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In short Your first enrollment window What it costs in 2026 If you are still working at 65 The penalty for waiting Signing up before 65 Once you are in Common questions SourcesYour first chance to sign up for Medicare is a 7-month window that starts 3 months before the month you turn 65 and ends 3 months after it. Most people sign up for both Part A (hospital insurance) and Part B (medical insurance) then. Signing up late can mean a coverage gap and a premium penalty that follows you. Some people qualify before 65: after 24 months of Social Security disability benefits, or right away with ALS or end-stage renal disease.
Your first enrollment window
According to Medicare.gov, you are first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. If you are already receiving Social Security benefits when you turn 65, you are typically enrolled automatically. Otherwise you sign up through Social Security, online, by phone, or at a local office.
What it costs in 2026
Most people pay no premium for Part A, because they or a spouse paid Medicare taxes for at least 10 years. CMS says about 99% of beneficiaries are in that group. People with less work history can buy Part A: in 2026 that costs $311 a month with at least 30 quarters of coverage, or $565 a month with fewer.
Part B has a standard monthly premium of $202.90 in 2026, and an annual deductible of $283. If your income is above certain levels, you pay more for Part B; CMS publishes the income tiers.
If you are still working at 65
If you have health insurance from your job or your spouse’s job, and that employer has 20 or more employees, you can usually delay Part B without a penalty while that coverage continues. When the work or the coverage ends, you get a Special Enrollment Period of up to 8 months to sign up.
Coverage like COBRA, retiree coverage, or a Marketplace plan does not count the same way, so check your situation on Medicare.gov before assuming you can wait.
The penalty for waiting
If you do not sign up for Part B when you are first eligible and you do not qualify for a Special Enrollment Period, Medicare.gov says you will have to wait to sign up, can go months without coverage, and may pay a monthly penalty for as long as you have Part B. The penalty grows the longer you waited. Part A has a similar penalty for people who must buy it.
Signing up before 65
Some people get Medicare earlier. You are first eligible after receiving disability benefits for 24 months, or as soon as disability benefits start if you have ALS, also called Lou Gehrig’s disease. People with End-Stage Renal Disease have their own rules.
Once you are in
After you enroll, each fall brings Open Enrollment, October 15 to December 7, when you can change how you get coverage. Our guide on Medicare Open Enrollment explains what to check each year, and what Original Medicare does not cover is worth reading before you assume something is included.
- Medicare.gov - When can I sign up for Medicare?
- CMS - 2026 Medicare Parts A and B Premiums and Deductibles
Common questions
Is Medicare automatic at 65?
Only if you are already receiving Social Security benefits. If not, you need to sign up yourself through Social Security during your enrollment window.
What does Part B cost in 2026?
The standard monthly premium is $202.90, and the annual deductible is $283, according to CMS. People with higher incomes pay more, following CMS’s income tiers.
What happens if I miss my window?
You generally wait for the General Enrollment Period, January 1 to March 31 each year, and you may owe a lasting premium penalty for Part B. If you had qualifying employer coverage, you may get a Special Enrollment Period instead.
Can Pymander answer Medicare questions?
Pymander can answer everyday health questions and explain common terms, but it does not enroll anyone in Medicare and is not an insurance service. Pymander is available in all 50 states.