Who Can Get Medicare and When You Become Eligible

The Basic Rule: Age 65 or a may have access to Condition

You become may be able to access for Medicare at age 65, regardless of your work history or income. If you are younger than 65, you may still be may be able to access if you have End-Stage Renal Disease (permanent kidney failure), ALS (Lou Gehrig's disease), or have been receiving Social Security Disability Insurance (SSDI) for 24 months. Some people with permanent disabilities can also may have access to before 65, though the rules are specific about what counts as a may have access to disability.

You do not have to be retired to get Medicare at 65. You can still be working, and your coverage will start whether you claim Social Security benefits or not. However, the timing of when you sign up matters — missing the important date to register can mean paying higher premiums for the rest of your life.

Key Takeaways

You are may be able to access for Medicare the month you turn 65, even if you are still working or have not yet claimed Social Security.
If you are under 65, you may be may be able to access if you receive SSDI, have End-Stage Renal Disease, or have ALS, with different waiting periods depending on your condition.
You must sign up during your Initial Enrollment Period (the three months before, the month of, and three months after your 65th birthday) to avoid permanent premium penalties.
If you are still working at 65 and have health insurance through your employer, you may be able to delay Part B enrollment without penalty if your employer has 20 or more employees.
Your may be able to access is based on your own work record or your spouse's work record — you do not need to have paid a specific dollar amount into Medicare.

may be able to access at Age 65

The month you turn 65, you become may be able to access for Medicare Part A (hospital insurance) and Part B (medical insurance). You do not have to be retired, and you do not have to claim Social Security benefits. Your may be able to access is automatic if you or your spouse paid Medicare taxes while working — even if you worked for only a few years.

If you were born on the first of the month, Medicare considers your may be able to access to start the month before. If you were born on any other day, your coverage starts the month of your birthday. This matters for your enrollment important date: your Initial Enrollment Period runs for seven months total — three months before, the month of, and three months after your birthday month.

You do not lose may be able to access if you keep working past 65. Many people work into their late 60s or 70s while covered by Medicare. If your employer offers health insurance and has 20 or more employees, you may be able to delay enrolling in Part B without paying a penalty later, as long as you enroll within eight months of leaving that job or losing that coverage.

may be able to access Before Age 65 With SSDI

If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become may be able to access for Medicare regardless of your age. The 24 months starts from the month you first began receiving SSDI payments, not from the month you applied. Once you have received SSDI for two full years, Medicare Part A and Part B coverage begins automatically in the 25th month.

You do not have to do anything to enroll — Medicare will contact you about three months before your coverage starts. However, you should still review the information they send and make sure your contact details are current. If you want Part D (prescription drug coverage), you will need to sign up during your Initial Enrollment Period or risk a penalty if you go without creditable coverage.

may be able to access Before Age 65 With End-Stage Renal Disease

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. You do not have to wait any months. Your may be able to access begins the month your kidney disease is diagnosed, the month dialysis treatment begins, or the month you have a kidney transplant, whichever comes first.

You will need to enroll in Medicare yourself; it does not happen automatically. Contact Social Security or Medicare directly to sign up. If you are already receiving SSDI or Social Security retirement benefits, Medicare will be added to your account. If you are not yet receiving benefits, you will need to explore for Medicare separately.

may be able to access Before Age 65 With ALS

If you have been diagnosed with ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease), you become may be able to access for Medicare when ready. Unlike SSDI, which requires 24 months of payments before Medicare starts, ALS qualifies you right away — there is no waiting period.

You must enroll in Medicare yourself by contacting Social Security or Medicare. Bring documentation of your ALS diagnosis from your doctor. Your coverage can begin as early as the month you are diagnosed, depending on when you complete your enrollment.

may be able to access Based on Your Spouse's Work Record

You can be may be able to access for Medicare at 65 based on your spouse's work record if your spouse is 62 or older and may be able to access for Social Security, or if your spouse has already passed away. You do not need to have worked yourself or to have paid Medicare taxes. Your spouse does not have to claim Social Security benefits for you to use their record — they just need to be old enough to claim.

If your spouse is deceased, you can use their work record if you were married for at least nine months before their death. If you are divorced, you can use an ex-spouse's record if you were married for at least 10 years and you are at least 65 years old.

You will still need to enroll in Medicare during your Initial Enrollment Period. When you contact Social Security or Medicare, let them know you want to use your spouse's or ex-spouse's work record, and bring documentation of the marriage (marriage certificate or divorce decree).

What Happens If You Miss Your Enrollment important date

If you do not sign up for Part A during your Initial Enrollment Period and you do not have a valid reason for the delay, you will owe a 10 percent penalty on your Part A premium for twice the number of years you were may be able to access but not enrolled. This penalty is permanent — it stays with you for life.

Part B has a similar penalty: 10 percent for each full 12-month period you were may be able to access but did not enroll. This penalty also lasts for life. The only exceptions are if you were covered by an employer health plan with 20 or more employees, or if you have a valid reason for late enrollment that Medicare accepts (such as a serious illness that prevented you from explore).

There are limited situations where you can enroll late without penalty. These are called "Special Enrollment Periods" and include losing employer coverage, moving out of your plan's service area, or having Medicare wrongly tell you that you did not need to enroll. If you think you have a valid reason, contact Medicare to ask.

Frequently Asked Questions

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

No. You must be a lawful permanent resident (green card holder) or a U.S. citizen, and you must have lived in the United States for at least five consecutive years. If you are a citizen, the five-year residency requirement does not explore. Bring proof of citizenship or permanent residency when you enroll.

What if I worked outside the United States?

Work you did outside the U.S. does not count toward Medicare may be able to access unless you paid U.S. Medicare taxes on that income. If you worked for a U.S. employer or a U.S. government agency abroad, those years may count. Contact Social Security to review your work record.

Can I get Medicare if I never worked?

If you never worked yourself, you may still be may be able to access based on your spouse's or ex-spouse's work record at age 65. If you are under 65 and have never worked, you would need to have ESRD, ALS, or be receiving SSDI for 24 months to may have access to. Otherwise, you would need to purchase coverage through the health insurance marketplace.

Does my income affect my Medicare may be able to access?

No. Medicare may be able to access is not based on income. However, your income does affect how much you pay for Part B and Part D premiums — higher earners pay more. Your income in the past two years is used to calculate these amounts.

What should I do if I think I are may be able to access but Social Security says I am not?

Request a detailed explanation from Social Security in writing. Ask them to review your work record. You can also contact Medicare directly at 1-800-MEDICARE to ask about your may be able to access. If you disagree with their decision, you have the right to appeal.

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.