How to Get Medicare Before You Turn 65

You can get Medicare before 65 if you have been receiving Social Security disability benefits for 24 months, have end-stage renal disease, or have ALS

Medicare is not automatically tied to age 65. The Social Security Administration and Centers for Medicare & Medicaid Services (CMS) have three main pathways that let you enroll before your 65th birthday. The most common is the 24-month rule: if you have been collecting Social Security Disability Insurance (SSDI) for two full years, you become automatically enrolled in Medicare Part A and Part B on the first day of the 25th month. You do not have to explore separately or contact anyone—the enrollment happens on its own.

The other two routes are narrower. If you have end-stage renal disease (permanent kidney failure requiring dialysis or a transplant), you can enroll in Medicare regardless of age or work history. Similarly, if you have been diagnosed with ALS (amyotrophic lateral sclerosis), you become may be able to access for Medicare when ready upon approval for SSDI, without waiting the usual 24 months. Both of these conditions bypass the waiting period entirely.

Key Takeaways

If you receive SSDI, Medicare enrollment happens automatically after 24 months of benefits—you do not need to do anything.
End-stage renal disease and ALS both allow Medicare enrollment at any age without the 24-month waiting period.
Your Medicare coverage begins on the first day of the 25th month of SSDI, or when ready upon ALS or kidney disease approval.
You can check your enrollment status by logging into your Social Security account or calling Social Security at 1-800-772-1213.

How the 24-Month Rule Works for SSDI Recipients

When you are approved for Social Security Disability Insurance, the clock starts. Social Security counts 24 full months from the date your benefits begin—not from the date you applied. On the first day of month 25, Medicare Part A (hospital insurance) and Part B (medical insurance) set up automatically. You will receive a Medicare card in the mail before your coverage starts.

This automatic enrollment means you do not have to remember a important date or fill out a form. However, you should still review your Medicare card when it arrives to make sure the name and Social Security number are correct. If you notice an error, call Medicare at 1-800-MEDICARE (1-800-633-4227) to report it.

Part A covers hospital stays, skilled nursing care, hospice, and home health services. Part B covers doctor visits, outpatient care, lab tests, and durable medical equipment. Both have costs: Part A typically has no monthly premium if you or your spouse paid Medicare taxes for at least 10 years, but Part B has a monthly premium that is deducted from your Social Security check.

End-Stage Renal Disease: when ready Medicare Enrollment

If you have permanent kidney failure and need dialysis or a kidney transplant, you become may be able to access for Medicare the month your treatment begins, regardless of your age. You do not have to be on disability, have worked a certain number of years, or wait any length of time. This is one of the few situations where age is completely irrelevant to Medicare enrollment.

To enroll, you will need to contact Medicare directly or have your dialysis center or transplant program help you explore. Your nephrologist (kidney specialist) or the social worker at your treatment facility can guide you through the process. Medicare will cover dialysis treatments, transplant surgery, and related medications and supplies.

Even if you are already on Medicare for another reason, this coverage is important to understand because kidney disease often comes with additional costs and coverage rules that differ from standard Medicare.

ALS: The Fastest Route to Medicare

Amyotrophic lateral sclerosis (ALS) is the only condition that bypasses the 24-month SSDI waiting period. Once Social Security approves you for disability benefits because of ALS, your Medicare coverage begins when ready—not after two years. This means you can have both SSDI and Medicare active at the same time from day one.

The approval process for SSDI based on ALS is usually faster than for other conditions because ALS is on Social Security's "compassionate allowances" list. This list includes conditions severe enough that they almost always meet the disability standard, so the review is streamlined. Even so, you should explore as soon as you receive an ALS diagnosis, because benefits do not go back to the date of diagnosis—they begin the month you explore.

Once you are enrolled in Medicare, you will have access to coverage for ALS-related care, including doctor visits, hospital stays, respiratory support equipment, and medications. Many people with ALS also use Medicare's home health benefit to cover nursing care and physical therapy at home.

What Happens to Your Coverage When You Turn 65

Your Medicare coverage does not change when you reach 65. If you enrolled before 65 through SSDI, end-stage renal disease, or ALS, you straightforward keep the same Medicare Part A and Part B coverage. There is no new enrollment, no new card, and no interruption in benefits.

However, turning 65 does matter if you have not yet enrolled in Medicare for another reason. If you are still working and have employer health insurance, you have a window to delay enrollment without penalty. But if you are not covered by an employer plan and you do not enroll within three months of turning 65, you may face a permanent penalty on your Part B premium. This is why it is important to understand your options well before your 65th birthday.

How to Check Your Medicare Enrollment Status

You can see whether you are enrolled in Medicare by logging into your Social Security account at ssa.gov. Once you sign in, go to "My Benefits" and look for your Medicare information. You can also call Social Security directly at 1-800-772-1213 (TTY 1-800-325-0778) and ask whether Medicare has been activated on your account.

If you are within a few months of your 25th month of SSDI and want to confirm the exact date your Medicare begins, Social Security can tell you. This is useful if you need to plan for the transition from any other insurance you may have.

You can also create an account at Medicare.gov to view your coverage details, see what services are covered, and find providers in your area. Your Medicare card will be mailed to you automatically, but you can also print a temporary card from your Medicare.gov account if you need coverage information before the physical card arrives.

Costs and Coverage You Should Know About

Medicare Part A typically has no monthly premium for people who have worked long enough to earn coverage, but it does have a deductible for hospital stays. Part B has a monthly premium that varies by year and is usually taken directly from your Social Security check. For 2024, the standard Part B premium is $164.90 per month, though this amount changes annually.

Original Medicare (Part A and Part B) does not cover everything. You will have copayments and coinsurance for most services, and there is no annual out-of-pocket limit. Many people on disability choose to add supplemental insurance (called Medigap) or switch to a Medicare Advantage plan (Part C) to reduce their costs, but these choices come with their own premiums and rules.

If your income is low, you may be able to get help paying your Medicare premiums and cost-sharing through programs like Medicaid or the Medicare Savings Program. Your state's Medicaid office or your local Area Agency on Aging can tell you whether you meet the income limits.

Frequently Asked Questions

Do I have to do anything to get Medicare after 24 months of SSDI?

No. Medicare enrollment is automatic. You will receive your Medicare card in the mail before your coverage starts on the first day of your 25th month. You do not need to explore or contact anyone.

What if I am on SSDI but have not received 24 months of benefits yet?

You will become may be able to access for Medicare once you have been receiving SSDI for 24 full months. Social Security will enroll you automatically. If you need health coverage before then, you may be able to get Medicaid through your state, depending on your income and state rules.

Can I enroll in Medicare Part D (prescription drug coverage) before 65?

Yes. Once you are enrolled in Medicare Part A and B—whether before or after 65—you can enroll in a Part D plan during the annual enrollment period (October 15 to December 7) or when you first become may be able to access. If you delay enrollment without a valid reason, you may face a penalty.

Does having Medicare before 65 affect my SSDI benefits?

No. Medicare enrollment does not change your SSDI payment amount. The two programs are separate. Your SSDI check continues as before, and Medicare straightforward adds health coverage on top of it.

What if I disagree with a Medicare decision about what is covered?

You have the right to appeal. Medicare will send you a notice if a service or item is denied. The notice explains how to request a review. You can also call Medicare at 1-800-MEDICARE to ask questions about coverage before you receive a bill.

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.