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Initial Enrollment Period

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Despite what you might think, you don't have to wait until you're 65 to sign up for Medicare. Your Initial Enrollment Period (often referred to as “IEP”) is actually a 7-month “window” around your 65th birthday during which time you can sign up for Medicare.

When does coverage begin?

It's important to note that your Medicare coverage will begin depending on when within your 7-month window you sign up.

Sign Up Three Months Before Birthday

If you sign up for Medicare Part A and/or Medicare Part B during the first 3 months of your Initial Enrollment Period, your coverage begins on the first day of the month in which you turn 65.

Your 65th birthday is on May 20th. If you sign up for Medicare in February, March or April then your coverage will start on May 1st.



Exception: The only exception to this rule occurs when your birthday falls on the first of the month. When this happens Medicare essentially treats it as if your birthday took place in the previous month. So, if your birthday is on May 1st Medicare treats it as an April birthday and your seven-month window is shifted accordingly.


If your birthday is on May 1st, then your seven-month window would actually start in January instead of February. In this case, if you were to sign up for Medicare in January, February or March your coverage would begin on April 1st, a full month before your actual May 1st birthday.



Sign up in Your Birthday Month or the Three Months After

The chart below lists when your coverage starts if you sign up during the month of your 65 birthday or if you signed up within three months after your birthday.

If you sign up... Your Coverage begins...
The month you turn 65 1 month later
1 month after you turn 65 2 months later
2 months after you turn 65 3 months later
3 months after you turn 65 3 months later

What if I fail to enroll for Part D coverage during my Initial Enrollment Period?

Medicare Part D is optional coverage. However, it often makes sense to join a Medicare Part D prescription drug plan when you first become eligible for Medicare because you may pay a penalty if you need to enroll in Part D at a later time -- and the penalty will increase every month you wait to enroll. Also, while you may be healthy now and require minimal medication, health needs can change unexpectedly.

The penalty is applied to your Medicare Part D premium after your initial enrollment period has ended and you’ve gone 63 consecutive days without either Medicare Part D coverage or some other form of creditable prescription drug coverage (often through an employer or union) that covers the same costs as standard Medicare Part D. 


What if I’m turning 65 but already have health insurance through a group or employer?

You may be eligible to apply for Medicare under special circumstances, such as after your employment or group health insurance ends. These circumstances fall under what Medicare refers to as the Special Enrollment Period.


If you’re 65 or over and have COBRA coverage on an employer’s policy, you must sign up for Part B during the first eight months you have COBRA to avoid the Part B late-enrollment penalty during this period.

More about the Special Enrollment Period


If my spouse is covered, will I be covered automatically?

No. If you plan to receive Medicare benefits through a spouse, you must still sign up for Medicare individually. There is no automatic spousal coverage with Medicare.

If you are a spouse, divorced spouse, widow, widower, or a dependent parent, you may be eligible for Medicare benefits when you turn 65, based on your spouse’s work record. Generally, to be eligible your spouse must be receiving or eligible to receive Social Security or railroad retirement benefits, or have worked long enough in a government job where Medicare taxes were paid.

In some cases you may be able to receive spouse's retirement benefits if you are at least 62 years of age and your spouse is already receiving retirement or disability benefits. Please see the Benefits Planner: Retirement page on the Social Security Administration website for more information about spousal retirement benefits. 


What if I missed the Initial Enrollment Period?

If you missed the sign up for Medicare, you can still sign up during a General Enrollment Period every year (January 1–March 31.) However, it’s something you’ll want to avoid for these reasons:

  • Coverage won’t begin until July 1. That leaves you unprotected for several months — and 100% responsible for any medical expenses you may have.
  • You may have to pay a late-enrollment penalty, which can raise your monthly premium for Medicare Part B by 10% for every full 12-month period that you don't have Medicare Part B or equivalent coverage. In most cases, this penalty will be added to your Part B premium for the remainder of your enrollment in Medicare.

More about the General Enrollment Period