Turning 65 · Utah

Can I Get Medicare at 65 Without Taking Social Security?

Yes, and for anyone born in 1960 or later it is the normal thing to do, because full retirement age is now 67. The catch is that Medicare stops being automatic the moment you are not drawing a Social Security check: nobody signs you up, nobody deducts the premium, and one rule runs the other direction and surprises people who do take the check. Here is how the two programs connect, straight from Social Security's own operating manual.

Medicare On Main Data Desk

Published October 8, 2026 · 7 min read · Reviewed by Brian Penner

Utah had 490,235 people with Medicare in June 2026. A generation ago most of them would have started Medicare and Social Security in the same month, because full retirement age was 65 and the two arrived together. For anyone turning 65 now, full retirement age is 67, and the people who sit down at our Moab office are increasingly asking the question in the title: can I take the one without the other? The answer is in Social Security's own Program Operations Manual System, which is the instruction book its claims representatives work from, and it is a clean yes. The rest of this post is the fine print, which is where the money is.

Two programs, one agency, two separate applications

Medicare eligibility at 65 is defined in POMS HI 00801.006. A person is entitled to hospital insurance, Part A, "beginning with the first month they attained age 65" if they are receiving Social Security or Railroad Retirement benefits, or if they are "eligible to receive Social Security or Railroad benefits (even if they have not filed an application for monthly benefits) and has filed an application for HI." The parenthetical is the whole answer. Eligibility for benefits, which generally means 40 quarters of work, is what matters; actually drawing them is not required. Part B is looser still. POMS HI 00805.001 describes it as "voluntary insurance" and says plainly: "It is possible to be entitled to SMI without being entitled to monthly benefits or HI, but only for those aged 65 or over."

So the two programs are administered by the same agency, Social Security, and applied for through the same website, but they are separate elections. Medicare.gov's sign-up page lists the situation "I want to sign up for both Part A & Part B or only Part A when I turn 65" and answers it with "Apply online (at Social Security) – This is the easiest and fastest way to sign up. You'll create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online." Sign up for Medicare, or apply for benefits: the sentence offers them as two different things, and the online application asks you which you want. Choosing Medicare only leaves your retirement benefit exactly where it was.

Who is enrolled for you, and who has to ask

Medicare.gov opens with the honest version: "Some people get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) automatically, and some have to sign up for it." Its tool sorts you with one question, "Did you start getting benefits from Social Security (or the Railroad Retirement Board) at least 4 months before you turned 65?" Here is how the four situations we see most often play out:

Sources: Medicare.gov, How do I sign up for Medicare?; Ready to sign up for Part A & Part B; POMS HI 00801.002. The 20-employee rule and the Special Enrollment Period in the last row are covered in the working-past-65 post; the exact start date your sign-up month produces is in when does Medicare coverage start after I sign up at 65?

The second row is most of our Turning-65 calls. If you are not drawing Social Security, nothing arrives in the mail, no card, no welcome package, no reminder. Your 7-month Initial Enrollment Period opens three months before your birthday month and closes three months after it, and if it closes with no application on file, the next door is the General Enrollment Period in January, with a Part B penalty attached. The application itself takes most people under half an hour online, and it is the single most important half hour of the year you turn 65.

What claiming Social Security at 65 "to get Medicare" actually costs

Every few months someone tells us they are going to start Social Security at 65 so that Medicare is handled. It is worth seeing the price of that convenience. POMS RS 00615.003 sets full retirement age at 67 for anyone born January 2, 1960 or later, which is everyone turning 65 in 2025 or after. POMS RS 00615.101 gives the reduction for claiming early: the benefit "is equal to the PIA reduced by 5/9 of 1% for each of the first 36 months prior to FRA. The total reduction for 36 months is 20%," and beyond 36 months the reduction is "20% (for the first 36 months) plus 5/12 of 1% for each month in excess of 36." Applied to a full retirement age of 67:

Derived from POMS RS 00615.101 for a full retirement age of 67 (RS 00615.003); "PIA" is the primary insurance amount, the full benefit. Figures are before cost-of-living adjustments and assume no months of work-test withholding. Waiting past 67 earns delayed retirement credits for every "increment month" up to age 70 (RS 00615.690).

Thirteen percent of a benefit for the rest of your life, and for a surviving spouse's life if yours was the larger record, is a steep fee for skipping a half-hour application. For the higher-earning households we tend to work with, the arithmetic usually points the other way entirely: Medicare at 65 because it is the only window without penalties, Social Security at 67 or 70 because every month of delay is a raise. The two decisions are independent, and treating them as one is the most common and most expensive confusion we see in this age group. None of this is a recommendation about when to claim; that depends on health, other income and a spouse's record, and a fee-only planner or Social Security itself is the place to run those numbers.

Paying Part B without a check to deduct it from

The practical consequence of Medicare without Social Security is a bill. In 2026 the standard Part B premium is $202.90 a month, "or higher depending on your income," per Medicare.gov, and if you are not receiving benefits there is nothing to deduct it from, so Medicare bills you directly, quarterly for Part B. Most people qualify for premium-free Part A "because they or a spouse paid Medicare taxes long enough while working — generally at least 10 years"; anyone who does not can buy it for $311 or $565 a month in 2026 and must also take Part B to do so. The envelope, its due date, Medicare Easy Pay and what actually happens if a payment is late are all in how do I pay Medicare premiums without Social Security?, so we will not repeat them here. The one addition for the readers of this post: if your income puts you in an income-related surcharge bracket, that surcharge rides on the same bill, and the appeal for a drop in income after retirement is covered in can I appeal my IRMAA after I retire? CMS had not announced the 2027 Part B premium as of this writing.

The rule that runs the other way

The question in the title has a mirror image, and the mirror has a sharper edge. Can you take Social Security and not take Medicare? For Part B, yes, at any time; it is voluntary. For Part A, no. POMS HI 00801.002, titled "Waiver of HI Entitlement by Monthly Beneficiary," says: "Individuals entitled to monthly benefits which confer eligibility for HI may not waive HI entitlement. The only way to avoid HI entitlement is through withdrawal of the monthly benefit application. Withdrawal requires repayment of all RSDI and HI benefit payments made." Receiving a Social Security check and holding Part A come as a pair, and the only way to separate them is to give the checks back.

Why would anyone want to? Health Savings Accounts. Part A enrollment ends your eligibility to contribute, and when Part A is backdated, as it is for anyone who files after their birthday month, it can reach back into months you already funded. A person who starts Social Security at 65 and keeps contributing to an HSA through a high-deductible employer plan has created a tax problem without knowing it. The six-month backdating rule and the fix are in when do I have to stop contributing to my HSA before Medicare? For this post the point is simpler: delaying Social Security is what keeps the Part A decision in your hands, and taking it is what takes that decision away.

The window the application opens

One last reason the Medicare-only application matters on its own schedule. Medicare.gov: your "one-time Medigap Open Enrollment Period starts once you sign up for Part B and lasts for 6 months." Those six months are the only period in which every Utah Medicare Supplement insurer must accept you at its standard rate with no health questions, and they are keyed to the Part B date, not to your birthday and not to Social Security. Someone who takes Part B at 65 and Social Security at 70 has a Medigap window at 65 and nothing to do with Social Security's timing at all. Utah's birthday rule, covered in can I change my Medicare Supplement plan anytime in Utah?, helps in later years but never reopens those six months. If Original Medicare with a supplement is the direction you are leaning, Plan G versus Plan N in Utah is the comparison to read inside the window, not after it.

What I would do this week

1. Separate the two decisions on paper. Write "Medicare: 65" on one line and "Social Security: ___" on the other, and fill in the second only after running the reduction table and your own numbers.
2. Check the automatic-enrollment test. Benefits at least 4 months before your 65th birthday month means a card in the mail; anything else means you file.
3. File for Medicare only, online at Social Security, in the first of the three months before your birthday month, so Part A and Part B both start on the first of that month.
4. Set up the Part B bill before it arrives. Medicare Easy Pay or your bank's bill-pay; a missed first quarter is the most common early mistake for people without a check.
5. If you already receive Social Security and fund an HSA, stop the contributions now and read the HSA post; Part A is coming with the check whether or not you asked for it.
6. Use the Turning 65 page to get your exact window and bring it to the call.

How we know all this: the Medicare On Main Data Desk frames every article with public data — here, the Social Security Administration's Program Operations Manual System sections HI 00801.006, HI 00805.001, HI 00801.002, RS 00615.003, RS 00615.101 and RS 00615.690; Medicare.gov's "How do I sign up for Medicare?", "Ready to sign up for Part A & Part B", "Medicare costs" and "When can I buy a Medigap policy?" pages; and the CMS Medicare Monthly Enrollment dataset for Utah, June 2026, all read October 8, 2026. The reduction table is arithmetic on the POMS factors for a full retirement age of 67 and is shown before cost-of-living adjustments. 2026 Medicare figures are shown because CMS had not published 2027's. Nothing here is a recommendation about when to claim Social Security; that is a decision for you, Social Security and, if you use one, your financial or tax advisor. This is education, not advice; confirm your own dates with Social Security, a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.