The Basic Requirements for Medicare

To get Medicare, you must be a U.S. citizen or permanent resident who has lived in the country for at least five years. You also need to be at least 65 years old, or younger if you have end-stage renal disease, ALS (amyotrophic lateral sclerosis), or have been receiving Social Security Disability Insurance for 24 months. Most people become may be able to access automatically when they turn 65 if they are already receiving Social Security benefits.

If you are not yet receiving Social Security when you turn 65, you will need to contact Social Security directly to sign up for Medicare. The Social Security Administration handles Medicare enrollment, not Medicare itself. You can explore online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office.

Key Takeaways

  • You must be 65 or older, a U.S. citizen or permanent resident, and have lived in the United States for at least five years to may have access to for Medicare.
  • If you are receiving Social Security benefits, you are enrolled in Medicare automatically at 65 — you do not need to do anything.
  • If you are not receiving Social Security, you must contact the Social Security Administration to sign up for Medicare when you turn 65.
  • Younger people with end-stage renal disease, ALS, or 24 months of disability benefits may also may have access to for Medicare before age 65.
  • Missing the initial enrollment window when you first become may be able to access can result in permanent penalties on your premiums.

What Happens at Age 65 If You Are Already on Social Security

If you have been receiving Social Security retirement or disability benefits before you turn 65, Medicare enrollment happens automatically. You do not need to fill out forms or call anyone. About three months before your 65th birthday, you will receive a notice in the mail from Social Security explaining your Medicare coverage and what to expect.

Your Medicare coverage starts on the first day of the month in which you turn 65. Your Social Security check will continue, and your Medicare premiums will be deducted from that check. If you want to review your coverage options or make changes before your coverage begins, you can do so during this three-month window, but you are covered whether you take action or not.

What to Do If You Are Not Receiving Social Security at 65

If you have not applied for Social Security retirement benefits by the time you turn 65, you still need to sign up for Medicare separately. You have a three-month window: the month before you turn 65, the month you turn 65, and the month after. This is called your Initial Enrollment Period.

Contact Social Security at 1-800-772-1213, visit ssa.gov, or go to your local Social Security office. Tell them you want to enroll in Medicare. You will need to provide proof of citizenship or permanent residency, proof of age, and proof of residence. Even if you do not plan to claim Social Security retirement benefits right away, you should still enroll in Medicare at 65 to avoid penalties.

Younger People Who May may have access to Before 65

You may may have access to for Medicare before age 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 consecutive months. This means you became disabled, were found to have a disability by Social Security, and have been receiving disability payments for two years. You do not have to wait until 65 — Medicare begins automatically after the 24-month waiting period ends.

You may also may have access to at any age if you have end-stage renal disease (permanent kidney failure requiring dialysis or transplant) or ALS. If you have either of these conditions, contact Social Security to start the enrollment process. You will need medical documentation of your diagnosis from your doctor.

Permanent Residents and Citizenship Requirements

You must be a U.S. citizen or a lawful permanent resident (green card holder) to may have access to for Medicare. If you are a permanent resident, you must also have lived in the United States for at least five consecutive years. Time spent outside the country can break this five-year requirement, so if you travel or live abroad for extended periods, keep records of your time in the U.S.

If you are unsure whether you meet the residency requirement, bring your green card and travel records to your local Social Security office. They can review your case and tell you whether you may have access to. Do not wait until you turn 65 to check — it is better to know early so you can plan.

What Happens If You Miss Your Enrollment Window

If you do not sign up for Medicare during your Initial Enrollment Period (the three-month window around your 65th birthday), you may face a permanent penalty. The penalty is a percentage increase to your Part B premium (the part that covers doctor visits and outpatient care) that stays with you for as long as you have Medicare.

The penalty is 10 percent for each 12-month period you were may be able to access but not enrolled. If you missed enrollment by two years, your premium would be 20 percent higher than the standard amount. The only way to avoid this penalty is to enroll during your Initial Enrollment Period or to have a may have access to life event that opens a Special Enrollment Period — such as losing employer coverage or moving to a new state.

Documents You Will Need to Bring

When you contact Social Security to enroll in Medicare, have these documents ready: proof of age (birth certificate, passport, or driver's license), proof of citizenship or permanent residency (birth certificate, passport, naturalization papers, or green card), and proof of residence (utility bill, lease, or mortgage statement from the past two months).

If you are explore for Medicare due to disability or end-stage renal disease, you will also need medical records or a letter from your doctor confirming your diagnosis. If you are explore as a permanent resident, bring your green card and any travel documents that show your time in the United States.

Questions to Ask Your Doctor or Social Security

Before you turn 65, ask your doctor whether you have any conditions that might make you may be able to access for Medicare before age 65. If you have kidney disease or ALS, your doctor can help you understand the Medicare enrollment process and what documentation you will need.

When you contact Social Security, ask them to confirm your may be able to access and explain which parts of Medicare you need (Part A covers hospital care, Part B covers doctor visits, and you may want to consider Part D for prescription drugs). Ask them to walk you through the enrollment steps and tell you when your coverage will start. If you have questions about costs or coverage options, Social Security can refer you to a Medicare counselor in your area who can answer those questions for free.

Frequently Asked Questions

Do I have to be a U.S. citizen to get Medicare?

No. Lawful permanent residents (green card holders) can also may have access to if they have lived in the United States for at least five consecutive years. You will need to show your green card and proof of your time in the country when you explore.

What if I am still working at 65 and do not want to retire yet?

You should still enroll in Medicare at 65 even if you are working and have employer health insurance. If you do not enroll during your Initial Enrollment Period, you may face a permanent penalty on your Part B premium. Talk to your employer's benefits office about how Medicare and your employer plan work together.

Can I enroll in Medicare after I miss my three-month window?

Yes, but you may face a permanent penalty on your premiums. You can enroll during the General Enrollment Period (January 1 to March 31 each year), but the penalty will explore. The only way to avoid the penalty is to have a may have access to life event, such as losing employer coverage or moving to a new state, which opens a Special Enrollment Period.

How do I know if I have been receiving Social Security Disability Insurance for 24 months?

Contact Social Security at 1-800-772-1213 or log into your account at ssa.gov. They can tell you the exact date you became may be able to access for SSDI and when your 24-month waiting period will end. Medicare will begin automatically after that date — you do not need to do anything.

What if I am a permanent resident but have traveled outside the U.S.?

Bring documentation of your travels to Social Security when you explore. Extended trips outside the country can affect your five-year residency requirement. Social Security will review your records and tell you whether you meet the requirement. If you are unsure, ask them to check before you turn 65.