Who Can Get Medicare and When You Become Eligible

The Basic Rules for Medicare may be able to access

You can enroll in Medicare when you turn 65, regardless of your work history or income. You do not have to be retired. You do not have to be poor. The program is open to U.S. citizens and permanent residents who have lived in the country for at least five years.

If you are already receiving Social Security retirement benefits when you turn 65, Medicare enrollment happens automatically. If you are not yet taking Social Security, you will need to sign up for Medicare separately. The enrollment window opens three months before your 65th birthday and closes three months after it.

Some people under 65 can also join Medicare if they have received Social Security Disability Insurance (SSDI) for 24 months, or if they have end-stage renal disease or ALS. These routes are less common but do exist.

Key Takeaways

You become may be able to access for Medicare at age 65 if you are a U.S. citizen or permanent resident who has lived in the country for at least five years.
If you receive Social Security retirement benefits, Medicare enrollment is automatic at 65; if not, you must sign up yourself during your enrollment window.
You can enroll starting three months before your 65th birthday through three months after it, and missing this window can mean paying a penalty for life.
Some people under 65 may have access to through disability (after 24 months of SSDI), end-stage renal disease, or ALS diagnosis.
Your enrollment date determines when your coverage begins, so timing your signup matters if you are still working or have other insurance.

Age 65 and Citizenship Requirements

The simplest path to Medicare is turning 65. You must be a U.S. citizen or a permanent resident (green card holder) who has lived in the United States for at least five consecutive years. The five-year clock resets if you leave the country for more than six months, so if you have been abroad recently, that time does not count.

Permanent residents who have not yet met the five-year requirement can still enroll in Medicare Part A (hospital insurance) if they have worked and paid Medicare taxes for at least 40 quarters — roughly ten years. This rule lets some people join hospital coverage before they meet the residency requirement, though it is less common.

What Happens If You Miss Your Enrollment Window

Your initial enrollment period runs from three months before your 65th birthday through three months after it — a seven-month window. If you do not sign up during this time and you do not have a valid reason for the delay, you will pay a permanent penalty on your premiums.

The penalty for late enrollment in Part B (medical insurance) is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. If you waited five years, you pay 50 percent more than the standard rate for the rest of your life. The penalty for Part D (prescription drug coverage) works the same way.

A valid reason to delay — called a "may have access to event" — includes staying on your employer's health plan while you work, or being covered by a spouse's plan. If either applies to you, you get a special enrollment period after you lose that coverage. Keep records of your employer coverage or your spouse's plan to prove the delay was justified.

Disability and Younger Enrollees

You can join Medicare before 65 if you have received SSDI for 24 consecutive months. The 24-month clock starts when your disability benefits begin, not when you applied. Once you hit that mark, you become may be able to access for Medicare automatically — you do not have to do anything.

Two other conditions open Medicare to younger people: end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS). If you are diagnosed with ESRD, you can enroll in Medicare when ready, regardless of age. If you have ALS, you also enroll right away without waiting for disability approval. Both conditions require medical documentation from your doctor.

Work Status and Employer Coverage

Working past 65 does not disqualify you from Medicare. You can be employed full-time and still enroll. However, if your employer has 20 or more employees and offers health insurance, you may want to delay Medicare Part B and stay on your employer plan instead. This can save money if your employer coverage is strong.

If you choose to stay on your employer plan and delay Part B, you will not pay the late-enrollment penalty when you finally sign up, as long as you enroll within eight months of leaving your job or losing employer coverage. This is called creditable coverage, and it protects you from penalties.

Part A (hospital insurance) works differently. Even if you have employer coverage, you should enroll in Part A at 65 because it rarely has a premium and the late-enrollment penalty is smaller. Delaying Part A can cost you more in the long run.

How to Confirm Your may be able to access

You can check your work record and estimated benefits online through your Social Security account at ssa.gov. This shows you how many quarters of work you have completed and whether you meet the 40-quarter requirement for Part A. You can create an account or log in to view this information.

If you are unsure whether you meet the five-year residency requirement as a permanent resident, contact U.S. Citizenship and Immigration Services (USCIS) to verify your green card status and entry date. If you have questions about disability or ESRD may be able to access, your doctor or your SSDI caseworker can help you understand whether you may have access to.

Three months before your 65th birthday, you can also call Social Security at 1-800-772-1213 to ask about your specific situation. They can tell you whether you are may be able to access and walk you through the enrollment process.

Frequently Asked Questions

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

No. You can be working full-time and still enroll in Medicare at 65. Your employment status does not affect your may be able to access. However, if your employer offers health insurance with 20 or more employees, you may choose to delay Part B and stay on that plan instead.

What if I was not born in the United States but have a green card?

You can enroll in Medicare at 65 if you have been a permanent resident for at least five consecutive years. If you have not yet reached five years, you may still join Part A if you have worked and paid Medicare taxes for 40 quarters (about ten years).

Can I enroll in Medicare after my 65th birthday if I missed the window?

Yes, but you will likely pay a penalty. If you had a valid reason to delay — such as staying on an employer plan — you can enroll without penalty within eight months of losing that coverage. Otherwise, you pay a permanent surcharge on your premiums.

How do I know if I have worked 40 quarters for Medicare?

Log into your Social Security account at ssa.gov to see your work record. You can also call Social Security at 1-800-772-1213 and ask them to review your quarters with you. They will tell you exactly how many you have earned.

What if I am disabled and under 65 — can I get Medicare now?

If you have received SSDI for 24 consecutive months, you become may be able to access for Medicare automatically. If you have end-stage renal disease or ALS, you can enroll when ready regardless of how long you have been on disability. Your doctor can help you understand which category applies to you.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.