Medicare 2026

Turning 65 Before Full Retirement Age? Here's How to Get Medicare When You're Not Yet on Social Security

For a long time, turning 65 and starting Social Security happened at roughly the same moment. That's no longer true for most people. Social Security's full retirement age is 67 for anyone born on January 2, 1960 or later, so most people turning 65 in 2026 or 2027 hit Medicare's usual starting age about two years before they can collect unreduced Social Security retirement benefits. That gap matters, because it changes how you get into Medicare — and what you have to do yourself.

Automatic enrollment vs. signing up yourself

People already receiving Social Security or Railroad Retirement Board (RRB) benefits are enrolled in Part A and Part B automatically, with coverage starting the first day of the month they turn 65 (or the first day of the prior month if their birthday falls on the 1st).

If you're not yet taking those benefits, nothing happens automatically. You need to apply. Medicare & You 2027 tells people who need to sign up to apply at SSA.gov/medicare/sign-up or to contact Social Security about 3 months before turning 65 to set up an appointment. Medicare.gov says the easiest and fastest way is to apply online through a my Social Security account.

Your Initial Enrollment Period

The Initial Enrollment Period (IEP) generally covers 7 months: the 3 months before the month you turn 65, the birthday month itself, and the 3 months after. Signing up during the first 3 months usually means coverage starts on the first day of your birthday month. Signing up during your birthday month or the 3 months after it means coverage starts the first day of the month after you sign up. Acting early is the simplest way to avoid a gap.

Paying the Part B premium without Social Security

Most people have the Part B premium deducted from their Social Security check. If you aren't collecting benefits yet (and don't have premiums taken from an OPM annuity), Medicare bills you directly, typically every 3 months. The standard Part B premium in 2026 is $202.90 per month. The 2027 Part B standard premium and deductible, along with the IRMAA income-related surcharges, are announced by CMS in the fall — usually November — so until then there's no official 2027 figure to share. Once you later start Social Security, the premium starts coming out of your monthly benefit instead.

Still working at 65? You may be able to delay Part B

If you're still working at 65 and covered by a group health plan based on your own or a spouse's current job, you can generally wait to sign up for Part B. A Special Enrollment Period lets you enroll any time you're still covered by that current employer plan, and for 8 months beginning the month after the job or the coverage ends, whichever comes first. COBRA and retiree coverage don't count as current employer coverage for this purpose, so check before you lean on them.

Many people in this situation still take Part A, because it's premium-free if they or a spouse paid Medicare taxes long enough. If you qualify for premium-free Part A and didn't get it automatically, you can sign up any time after first becoming eligible. Part A coverage then generally goes back up to 6 months from the date you sign up (or apply for Social Security/RRB), but never earlier than the first month you were eligible for Medicare.

The HSA wrinkle

If you contribute to a Health Savings Account, timing matters. Medicare & You 2027 says you can't contribute to an HSA after you have Medicare, and because premium-free Part A can be retroactive, it suggests making your last HSA contribution the month before Part A coverage begins. Medicare.gov's "Working past 65" page suggests people with an HSA (and their employers) stop contributing 6 months before retiring or applying for Social Security or RRB benefits to avoid a tax penalty tied to that retroactive Part A start.

Part D and your drug coverage

Even if you delay Part B, think about drug coverage. If you don't have creditable prescription coverage through your employer plan, enrolling in Part D on time avoids a late-enrollment penalty tied to the national base beneficiary premium, which is $41.33 for 2027. In 2027, no Part D plan can charge a deductible higher than $700, and once your out-of-pocket spending on covered drugs reaches $2,400 (up from $2,100 in 2026), you pay nothing more for covered drugs for the rest of the year.

Choosing how to get your Medicare

Once enrolled, you'll choose how to receive your benefits. Original Medicare (Parts A and B) lets you see any provider that accepts Medicare, and many people pair it with a stand-alone Part D plan and, if they want, a Medigap policy to help with cost sharing. Medicare Advantage (Part C) bundles Parts A and B — usually with drug coverage — through a private plan, often with network rules and extra benefits. Neither is "better"; they're different structures with different trade-offs in flexibility, cost sharing, and provider choice. The right fit depends on your doctors, prescriptions, travel patterns, and budget.

If you have Medicaid or Extra Help, you get a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan (or switch stand-alone plans). Full-benefit dual-eligible people can join an integrated D-SNP in any month.

Annual Enrollment for 2027 coverage runs October 15 – December 7, 2026, with changes taking effect January 1, 2027.

Where can you get help with Medicare questions?

For personalized answers, start at Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), available 24/7. To sign up for Medicare itself, use SSA.gov/medicare/sign-up or contact Social Security.