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When Does Medicare Start? | Medicare Coverage Dates

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For most people, Medicare coverage starts on the first day of the month you turn 65. But your Medicare start date can be different if you qualify for Medicare based on a disability. Learn more about when your Medicare coverage starts.

When Does Medicare Coverage Start?

Most individuals become eligible for Medicare when they turn 65. If that’s the case for you, you will begin Medicare coverage on the first day of your birth month. Medicare coverage will begin on the first day of the previous month if you turn 65 on the first day of the month.

A few more things to know:

  • If you are still actively employed or you are not receiving retirement benefits at least four months before your 65th birthday, you will need to contact the Social Security Administration (SSA) or Railroad Retirement Board (RRB) and sign up for Medicare.
  • Those with Social Security Disability Insurance (SSDI) will automatically be enrolled in Original Medicare on the first day of the 25th month of disability coverage.
  • Those with end-stage renal disease (ESRD) may sign up for Medicare at any age if they meet the qualifications.
  • If you receive SSA or RRB benefits, or you are a state, local, or federal government worker (including American Foreign Service workers), you should be automatically enrolled in Original Medicare Parts A and B when you turn 65.
  • Anyone who is not automatically enrolled in Part A and Part B needs to contact SSA or the RRB during the three-month period before they turn 65 — the earlier, the better. It is important to  make this contact three months before turning 65 and confirm that everything is in order.
  • Medicare Supplement, Advantage, and Part D drug coverage can be enrolled concurrently with your Part B start date.

Medicare start dates by plan

It is always best to enroll in Original Medicare Parts A and B when you are first eligible. If you do not have a Special Enrollment Period (SEP), you may encounter penalties and delayed coverage when enrolling later.

If you’re eligible for Medicare when you turn 65, you can sign up during your Initial Enrollment Period (IEP). This seven-month period begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month in which you turn 65.

Medicare Designation Type of Enrollment Period Turning 65 Enrollment Timeline Delayed Part B Enrollment Timeline Date Coverage Starts
Original Medicare Parts A and B IEP Three months before turning 65, the month you turn 65, three months after the month you turn 65. During the Part B Enrollment SEP or the General Enrollment Period (GEP). The Part B SEP starts when employer coverage or active employment ends and lasts for 8-months.
 
IEP start is complicated:
 
Enroll during the first three months and coverage starts the 1st day of your birth month. Enroll during your birth month and coverage starts the next month.
 
Enroll during the month after your birth month and coverage starts 2 months later.
 
Enroll during the 2nd or 3rd month after your birth month and coverage begins 3 months after the month in which you enroll.
Prescription Drug Plans (PDP) IEP Concurrent with the Original Medicare IEP. Any time you meet the Part D enrollment qualifications: You must be entitled to Part A and/or enrolled in Part B and living in the Plan coverage area.
 
Expats who have Part A and/or Part B when they return to the U.S. may enroll in Part D immediately upon return.		 Part D can be started concurrently with the time you are enrolled in Part A or Part B.
Medicare Supplement (Medigap) Plans Open Enrollment Period (OEP) If you enroll in Part B when you turn 65, your Medigap OEP runs for six months beginning the month you turn 65. Your Medigap OEP runs for six months beginning the month you enroll in Part B. You may enroll any time during your OEP and coverage will start the first of the following month.
 
You can enroll in Medigap plans any time once you have A and B coverage. However, if enrollment is not during your OEP or a Guaranteed Issue Period you will undergo underwriting.
Medicare Advantage Plans (MA or MA-PD) Initial Coverage Enrollment Period (ICEP) Concurrent with the Original Medicare IEP. During the three months leading up to the start of Part B; coverage begins when Part B begins. If enrollment is made during your ICEP your coverage will start concurrent with your Part B coverage date.

Learn more on Medicare Advantage enrollment periods.

Do You Have To Start Medicare Coverage at 65?

You don’t have to start Medicare coverage at 65. Because most people pay a monthly premium for Part B ($170.10 per month in 2022), some choose not to sign up when turning 65, during their IEP. This may be because they have current coverage under an employer or union group plan through their own or their spouse’s current employer.

If you delay enrollment in Medicare Part B because you have current employer or union group coverage, you can sign up later during a SEP without encountering delayed coverage or a late enrollment penalty. Check with your health benefits administrator to see how your insurance and Medicare could work together. This SEP lasts for eight months after termination of your employment or loss of employer coverage.

However, you can enroll in Medicare Part B at any time you are still covered by a qualified plan based on your current employment.

If you do not sign up during your SEP, you will be unable to sign up for Part B until the next Medicare GEP, which runs January 1 through March 31 annually, with coverage beginning July 1. You may also incur a lifetime Part B penalty in the form of higher monthly premiums.

What is creditable coverage?

Creditable coverage refers to medical or prescription programs offered by Medicare-authorized private insurance carriers. For Original Medicare Parts A and B, creditable coverage is defined as health insurance that meets or exceeds what Medicare covers.

For policies including prescription drug coverage, Advantage Plans (MA-PD), or PDPs, creditable coverage means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.

If you have creditable coverage, you may qualify for a SEP which would allow you to delay your Medicare Part B or Part D coverage without incurring late enrollment periods and laps in coverage.

When Does Medicare Open Enrollment Start?

Much confusion is generated concerning the use of the term Open Enrollment in Medicare. Many use it to refer to the Annual Enrollment Period (AEP) which runs from October 15 through December 7 with coverage beginning January 1. During this period, you can newly enroll, change, or disenroll in Part C Medicare Advantage Plans or Part D prescription drug plans.

The term Open Enrollment is often used to refer to the Medicare Advantage-Open Enrollment (MA-OEP) which runs from January 1 through March 31 each year with coverage beginning the first of the month after enrollment. This period allows for those already enrolled in Medicare Advantage Plans to change their coverage options or return to Original Medicare.

Open Enrollment is also used to refer to the IEP for Original Medicare. This seven-month period begins three months before you turn 65, includes the month you turn 65 and ends three months after the month in which you turn 65.

During this period, you can enroll in Parts A and B. If you enroll in both parts, you may sign up for an Advantage Plan, Drug Plan, or Supplement Plan offered in your area with no underwriting questions asked. Coverage for these plans will start concurrently with your Part B enrollment.

Medicare IEP schedule

Medicare information states that you may sign up for Parts A and/or B anytime during your IEP with no penalties. However, the information fails to caution on the impact of waiting longer to enroll on the timeline of your coverage. If you enroll in Medicare:

  • During the three months before you turn 65, coverage begins the first day of the month you turn 65.
  • The month you turn 65, your coverage will start the first day of the month after you turn 65.
  • During the month after you become 65, your coverage will begin two months after you sign up.
  • Two or three months after you turn 65, your coverage will start three months after you sign up.

For example, Dave is turning 65 on May 1 and has until the end of August to enroll in Part B during his IEP. In August he begins to feel sick and enrolls in Medicare so he can see a doctor in early September. When Dave enrolls on August 15, he finds out that his coverage will not begin until November 1.

The earlier you enroll during your Medicare IEP, the earlier your coverage begins.

How Do You Enroll in Medicare?

Enrollment in Original Medicare A and B is a straightforward process. It is handled by SSA and can be done automatically, over the phone, online, or in person.

  • Automatic enrollment: If you are receiving SSA or RRB benefits for at least four months before you turn 65 you will be automatically enrolled in Parts A and B. You should receive communication from SSA approximately three months before turning 65. If you wish to delay either Parts A and/or B, be sure to contact SSA during the three months before your 65th birthday.
  • By phone: You can enroll in Original Medicare by calling SSA at (800) 772-1213. Normally your enrollment can be completed in one call.
  • In person: You can also go to your local SSA office to complete the enrollment process. It is best to call and make an appointment before appearing at the local office.
  • Online: Signing up online is the preferred way. The simple process can be completed in a few minutes here. Click on the SIGN IN/UP link in the upper right portion of the page. You will then be able to track your SSA business and sign up for Medicare. There is the option to sign up for Medicare whether you wish to receive SSA benefits or not.

Here is more in-depth coverage of this subject.

ron square headshot
Ron Elledge
Medicare consultant

Ron Elledge is an accomplished Medicare agent, planner, and author. Elledge earned a bachelor’s degree in Bible theology from International Seminary and spent 30 years in pastoral ministry. He began his current career in insurance with a specialty in Medicare in 2008 and has since authored “Medicare Made Easy: What Expats, Frequent Travelers and You Need to Know” and is often a featured speaker at the International Living conferences. Elledge is a contributor to International Living, supporting Medicare beneficiaries with articles, podcasts, and Q&As.

A licensed seniors market insurance agent in Arizona and New Mexico, Elledge has helped thousands decipher the intricacies of Medicare rules and regulations, enabling them to make educated selections for their health care needs. As a world traveler with his wife, Shelli, Elledge specializes in Medicare for expats and frequent travelers. He’s up to date with Medicare regulations, coverage options, and enrollment protocols and is fervent in his resolve to present trustworthy data on this confusing and often maligned program.

“By obtaining dependable details on how to read their Medicare options, recipients can plan for it correctly and make the best choices,” says Elledge. “These choices often make a huge financial and emotional difference in their futures. When Medicare is correctly utilized, it becomes a powerful financial and medical tool for all who qualify.”

ron square headshot
Ron Elledge
Medicare consultant

Ron Elledge is an accomplished Medicare agent, planner, and author. Elledge earned a bachelor’s degree in Bible theology from International Seminary and spent 30 years in pastoral ministry. He began his current career in insurance with a specialty in Medicare in 2008 and has since authored “Medicare Made Easy: What Expats, Frequent Travelers and You Need to Know” and is often a featured speaker at the International Living conferences. Elledge is a contributor to International Living, supporting Medicare beneficiaries with articles, podcasts, and Q&As.

A licensed seniors market insurance agent in Arizona and New Mexico, Elledge has helped thousands decipher the intricacies of Medicare rules and regulations, enabling them to make educated selections for their health care needs. As a world traveler with his wife, Shelli, Elledge specializes in Medicare for expats and frequent travelers. He’s up to date with Medicare regulations, coverage options, and enrollment protocols and is fervent in his resolve to present trustworthy data on this confusing and often maligned program.

“By obtaining dependable details on how to read their Medicare options, recipients can plan for it correctly and make the best choices,” says Elledge. “These choices often make a huge financial and emotional difference in their futures. When Medicare is correctly utilized, it becomes a powerful financial and medical tool for all who qualify.”

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