Who Medicare covers

You can get Medicare if you are 65 or older, or if you are under 65 and have been receiving Social Security Disability Insurance (SSDI) for at least 24 months, or if you have end-stage renal disease (ESRD) or ALS (amyotrophic lateral sclerosis). You must also be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years.

Most people become Medicare-may be able to access automatically when they turn 65, even if they have not yet retired. You do not have to stop working to get Medicare. If you are already receiving Social Security benefits when you turn 65, Medicare enrollment happens on its own. If you are not yet receiving Social Security, you will need to sign up for Medicare separately.

Age 65 is the standard entry point, but there are exceptions. If you have been on SSDI for 24 months, you become may be able to access regardless of your age. If you receive Railroad Retirement Board benefits instead of Social Security, the same 24-month rule applies. If you have ESRD, you may be may be able to access sooner, sometimes within three months of starting dialysis or after a kidney transplant.

Key Takeaways

  • You are may be able to access for Medicare at 65 if you are a U.S. citizen or lawful permanent resident who has lived here for at least five years.
  • If you are under 65, you may still be may be able to access if you have received SSDI for 24 months, have ESRD, or have ALS.
  • If you are already getting Social Security at 65, Medicare enrollment is automatic; if not, you must sign up yourself.
  • You have a limited window to sign up without penalty: three months before you turn 65, the month you turn 65, and three months after.
  • Missing this window can result in a permanent penalty on your Medicare Part B and Part D premiums.

The three-month enrollment window and why it matters

Medicare has a specific enrollment period called the Initial Enrollment Period (IEP). It runs for seven months: three months before the month you turn 65, the month you turn 65 itself, and three months after. If you sign up during this window, your coverage begins on the first day of your birth month (or the first day of the month you become may be able to access, if that is later).

If you miss this window, you can still sign up later, but you will face a permanent penalty. For Part B, the penalty is 10 percent of the standard premium for each full year you delayed. For Part D (prescription drug coverage), the penalty is 1 percent of the national average premium for each month you went without coverage. These penalties stay with you for life, even after you finally enroll.

There is one exception: if you or your spouse are still working and have health insurance through that job, you may be able to delay without penalty. This is called creditable coverage. You will still need to sign up for Medicare eventually, usually within eight months of leaving that job, but the penalty clock does not start until then. You should contact Social Security to confirm your situation before deciding to delay.

How to confirm your may be able to access before you turn 65

You do not have to wait until you turn 65 to find out whether you are may be able to access. You can check your Social Security record online at ssa.gov by creating a my Social Security account. Your account will show your earnings history and tell you when you become may be able to access for benefits. This is the same information Medicare uses to determine may be able to access.

If you are under 65 and think you may be may be able to access because of SSDI, ESRD, or ALS, you can contact Social Security directly at 1-800-772-1213 (TTY 1-800-325-0778). They can tell you your exact may be able to access date. If you are deaf or hard of hearing, you can use the relay service or video relay service.

You can also create an account on Medicare.gov to check your may be able to access and see what your coverage options are. This account is separate from your Social Security account. Having both accounts set up before you turn 65 makes the enrollment process faster.

What happens if you are not a citizen or permanent resident

If you are not a U.S. citizen or lawful permanent resident, you cannot get Medicare based on age alone. However, if you are a lawful permanent resident and have lived in the United States for at least five consecutive years, you become may be able to access at 65 just as a citizen would.

If you are a non-citizen and do not meet the permanent resident requirement, you may still have other coverage options. Some states offer Medicaid to certain non-citizens, and some community health centers offer sliding-scale care based on income. You can find local resources by calling 211 or visiting 211.org.

What to do if you turned 65 and missed the enrollment window

If you are past the Initial Enrollment Period and did not sign up, you can still enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. Coverage begins July 1 of that year. However, you will owe the permanent late-enrollment penalty on Part B and Part D premiums for as long as you have Medicare.

There is one situation where you may be able to avoid the penalty: if you had creditable coverage (health insurance through work or a spouse's job) and did not sign up within eight months of losing that coverage, you may be able to request a penalty waiver. This is not automatic. You will need to contact Social Security and explain your situation. Social Security will review your case, but approval is not may provide.

If you are currently uninsured and cannot afford to wait until the next General Enrollment Period, look into whether you may have access to for Medicaid in your state. Medicaid has different rules and does not have enrollment important date the way Medicare does. You can check your state's Medicaid program by visiting medicaid.gov or calling 211.

Special situations: SSDI, ESRD, and ALS

If you are receiving SSDI, you become may be able to access for Medicare after you have been on SSDI for 24 consecutive months. Social Security will send you information about Medicare enrollment about three months before you become may be able to access. You do not need to do anything to trigger this; it happens automatically based on your SSDI record.

If you have ESRD and start dialysis, you may become may be able to access for Medicare within three months, depending on when your treatment begins. If you receive a kidney transplant, you remain may be able to access for Medicare for 36 months after the transplant, even if your kidney function improves and you no longer need dialysis. After 36 months, you will need to meet one of the other may be able to access rules (age 65, SSDI, or ALS) to keep Medicare.

If you have ALS, you become may be able to access for Medicare when ready, without waiting 24 months on SSDI. Social Security will identify you as having ALS based on your medical records and will enroll you in Medicare automatically. You should still receive a notice from Social Security confirming your may be able to access date.

Understanding the difference between may be able to access and enrollment

may be able to access means you meet the rules to get Medicare. Enrollment means you have actually signed up and your coverage is active. You can be may be able to access but not enrolled. If you are may be able to access and do not enroll during your Initial Enrollment Period, you will face a penalty when you eventually do sign up.

The only time enrollment is automatic is if you are already receiving Social Security benefits when you turn 65. In every other situation—if you have not yet claimed Social Security, if you are under 65 and may be able to access because of SSDI or ESRD, or if you are past 65 and missed your window—you must take action to enroll yourself. Waiting for something to happen on its own will cost you money in penalties.

Frequently Asked Questions

Do I have to be retired to get Medicare at 65?

No. You can be working full-time and still get Medicare at 65. There is no retirement requirement. However, if you are working and have health insurance through your job, you may want to delay enrolling in Medicare Part B to avoid paying two premiums. Contact Social Security to discuss your specific situation.

What if I am 65 but not yet receiving Social Security?

You must sign up for Medicare separately, even if you have not claimed Social Security yet. You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Do this during your Initial Enrollment Period to avoid penalties.

Can I get Medicare if I am a green card holder?

Yes, if you have been a lawful permanent resident for at least five consecutive years. You become may be able to access at 65, just as a U.S. citizen does. You will need to provide proof of your permanent resident status when you enroll. If you have not lived in the U.S. for five years yet, you are not yet may be able to access.

What happens if I sign up late?

You will owe a permanent penalty on your Part B and Part D premiums. The Part B penalty is 10 percent of the standard premium for each full year you delayed. The Part D penalty is 1 percent of the national average premium for each month you went without coverage. These penalties never go away.

How do I know my exact may be able to access date?

Check your my Social Security account at ssa.gov, or call Social Security at 1-800-772-1213. They can tell you the exact date you become may be able to access based on your age, work history, or medical condition. Write down this date so you know when your Initial Enrollment Period begins.