If you’re coming up on retirement or have already retired, you may be thinking, “When does my Medicare start?” Don’t worry, you’re not alone in your wonderment or confusion.

When does Medicare coverage start? 

Your Medicare coverage start date will depend on which plan you have and when you sign up for it. Overall, Medicare coverage can start the month you turn 65 years old. All Medicare coverages will begin on the 1st day of the month in which your coverage begins. 

When does Medicare Part A start?

Initial Enrollment Period: If you qualify for Medicare Premium-Free Part A, your coverage can begin the month of your 65th birthday. If your birthday falls on the 1st of the month, your coverage will begin the month before your 65th birthday. 

After Initial Enrollment Period: If signing up for Medicare Premium-Free Part A after your Initial Enrollment Period, your coverage will be applied for 6 months prior to your application date. However, coverage can only begin when you turn 65 years old. If you apply when you are 65 years old and 3 months, the coverage will only post-date until your 65th birthday. 

If you do not qualify for Premium-Free Part A Medicare coverage, you will be able to purchase Premium Part A coverage. Premium Part A coverage will start in the same time frame as Medicare Part B.

When does Medicare Part B start?

Medicare Part B and Premium Part A both start at varying times based on when you sign up for Medicare. 

• If you sign up prior to your 65th birthday, your coverage will start during the month you turn 65;
• If you sign up in the month of your 65th birthday, your coverage will start the following month;
• If you sign up 1 month after your 65th birthday, your coverage will start 2 months after the month you sign up;
• If you sign up 2-3 months after your 65th birthday, your coverage will start 3 months after you sign up;

General Enrollment Period

You are able to sign up for Medicare at any time during the Annual General Enrollment Period. This period lasts from January 1-March 31st. If you apply for Medicare during this time, your coverage will begin on July 1st.

When does Medicare start for SSDI?

Anyone who is eligible for receiving Social Security Disability Insurance (SSDI) benefits is eligible for Medicare. There is a waiting period for coverage which takes 24 months. During the 24-month coverage waiting period, you are eligible for health insurance coverage through your former employer. 

When does Medicare start for ESRD?

Anyone who is eligible for Medicare because of End-Stage Renal Disease (ESRD) has a slightly more complex coverage start date. If you delay signing up for Medicare with ESRD after you are eligible, your coverage could start up to 12 months prior to applying for coverage. 

For example: 

• You are eligible for Medicare by ESRD in March;
• You wait to sign up for coverage until December;
• Your Medicare coverage will start in March;

This backtracking of coverage is called retroactive coverage. 

There are other specific ESRD coverage considerations. We have listed these below. 

Coverage on dialysis 

When you sign up for Medicare on dialysis it usually starts on the 1st day of the 4th month during your dialysis treatment. The coverage waiting period will begin even if you have yet to sign up for Medicare. 

For example: 

• Your dialysis treatment starts on August 1st; 
• You sign up for coverage on December 1st; 
• Your Medicare coverage begins on November 1st. 

The dialysis coverage waiting period may be waived if all of the following conditions are met:

1. You partake in an at-home dialysis training program. This must be offered by an approved Medicare training facility throughout the first 3 months of the regular dialysis process.  
2. You have every intention of completing your training, and your doctors expect and approve you to complete your dialysis treatment at home
3. The regular dialysis process is followed throughout the regular waiting period

Coverage if getting a kidney transplant 

When you sign up for Medicare when getting a kidney transplant, your coverage may begin during the 1st month you are admitted to a Medicare-approved hospital for your transplant or for medical services that may be needed prior to your transplant (within two months of the surgery date). 

Coverage for special circumstances 

There are a few special circumstances where you may be eligible to sign up for Medicare and have coverage begin the very next month. Some of these situations are included below: 

• Currently coverage through a health insurance plan;
• Within 8 months of losing your job-related health insurance plan ;
• Within 8 months of stopping working;