The Basic Rule: Age 65 or Disability

You can collect Medicare when you turn 65, or earlier if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Most people become may be able to access at 65 straightforward by reaching that age — you do not have to be retired, and you do not have to stop working.

may be able to access is tied to your work history or your spouse's work history. You or your spouse must have paid Medicare taxes for at least 10 years (40 quarters) to may have access to based on age. If you do not meet that requirement yourself, you may still be covered under your spouse's record if you are 62 or older and married, or under an ex-spouse's record if you were married for at least 10 years.

If you are not yet 65 and do not have a disability or terminal illness, you cannot collect Medicare, even if you have retired early or have very low income. Medicaid, marketplace insurance, or COBRA coverage through a former employer are your other options during those years.

Key Takeaways

  • You become may be able to access for Medicare at 65 if you or your spouse paid Medicare taxes for at least 10 years, regardless of whether you are still working.
  • You can collect Medicare before 65 if you have been on SSDI for 24 months, or if you have end-stage renal disease or ALS.
  • If you are divorced, you may be covered under an ex-spouse's work record if you were married for at least 10 years and are now 62 or older.
  • You must enroll during your initial enrollment period or face permanent late penalties on your premiums, even if you delay coverage.

may be able to access Based on Your Own Work History

The standard path to Medicare is reaching 65 and having paid into the system. Medicare taxes are the 1.45% that comes out of your paycheck under "FICA" or "self-employment tax." You need 40 quarters of coverage — roughly 10 years of work — but those quarters do not have to be recent or consecutive. If you worked for 10 years at any point in your life and paid these taxes, you meet the requirement.

You do not have to be a U.S. citizen to collect Medicare, but you must be a permanent resident (green card holder) or a citizen. If you are a citizen, you can live anywhere in the world and still receive Medicare Part A and Part B, though coverage outside the United States is limited.

Your age 65 may be able to access is automatic if you are already receiving Social Security retirement benefits — Medicare will be mailed to you about three months before your 65th birthday. If you have not yet claimed Social Security, you will need to enroll in Medicare separately during your initial enrollment period, which runs from three months before your 65th birthday through three months after.

may be able to access Before 65: Disability and Serious Illness

If you are under 65 and have been approved for SSDI, you become may be able to access for Medicare after you have been on disability for 24 months. This means you must have been receiving SSDI payments for two full years before Medicare coverage begins. During those first 24 months, you may be covered by Medicaid or marketplace insurance instead, depending on your state and income.

Two conditions bypass the age and work-history requirements entirely. If you have end-stage renal disease — permanent kidney failure requiring dialysis or transplant — you can enroll in Medicare when ready, regardless of age or work history. Similarly, if you have been diagnosed with ALS (Lou Gehrig's disease), you become may be able to access for Medicare right away without waiting for SSDI approval or the 24-month clock.

If you are under 65 and do not fall into one of these categories, you cannot collect Medicare. You will need to explore other coverage: Medicaid (if your income is low enough), marketplace insurance through Healthcare.gov, or COBRA if you recently left an employer with health benefits.

may be able to access Through a Spouse or Ex-Spouse

If you are 62 or older and married, you can be covered under your spouse's Medicare record even if you yourself have no work history or an incomplete one. Your spouse must be 65 or older and may be able to access for Medicare. You do not have to be retired, and your spouse does not have to have claimed Social Security yet — they just need to be old enough to be may be able to access.

If you are divorced, you can use an ex-spouse's work record if you are 62 or older, were married for at least 10 years, and are not currently married. Your ex-spouse does not have to have claimed Social Security or Medicare themselves — as long as they are 62 or older, you can use their record. This is true even if they have remarried.

If you are widowed, you can collect Medicare based on your deceased spouse's work history if you are 60 or older. You do not need to have been married for any minimum length of time, though you cannot have remarried before age 60 (remarriage at 60 or later does not affect this benefit).

When to Enroll and What Happens If You Miss the important date

Your initial enrollment period is the window when you can sign up for Medicare without penalty. For most people, this is the three-month period before the month you turn 65, the month you turn 65, and the three months after. If you are already on SSDI when you turn 65, you are enrolled automatically in Parts A and B, and you do not need to do anything.

If you miss your initial enrollment period and do not have other may have access to coverage (such as an active employer health plan), you will pay a permanent penalty on your Part B and Part D premiums for as long as you have Medicare. The penalty is 10% of the standard Part B premium for each full 12-month period you were not enrolled. For Part D (prescription drug coverage), the penalty is 1% of the national average premium for each month you were not enrolled. These penalties do not go away even if you enroll later.

The only exception is if you had creditable coverage — health insurance through an employer, COBRA, or certain other sources — during the time you were not enrolled in Medicare. If you can show you had continuous coverage, you may avoid the penalty. You will need to provide proof from your former employer or insurance company.

Special Situations: Government Workers and Non-Citizens

Some government employees — particularly those hired before 1984 by federal, state, or local government — may not have paid Medicare taxes and therefore may not be may be able to access for Medicare Part A at 65. These workers often had their own pension systems instead. If this applies to you, you can still buy into Part A at 65 if you are 65 or older and a U.S. citizen or permanent resident, but you will pay a higher premium. Contact Social Security to find out whether you paid Medicare taxes during your government employment.

Non-citizens can collect Medicare if they are permanent residents (green card holders) and meet the age or disability requirements. Undocumented immigrants are not may be able to access for Medicare. Temporary visa holders (such as H-1B workers) are not may be able to access, even if they have paid Medicare taxes — they must have permanent resident status or citizenship.

How to Confirm Your may be able to access

You can check your work history and quarters of coverage by creating an account on ssa.gov and viewing your Social Security Statement. This shows how many quarters you have earned and whether you are on track for retirement or disability benefits. If you see an error — a missing job, incorrect earnings, or a duplicate Social Security number — you can correct it through Social Security.

If you are unsure whether you meet the requirements, you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask about your may be able to access. Have your Social Security number ready. You can also visit your local Social Security office in person, though calling ahead to schedule an appointment is recommended.

About three months before you turn 65, Social Security will mail you information about Medicare enrollment if you are already receiving benefits. If you are not receiving benefits, you will not receive this notice automatically — you must enroll yourself during your initial enrollment period.

Frequently Asked Questions

Can I collect Medicare if I am still working?

Yes. Reaching 65 makes you may be able to access for Medicare regardless of whether you are working. If you are still employed and your employer offers health insurance, you can keep that coverage and delay Medicare Part B without penalty, as long as your employer has 20 or more employees. You must enroll in Part A (hospital insurance) at 65, but you can delay Part B.

What if I worked in another country — does that count toward the 10 years?

Work in most countries does not count toward Medicare may be able to access. You need 10 years of work in the United States where you paid Medicare taxes. There are a few exceptions for workers in countries with social security agreements with the U.S., but these are rare. Contact Social Security to ask whether your foreign work history qualifies.

Can my adult child collect Medicare on my record?

No. Medicare is not available to adult children. Unmarried children under 19 (or up to 23 if they are full-time students) can be covered under a parent's Medicare record only in very limited circumstances, and this is uncommon. Adult children have no Medicare may be able to access based on a parent's work history.

If I am on SSDI, do I automatically get Medicare after 24 months?

You are automatically enrolled in Medicare Part A and Part B after you have been on SSDI for 24 months. You do not have to explore or enroll — it happens automatically. You will receive your Medicare card in the mail. If you do not receive it, contact Social Security to confirm your enrollment.

What if I delayed Social Security past 65 — can I still get Medicare at 65?

Yes. Medicare may be able to access at 65 is separate from when you claim Social Security retirement benefits. You can claim Medicare at 65 and delay Social Security until 70 to get a higher monthly benefit. You must enroll in Medicare during your initial enrollment period even if you are not yet taking Social Security.