Who Can Get Medicare Based on Age
You become may be able to access for Medicare at age 65, regardless of your work history or income. This is the most straightforward path to coverage. You do not have to be retired — you can still be working — but you must be a U.S. citizen or a lawful permanent resident who has lived in the country for at least five years.
If you were born on the first of the month, Medicare coverage begins the month before you turn 65. If you were born on any other day, coverage begins the month you turn 65. You can sign up starting three months before the month you turn 65 and continuing for three months after. If you miss this window and do not have other coverage, you may pay a permanent penalty on your premiums.
Key Takeaways
- You become may be able to access for Medicare at age 65 if you are a U.S. citizen or lawful permanent resident who has lived in the country for at least five years.
- You can get Medicare before age 65 if you have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease or ALS, regardless of age.
- You must have worked and paid Medicare taxes for at least 10 years (40 quarters) to receive Part A hospital coverage without paying a monthly premium.
- If you do not meet the work requirement, you can still purchase Part A coverage, though the monthly cost will be higher than for those who do.
- Sign up during your initial enrollment period — three months before you turn 65, the month you turn 65, and three months after — to avoid permanent premium penalties.
Medicare Before Age 65: Disability and Medical Conditions
You can get Medicare before age 65 if you have been receiving Social Security disability benefits for 24 months. This applies whether you became disabled at 30 or 60 — the 24-month waiting period starts from the month you first received your disability check, not from the month you applied.
You also become may be able to access for Medicare when ready, at any age, if you have end-stage renal disease (permanent kidney failure requiring dialysis or a transplant) or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig's disease). For end-stage renal disease, you must have a diagnosis from a doctor, but you do not have to wait for dialysis to begin. For ALS, may be able to access begins the month you are diagnosed.
The Work History Requirement for Part A
Part A of Medicare covers hospital stays, skilled nursing care, and hospice. If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), you can get Part A without paying a monthly premium when you turn 65. A quarter is roughly three months of work; you do not need to have worked all 40 quarters consecutively.
If you do not have 10 years of work history under your own name, you may still get premium-free Part A based on your spouse's work record if you are married, or based on your ex-spouse's record if you were married for at least 10 years and are now at least 62. If neither you nor a spouse or ex-spouse has 40 quarters, you can still purchase Part A coverage, though you will pay a monthly premium. The cost varies depending on how many quarters of coverage you do have.
How to Check Your Work Record
Social Security keeps a record of the wages you earned and the Medicare taxes you paid. You can view your earnings record online at ssa.gov by creating a my Social Security account. The record shows each year you worked and how much you earned. If you spot an error — a year where you worked but no earnings appear, or earnings that seem too low — you can request a correction.
Corrections must be requested within three years, three months, and 15 days of the year the wages were earned. If you have old pay stubs or W-2 forms, gather those before you contact Social Security. If you were self-employed, tax returns from that period will help. Social Security can take several months to investigate and correct a record, so start early if you are approaching age 65.
What Happens If You Miss Your Enrollment Window
Your initial enrollment period is seven months long: three months before the month you turn 65, the month itself, and three months after. If you have employer coverage through your own job or your spouse's job, you may have a different window — you can delay signing up without penalty as long as you are still covered by that employer plan and you sign up within eight months of losing that coverage.
If you miss your initial enrollment period and do not have employer coverage, you will pay a permanent 10 percent increase on your Part B premium for each full year you delayed. For Part A, if you do not have the work history to get it premium-free, you will pay a 10 percent increase on the monthly premium. These penalties do not go away — they stay on your account for as long as you have Medicare.
Enrollment Steps and Documents You Will Need
You can sign up for Medicare online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need your Social Security number and information about any current health coverage. If you are signing up based on disability, you will need your Social Security disability award letter. If you are signing up based on end-stage renal disease or ALS, bring documentation of your diagnosis from your doctor.
If you are signing up based on a spouse's or ex-spouse's work record, you will need their Social Security number and proof of your marriage (or divorce decree if using an ex-spouse's record). Have this information ready before you call or explore online. Processing usually takes a few weeks, and your coverage will begin on the first day of the month in which you become may be able to access.
Part B and Part D Enrollment Timing
Part B (medical insurance) and Part D (prescription drug coverage) have their own enrollment rules. If you sign up for Part A at age 65, you should also sign up for Part B and Part D during the same initial enrollment period to avoid late penalties. If you have employer coverage that includes prescription drugs, you may be able to delay Part D without penalty, but you must tell Medicare about your coverage when you sign up for Part A.
If you delay Part B because you have employer coverage, you must sign up within eight months of losing that coverage. If you miss that window, you will pay a 10 percent increase on your Part B premium for each full year you delayed. Part D has a similar rule: if you go 63 days or more without creditable prescription drug coverage, you will pay a permanent increase on your Part D premium.
Frequently Asked Questions
Can I get Medicare if I have never worked?
You can get Part B and Part D at age 65 even without work history. You will not get premium-free Part A, but you can purchase it. If you are married and your spouse has 40 quarters of work history, you may be able to get premium-free Part A based on their record.
What if I am still working at 65 and have health insurance through my job?
You can delay signing up for Medicare Part B without penalty as long as your employer has 20 or more employees and you are covered under their plan. You must sign up within eight months of leaving that job or losing the coverage. You should still sign up for Part A at 65 because it is usually free and covers hospital care.
Do I need to be a U.S. citizen to get Medicare?
You must be a U.S. citizen or a lawful permanent resident who has lived in the country for at least five years. Lawful permanent residents include people with a green card. If you are not yet a permanent resident, you may not be may be able to access, even if you have worked and paid Medicare taxes.
How do I know if my disability qualifies me for early Medicare?
You become may be able to access for Medicare after receiving Social Security disability benefits for 24 months. The only exceptions are end-stage renal disease and ALS, which make you may be able to access when ready. If you are receiving disability benefits, Social Security will contact you automatically when you become may be able to access for Medicare.
What if I disagree with Social Security's decision about my work history?
You can request a detailed earnings record from Social Security and ask them to review it. If you believe there is an error, submit any pay stubs or tax returns you have as proof. You can also request a hearing before an administrative law judge if Social Security denies your correction request.