Who Can Get Medicare: It's Not Just for People Over 65

Medicare covers people younger than 65 in specific situations

Medicare is not limited to seniors. While most people become may be able to access at 65, you can get Medicare at any age if you have End-Stage Renal Disease (ESRD), receive Social Security Disability Insurance (SSDI), or have been diagnosed with ALS (amyotrophic lateral sclerosis). These three conditions override the age requirement entirely.

The rules are strict about which conditions may have access to and how long you must have received disability payments before coverage begins. Understanding which category applies to you matters because the timing of when your coverage starts and what you pay depends on it.

Key Takeaways

You can get Medicare before 65 if you receive SSDI, have ESRD, or have been diagnosed with ALS.
If you receive SSDI, you become may be able to access for Medicare after you have been on disability for 24 months, regardless of your age.
People with ESRD become may be able to access when ready upon diagnosis, and those with ALS become may be able to access when ready upon diagnosis without the 24-month wait.
You must contact Social Security to enroll in Medicare; it does not happen automatically for people under 65.

Medicare through Social Security Disability Insurance (SSDI)

If you receive SSDI, you become may be able to access for Medicare after 24 months of receiving disability payments. This 24-month period starts from the month your disability benefits began, not from when you applied. Once those 24 months have passed, Medicare Part A (hospital insurance) and Part B (medical insurance) coverage begins automatically on the first day of the month you reach the 24-month mark.

You do not need to do anything to enroll once you hit 24 months — Social Security handles the enrollment automatically. However, you should still review your Medicare options and decide whether to add Part D (prescription drug coverage) or a Medigap policy. Part D has a important date: if you do not enroll when you first become may be able to access and you go without coverage, you may pay a penalty later.

Contact Social Security at 1-800-772-1213 to confirm when your 24-month period ends and to ask questions about your specific situation. They can tell you the exact month your Medicare coverage will start.

Medicare for people with End-Stage Renal Disease (ESRD)

If you have ESRD and need dialysis or a kidney transplant, you become may be able to access for Medicare when ready upon diagnosis, regardless of age. You do not have to wait 24 months like people on SSDI. Your coverage can begin as early as the first day of the month in which you start dialysis treatment or the month you receive a kidney transplant.

You must enroll in Medicare yourself — it does not happen automatically. Contact Social Security or visit Medicare.gov to start the enrollment process. Bring documentation of your ESRD diagnosis and proof of when your treatment began. The process typically takes a few weeks, so contact them as soon as you receive your diagnosis.

Your Medicare coverage through ESRD continues for as long as you need dialysis or have a functioning transplant. If you later receive a successful transplant and no longer need dialysis, your coverage does not stop automatically — you will need to contact Social Security if your situation changes.

Medicare for people with ALS

If you have been diagnosed with ALS (Lou Gehrig's disease), you become may be able to access for Medicare when ready, without the 24-month waiting period that applies to other SSDI recipients. Your coverage can begin as early as the first day of the month in which you are diagnosed.

Like people with ESRD, you must enroll in Medicare yourself. Contact Social Security at 1-800-772-1213 or visit Medicare.gov with your ALS diagnosis documentation. Social Security will need proof of your diagnosis from your doctor. Enrollment typically takes a few weeks.

Your Medicare coverage continues as long as you remain on SSDI. If your situation changes — for example, if you return to work and your SSDI benefits end — your Medicare coverage may change as well. Contact Social Security before making any changes to your work status so you understand how it affects your coverage.

How to enroll in Medicare before age 65

You must take action to enroll in Medicare if you are under 65. Social Security does not automatically enroll you unless you have been on SSDI for 24 months, and even then you should confirm your enrollment and review your options.

Contact Social Security at 1-800-772-1213 to start the process. Have your diagnosis documentation ready, along with proof of when your condition began or when you started treatment. You can also visit your local Social Security office in person or explore online at ssa.gov.

Once you enroll in Medicare Part A and Part B, you have eight weeks to decide whether to add Part D (prescription drug coverage). If you take prescription medications, review the available plans in your area — waiting to enroll in Part D after this window closes may result in a penalty on your premiums.

What Medicare covers for people under 65

Your Medicare coverage works the same way whether you are 30 or 75. Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Part B covers doctor visits, outpatient care, lab tests, and preventive services. You pay the same premiums and have the same out-of-pocket costs as someone who became may be able to access at 65.

Most people under 65 who may have access to for Medicare also have low incomes, which may make them may be able to access for Medicaid as well. If you have both Medicare and Medicaid, Medicaid can help pay your Medicare premiums and out-of-pocket costs. Contact your state Medicaid office to learn whether you may have access to.

You may also want to consider a Medigap policy or a Medicare Advantage plan to help cover costs that Original Medicare does not pay. These options work the same way for people under 65 as they do for seniors.

When to contact your doctor and Social Security

If you have been diagnosed with ESRD, ALS, or a condition that may may have access to you for SSDI, contact Social Security as soon as possible. Do not wait to see if your condition improves — the sooner you explore for SSDI or enroll in Medicare, the sooner your coverage can begin.

If you are already receiving SSDI and approaching your 24-month mark, contact Social Security one month before to confirm your Medicare enrollment date and review your coverage options. If you have questions about what Medicare covers for your specific condition, call Medicare at 1-800-MEDICARE (1-800-633-4227) to speak with someone who can explain your options.

Frequently Asked Questions

Can I get Medicare if I am under 65 and not on disability?

No, unless you have ESRD or ALS. Medicare is available to people under 65 only if they receive SSDI, have been diagnosed with ESRD, or have been diagnosed with ALS. If you do not fall into one of these categories, you may be able to purchase coverage through the health insurance marketplace or through your employer.

Do I have to wait 24 months if I have ESRD or ALS?

No. The 24-month waiting period applies only to people who receive SSDI for other disabilities. If you have ESRD or ALS, you become may be able to access for Medicare when ready upon diagnosis, without waiting.

What happens to my Medicare if I go back to work?

If you are on SSDI and return to work, your benefits may end, which could affect your Medicare coverage. Contact Social Security before you start working to understand how it affects your may be able to access. Some people can continue Medicare coverage for a limited time even after SSDI benefits end.

Can I enroll in Medicare online if I am under 65?

You can start the process online at ssa.gov, but you will likely need to speak with someone at Social Security to complete your enrollment, especially if you need to provide medical documentation. Calling 1-800-772-1213 is often faster than waiting for an online process to be processed.

Do I pay the same Medicare premiums as someone who is 65?

Yes. Medicare premiums are based on your income and coverage choices, not your age. You will pay the same Part B and Part D premiums as a 65-year-old with the same income. You may pay less if you may have access to for Medicaid, which can help cover your premiums.

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.