The Basic Rule: Age 65 or Disability

You become may be able to access for Medicare when you turn 65, regardless of your income or health history. You do not have to retire, and you do not have to be poor. If you are under 65, you may still be may be able to access if you have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease or ALS (amyotrophic lateral sclerosis). These are the three main paths into Medicare.

may be able to access is not the same as enrollment. Becoming may be able to access means you meet the basic requirement. Enrollment means you have actually signed up. Most people become may be able to access at 65 but do not enroll until they contact Social Security or Medicare directly. There is a window of time to enroll without penalty, and missing it can cost you money for the rest of your life.

Key Takeaways

  • You become may be able to access for Medicare at age 65 if you or your spouse paid Medicare taxes for at least 10 years (40 quarters) during your working life.
  • If you are under 65, you may be may be able to access if you have received Social Security disability benefits for 24 months, or if you have end-stage renal disease or ALS.
  • may be able to access and enrollment are separate: you must contact Social Security or Medicare to actually sign up, usually three months before your 65th birthday.
  • If you miss your enrollment window, you will pay a permanent penalty on your Part B and Part D premiums unless you have may have access to coverage like employer insurance.
  • Your spouse's work history counts: if they paid Medicare taxes for 10 years, you may be may be able to access at 65 even if you did not work.

The 10-Year Work History Requirement

To be may be able to access for Medicare Part A (hospital insurance) at 65, you or your spouse must have paid Medicare taxes for at least 10 years. This means 40 quarters of coverage — roughly 10 years of work, though not necessarily consecutive. Each quarter you work and pay Medicare tax counts toward this total, even if you worked part-time or took years off between jobs.

You can check your own work history by creating an account on ssa.gov and viewing your Social Security statement. This statement shows how many quarters of coverage you have earned. If you are close to 40 quarters but not quite there, you may be able to work a few more months or years to reach the threshold. If your spouse has 40 quarters and you do not, you can still be may be able to access based on their work history once you turn 65.

Non-citizens who worked in the United States and paid Medicare taxes are also may be able to access at 65, as long as they meet the 10-year requirement and are now a lawful permanent resident or have been in the country for at least five years.

may be able to access Before Age 65

If you are under 65 and receiving Social Security disability benefits, you become may be able to access for Medicare after you have been on disability for 24 months. The 24 months starts from the month your disability benefit began, not from the month you filed. Once you reach 24 months of benefits, Medicare Part A and Part B begin automatically — you do not have to do anything, though you should still review your coverage.

If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or a transplant — you become may be able to access for Medicare when ready, regardless of age or work history. You must be a U.S. citizen or lawful permanent resident. Similarly, if you have been diagnosed with ALS, you become may be able to access for Medicare when ready without the usual waiting period.

For both ESRD and ALS, you will need to provide medical documentation to Medicare. Your doctor or dialysis center can help you report your condition. Once Medicare receives the documentation, your coverage begins the first day of the month in which you meet the medical criteria.

When to Enroll and Your Enrollment Window

Your Initial Enrollment Period is a seven-month window: three months before the month you turn 65, the month you turn 65, and three months after. If your birthday is June 15, your window opens March 1 and closes September 30. During this window, you can enroll in Medicare Part A and Part B without penalty.

If you are still working at 65 and have health insurance through your employer, you may be able to delay enrolling in Part B without penalty. This is called the Special Enrollment Period for people with group health plan coverage. You must enroll within eight months of losing that coverage or retiring, whichever comes first. Keep documentation of your employer coverage in case Medicare asks for proof later.

If you miss your Initial Enrollment Period and do not have may have access to employer coverage, you will pay a permanent penalty. Your Part B premium increases by 10 percent for each year you were may be able to access but not enrolled. Your Part D (prescription drug) premium also increases by 1 percent for each month you were may be able to access but not enrolled. These penalties stay with you for life, even if you enroll later.

Documents You Will Need

When you contact Social Security or Medicare to enroll, have these documents ready: your Social Security number, proof of citizenship or lawful permanent residency (passport, birth certificate, or naturalization papers), and proof of age (birth certificate or passport). If you are enrolling based on disability or ESRD, you will also need medical records or a letter from your doctor confirming your condition.

If you are enrolling based on your spouse's work history, bring your marriage certificate. If you are divorced and want to use your ex-spouse's work history, bring your divorce decree and proof that you have not remarried. You do not need to bring these documents to explore — you can explore by phone or online — but you may need to mail or upload them later if Medicare asks for verification.

How to Report Your may be able to access

You can enroll in Medicare through three routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online enrollment through Medicare.gov is usually the fastest. You will create an account, answer questions about your work history and citizenship, and submit your information. You should receive confirmation within a few days.

If you are already receiving Social Security retirement or disability benefits, Medicare will contact you automatically about three months before you turn 65 or become may be able to access. You can accept their offer or make changes to your coverage. If you are not yet receiving Social Security benefits, you must contact Medicare or Social Security yourself — they will not reach out to you.

If you are enrolling based on ESRD or ALS, contact your doctor's office or dialysis center and ask them to report your condition to Medicare. They usually handle this paperwork. You can also call Medicare directly at 1-800-MEDICARE and tell them about your condition. Have your medical records available when you call.

What Happens After You Are may be able to access

Once you are may be able to access and enrolled, you will receive a Medicare card in the mail within two to four weeks. Your coverage begins on the first day of the month in which you enroll, or on the first day of the month after you turn 65 if you enroll during your Initial Enrollment Period. Part A (hospital insurance) and Part B (medical insurance) are the foundation of Medicare. You can also choose to add Part D (prescription drug coverage) or a Medigap or Medicare Advantage plan.

Your may be able to access does not change once you have it. You remain may be able to access for Medicare for life as long as you are a U.S. citizen or lawful permanent resident. Your premiums may change each year, and your coverage options may change, but your basic may be able to access does not expire or require renewal.

Frequently Asked Questions

What if I worked outside the United States?

Work you did outside the U.S. generally does not count toward the 10-year requirement, even if you paid taxes. However, some countries have agreements with the U.S. Social Security system that allow work in those countries to count. Call Social Security at 1-800-772-1213 to ask whether your country has a totalization agreement.

Can I get Medicare if I am not a U.S. citizen?

You must be a U.S. citizen or lawful permanent resident to be may be able to access for Medicare. If you are a lawful permanent resident, you must have been in the country for at least five years to be may be able to access based on your own work history. Refugees and asylees are treated as lawful permanent residents for Medicare purposes.

Do I have to be retired to be may be able to access?

No. You become may be able to access for Medicare at 65 whether you are still working or retired. If you are still working and have employer health insurance, you may delay enrolling in Part B without penalty, but you can enroll in Part A at any time.

What if my spouse is may be able to access but I am not?

At 65, you can be may be able to access based on your spouse's work history even if you never worked or did not work long enough. You must be married, and your spouse must have 40 quarters of coverage. If you are divorced, you can use your ex-spouse's work history if you were married for at least 10 years and are now at least 65.

How do I know if I have 40 quarters of coverage?

Create an account at ssa.gov and view your Social Security statement. It shows your quarters of coverage year by year. You can also call Social Security at 1-800-772-1213 and ask them to tell you your total. If you are close, ask how much longer you need to work to reach 40 quarters.