’t have health care benefits from your current employer; or
  • You live outside the U.S. and its territories and you’re not currently working.

To create your own personal Medicare enrollment timeline, use this step-by-step guide.

Automatic enrollment

Could I be automatically enrolled in Medicare?

Yes! If you are already receiving social security benefits when you turn 65, you don’t need to sign up for Original Medicare (Parts A & B). You’ll get a Medicare card in the mail prior to your 65th birthday, and your benefits will kick in the first day of your birthday month. If you’re already covered by an employer-sponsored health plan (or other creditable coverage), you may choose to decline (or delay) Part B. You’ll just need to follow the instructions on the letter you get from Social Security.

You’ll also be automatically enrolled in Medicare if you are under 65, have a disability, and have been receiving social security benefits for 24 months, or you have ALS (Lou Gehrig’s Disease).

If none of these cases applies to you, you’ll need to sign up for Medicare either during your IEP, which we discussed in the previous section, or during a Special Enrollment Period (SEP) or the General Enrollment Period, which we’ll talk about in a bit.

Special Enrollment Period

It’s not always the case that you want to sign up for Medicare during your IEP. Maybe you still have employer coverage and want to defer enrollment until you retire. You may also delay your enrollment if you are still covered under a spouse’s plan. This is where an understanding of Special Enrollment Periods (SEP) comes in handy.

Generally speaking, if you have coverage through an employer with more than 20 employees, you qualify for a SEP. You can sign up for Medicare Parts A & B anytime during active employment, but there is also an eight-month SEP that starts the month after your employment, or the employer-sponsored group health plan, ends.

It’s important to note that there may be some situations where you’d want to enroll in Medicare and disenroll in your employer based coverage. For example, perhaps you’re paying a lot for your employer plan and think you could find cheaper coverage through Medicare. That’s definitely a possibility, and it is worth exploring. Some people may choose to sign up for Part A even if they’re still employed and have employer healthcare coverage. This could be beneficial if you want some additional help from Medicare or if you’d like to formally document that you’re delaying Part B coverage. This could help you avoid potential confusion with Social Security later when you do decide to enroll in Part B.

General Enrollment Period

If you missed signing up for Part A and Part B during your IEP and aren’t eligible for a SEP, you can sign up between January 1 through March 31 yearly. Your benefits won’t kick in until July 1 of that year, and you may have to pay a higher premium for late enrollment. If you are worried about lacking coverage during this period, there are some options for intermediate health insurance. These options typically aren’t affordable or comprehensive, however. If you’re in that situation, you should speak with a broker or Social Security about your options.

Annual Enrollment Period

Each year from October 15th – December 7th you have the opportunity to switch Medicare plans if you’re already enrolled. It’s called the Annual Enrollment Period and it applies to everyone who’s currently enrolled in a Medicare plan. This is a good time to reassess your current plan and perhaps consider researching other options. For a list of reasons you may want to consider switching your plan, check out the following article.

The Medicare Advantage Open Enrollment Period

Beginning in 2019, a new enrollment period–called the Medicare Advantage Open Enrollment Period–will replace the Medicare Advantage Disenrollment Period of prior years. This new Open Enrollment Period will begin on January 1st and end on March 31st, giving individuals enrolled in a Medicare Advantage plan three entire months to make certain changes to their coverage. During this time, eligible individuals will have the opportunity to:

  • Switch from one Medicare Advantage plan to another (with or without prescription drug coverage)
  • Drop their Medicare Advantage plan and return to Original Medicare (In this case, the individual may also elect–but is not required–to purchase a standalone Part D plan)


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