Do I need to sign up for Social Security to get Medicare?

Can I get Medicare without taking Social Security benefits?

Yes. Medicare.gov says that if you want to get Medicare when you turn 65 but aren't planning to take retirement benefits at that time, you need to sign up for Medicare, and you do that through Social Security. When you contact Social Security, you can either sign up for Part A and Part B only, or apply for Social Security (or Railroad Retirement Board) benefits as well. If you apply for benefits, you get Part A automatically once benefits start, and you choose whether you want Part B when you apply.

You sign up through Social Security even though Medicare provides the coverage, because Social Security checks whether you're eligible, including whether you (or another qualifying person) paid Medicare taxes long enough to get Part A without a premium, and it processes requests to sign up for Part B. See How do I sign up for Medicare?.

When does Medicare sign me up automatically?

In the situations below you get Medicare without signing up, and your Medicare card comes in the mail before coverage starts. Part B is included, but because it has a monthly premium you can choose not to keep it: if you don't want Part B, say so before the coverage start date on your Medicare card. If you do nothing, you keep Part B and pay its premium through your Social Security or RRB benefits.

• Social Security or RRB benefits at least 4 months before 65: Part A and Part B start the first day of the month you turn 65 (the month before, if your birthday is on the first of the month).
• Under 65 with a disability: Part A and Part B start automatically after you get disability benefits for 24 months.
• ALS (Lou Gehrig's disease): Part A and Part B start the month your Social Security disability benefits begin.
• Puerto Rico or outside the U.S.: you get Part A automatically, but you must sign up for Part B if you want it.

How do I sign up for Medicare if I'm not getting Social Security?

Contact Social Security during your 7-month Initial Enrollment Period, which starts 3 months before you turn 65 and ends 3 months after the month you turn 65. Applying online at Social Security is the easiest and fastest way (you'll create a secure my Social Security account), and you can also contact Social Security 3 months before you turn 65 to set up an appointment. If you or your spouse worked for a railroad, contact the Railroad Retirement Board. About 2 weeks after you sign up, you get a welcome package with your Medicare card.

If you sign up before the month you turn 65, Part B starts the month you turn 65; if you sign up in your birthday month or the 3 months after, it starts the next month. If you don't sign up for Part B when you're first eligible and don't qualify for a Special Enrollment Period, such as the one for job-based coverage, you might have to wait to sign up and pay a Part B late enrollment penalty for as long as you have Part B. See When should I sign up for Medicare?.

How do I pay Medicare premiums if I don't get Social Security benefits?

Most people have the Part B premium ($202.90 a month, standard, in 2026) deducted from their Social Security or RRB benefit. If you don't get those benefits, Medicare sends you a Medicare Premium Bill (CMS-500): every 3 months if you pay only Part B (including any Part B income-related monthly adjustment amount), and every month if you pay a Part A premium or Part D IRMAA. The bill arrives around the 10th of the month and is due on the 25th.

Your first bill may be higher than you expected, because it can include premiums for earlier months that weren't billed yet. If a bill says "Delinquent Bill" at the top, pay the total amount due, or you could lose your Medicare coverage. Federal retirees with an Office of Personnel Management (OPM) annuity who don't get Social Security or RRB benefits can ask their local Social Security office to deduct Part B premiums from the annuity. There are 4 ways to pay a Medicare bill:

• Online through your secure Medicare account, the fastest way, by credit or debit card, Health Savings Account (HSA) card, or checking or savings account.
• Medicare Easy Pay, a free service that deducts your premium from your checking or savings account each month.
• Your bank's online bill payment service (some banks charge a fee).
• By mail, with the payment coupon from your bill, by check, money order, or credit, debit or HSA card.

What changes when I start Social Security benefits later?

An application for Social Security retirement benefits also serves as your application for Medicare, and once you're approved you get Part A automatically, without a premium, if you're eligible for Medicare. If you're 65 or older, Part A coverage starts up to 6 months back from when you apply, but no earlier than the month you turned 65. That's why Medicare.gov says you and your employer should consider stopping contributions to a Health Savings Account at least 6 months before you apply. See Can I contribute to an HSA once I have Medicare?.

If Social Security sends you a notice that your benefit payments now cover your Medicare premiums, the premiums are deducted from your benefits automatically, and you should stop any Medicare Easy Pay or bank bill payments. Until you get a notice from Social Security, keep paying your Medicare premium bills so you don't lose coverage. If a benefit payment doesn't cover your whole premium, Medicare bills you for the rest.