How to Get Medicare Before You Turn 65

Yes, you can get Medicare before 65 if you meet specific conditions

Medicare is not automatically limited to people 65 and older. You can enroll before that age if you have been receiving Social Security disability benefits for 24 months, have end-stage renal disease (ESRD), or have amyotrophic lateral sclerosis (ALS). Each path has different timing and requirements, and the process differs depending on which condition applies to you.

The most common route is through disability. If you are already receiving Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) disability benefits, Medicare coverage begins automatically after you have been on those benefits for two years. You do not need to do anything — Social Security handles the enrollment. If you have ESRD or ALS, the rules are different and faster, which this article covers below.

Key Takeaways

If you receive SSDI or RRB disability benefits, Medicare starts automatically after 24 months on those benefits, with no separate enrollment step required.
People with end-stage renal disease can get Medicare when ready upon diagnosis, regardless of age or disability status, if they need dialysis or a kidney transplant.
ALS patients become may be able to access for Medicare right away without waiting the usual 24-month period.
You must be a U.S. citizen or permanent resident to enroll in Medicare at any age.
Part A (hospital insurance) is usually free for people who may have access to through disability, but Part B (medical insurance) has a monthly premium you can choose to pay or decline.

Getting Medicare through Social Security disability benefits

If you receive SSDI, your Medicare coverage begins on the 25th month of your disability benefit payments. You do not explore for Medicare separately — Social Security automatically enrolls you in Part A and Part B about three months before your coverage starts. You will receive a Medicare card in the mail.

The 24-month waiting period starts from the month Social Security approves your disability claim, not from the month you filed. If you were approved in January, your 24-month clock begins in January, and Medicare starts in January of the following year (month 25). If you are unsure when your approval month was, you can check your Social Security statement online at ssa.gov or call Social Security at 1-800-772-1213.

If you receive disability benefits through the Railroad Retirement Board instead of Social Security, the same 24-month rule applies. Your Medicare enrollment happens automatically through RRB, and you will receive your card by mail.

Medicare for people with end-stage renal disease

End-stage renal disease (ESRD) is permanent kidney failure that requires dialysis or a kidney transplant. If you have ESRD, you become may be able to access for Medicare when ready upon diagnosis, regardless of your age or whether you receive disability benefits. You do not have to wait 24 months.

To enroll, you must contact Social Security directly. Call 1-800-772-1213 or visit your local Social Security office in person. Bring documentation of your ESRD diagnosis — typically a letter from your nephrologist or dialysis center stating that you have end-stage renal disease and the date the condition was diagnosed. Social Security will enroll you in Medicare Part A and Part B, and coverage usually begins the first day of the month in which you meet the medical criteria.

Medicare coverage for ESRD continues for as long as you need dialysis or have had a kidney transplant, even if you later return to work or no longer receive disability benefits. If your transplanted kidney fails and you return to dialysis, your coverage continues without interruption.

Medicare for people with ALS

Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, qualifies you for Medicare when ready without the 24-month waiting period. You do not need to be approved for Social Security disability first.

To enroll, contact Social Security at 1-800-772-1213 or visit a local Social Security office. Bring medical documentation of your ALS diagnosis — a letter from your neurologist or the medical center treating you is usually sufficient. Social Security will process your Medicare enrollment, and coverage typically begins the first day of the month after you submit your process.

Unlike ESRD, ALS may be able to access for Medicare does require that you also be approved for SSDI or be a government employee with Medicare coverage through your employer. If you have not yet applied for SSDI, Social Security will help you file for both disability benefits and Medicare at the same time.

What Medicare costs when you enroll before 65

Part A (hospital insurance) is free for people who may have access to through disability, ESRD, or ALS. Part B (medical insurance) has a monthly premium that you pay. For 2024, the standard Part B premium is $164.90 per month, though your actual premium may be higher or lower depending on your income. The premium is deducted from your Social Security check if you receive SSDI.

You can choose to decline Part B when you first enroll, but if you do, you may face a permanent penalty if you enroll later. The penalty is 10 percent of the Part B premium for each 12-month period you were may be able to access but did not enroll. Most people should enroll in Part B when they become may be able to access to avoid this penalty, even if they do not plan to use it when ready.

Part D (prescription drug coverage) and Medigap or Medicare Advantage plans are optional. You can add these later during the annual enrollment period (October 15 to December 7) or during a special enrollment period if you have a may have access to life event.

Citizenship and residency requirements

To enroll in Medicare at any age, you must be a U.S. citizen or a permanent resident who has lived in the United States for at least five years. Permanent residents must provide proof of their status, such as a green card or I-551 document.

If you are not yet a permanent resident but are in the process of becoming one, you may still be able to enroll in Medicare if you meet the other requirements. Contact Social Security to discuss your specific situation.

What happens when you turn 65

If you enrolled in Medicare before 65 through disability, ESRD, or ALS, your coverage continues without interruption when you reach 65. You do not need to re-enroll or take any action. Your Medicare benefits remain the same.

If you are receiving SSDI and have not yet turned 65, you will automatically convert to regular Medicare (based on age) at 65. This is an administrative change only — your coverage and benefits do not change. You will receive a new Medicare card reflecting your age-based may be able to access, but your coverage dates and plan remain the same.

Frequently Asked Questions

How do I know if my disability benefits have been active for 24 months?

Log into your Social Security account at ssa.gov and view your statement, which shows your approval date. Count forward 24 months from that date. You can also call Social Security at 1-800-772-1213 and ask when your Medicare coverage will begin. They will give you the exact month.

Can I enroll in Medicare before my 24 months are up if I have a job?

No. The 24-month waiting period is fixed. However, if you return to work while receiving SSDI, your benefits may continue under a work incentive program, and your 24-month clock does not reset. Contact Social Security to understand how work affects your specific situation.

What if I was denied for Social Security disability but have ESRD or ALS?

You can still enroll in Medicare through ESRD or ALS without being approved for disability benefits. Contact Social Security with your medical documentation, and they will process your Medicare enrollment separately from any disability decision.

Do I have to enroll in Part B, or can I just take Part A?

You can decline Part B, but doing so may result in a permanent 10 percent penalty added to your premium if you enroll later. Most people should enroll in both Part A and Part B when they become may be able to access, even if they do not use Part B when ready.

What if I move outside the United States after I enroll in Medicare?

You can keep your Medicare coverage if you move to most countries, but coverage rules vary by location. Contact Medicare at 1-800-MEDICARE before you move to understand what services will be covered where you are going.

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.