Do You Have to Be 65 to Get Medicare?

You don't have to be 65 to get Medicare, but age 65 is when most people become may be able to access automatically

Medicare covers people under 65 in specific situations: if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, if you have end-stage renal disease (ESRD), or if you have amyotrophic lateral sclerosis (ALS). You can also buy into Medicare at any age if you are a U.S. citizen or permanent resident and meet other requirements. The rules are different depending on which category you fall into, and the timing matters—some people become may be able to access the moment they meet the condition, while others have to wait or actively enroll.

The key difference is that SSDI beneficiaries wait 24 months before coverage kicks in automatically, while people with ESRD or ALS can enroll when ready. If you do not fall into any of these categories, you have the option to purchase Medicare coverage yourself, though you will pay the full premium with no income-based subsidy.

Key Takeaways

People under 65 can get Medicare if they receive SSDI for 24 months, have ESRD, or have ALS, without any age requirement.
SSDI beneficiaries become may be able to access for Medicare automatically after 24 months; you do not have to do anything to enroll.
People with ESRD or ALS can enroll in Medicare as soon as they are diagnosed, even if they are in their 20s or 30s.
You can buy into Medicare at any age if you are a U.S. citizen or permanent resident and do not have coverage through an employer.
If you miss your enrollment window after turning 65, you may face a permanent penalty on your premiums, so timing your enrollment correctly matters.

Medicare through SSDI: The 24-month waiting period

If you are receiving SSDI, you become may be able to access for Medicare after you have been on SSDI for 24 consecutive months. You do not have to file anything or contact Medicare—the Social Security Administration handles the enrollment automatically. Your Medicare coverage begins on the first day of the 25th month after your SSDI benefits started.

This rule applies regardless of your age. A 30-year-old on SSDI will get Medicare after 24 months, just as a 55-year-old will. The waiting period is built into the system to align with how SSDI works, not because of age. You will receive a Medicare card in the mail before your coverage starts. If you do not receive it within a few weeks of your 25th month, contact Social Security to confirm your enrollment went through.

Medicare for people with end-stage renal disease

If you have ESRD and need dialysis or a kidney transplant, you can enroll in Medicare when ready upon diagnosis, regardless of age. You do not have to wait for any period of time. A person in their 20s with ESRD can have Medicare coverage while they are still working or in school.

You will need to enroll yourself—Social Security does not do this automatically for ESRD. Contact Medicare directly at 1-800-MEDICARE or go to Medicare.gov to start the enrollment process. You will need documentation from your doctor confirming your ESRD diagnosis and your need for dialysis or transplant. Your coverage can begin as early as the first day of the month in which you are diagnosed, or the month after, depending on when you enroll. If you enroll after the month of diagnosis, your coverage start date will be delayed, so enrolling quickly matters.

Medicare for people with ALS

If you have been diagnosed with amyotrophic lateral sclerosis (ALS), you can enroll in Medicare right away, at any age. Like ESRD, there is no waiting period and no age requirement. Your coverage can begin as early as the month you are diagnosed.

You must enroll yourself by contacting Medicare at 1-800-MEDICARE or through Medicare.gov. Bring your diagnosis documentation from your doctor. Because ALS is a progressive condition, Medicare recognizes it as a reason for when ready coverage, and the enrollment process is usually faster than for other conditions. Once you are enrolled, your coverage continues without interruption as long as you pay your premiums.

Buying into Medicare before age 65

If you do not fall into the SSDI, ESRD, or ALS categories, you can still buy Medicare coverage at any age if you are a U.S. citizen or permanent resident who has lived in the United States for at least five years. You will pay the full premium for Part A (hospital insurance) and Part B (medical insurance), with no subsidy based on income.

The monthly premium for Part A is higher for people who buy in than for people who become may be able to access at 65 through work history. As of 2024, the standard Part B premium is the same for all enrollees, but your Part A cost depends on how many work credits you have accumulated. If you have very few work credits, your Part A premium will be substantially higher. You can enroll at any time by contacting Social Security or Medicare directly. There is no enrollment window or penalty for late enrollment when you are buying in before 65, because you are not yet in the age group where Medicare is the default.

How enrollment important date work for people under 65

The rules about enrollment important date and penalties are different for people under 65 than for people turning 65. If you become may be able to access for Medicare before 65 through SSDI, ESRD, or ALS, you do not face a penalty for enrolling late—your coverage straightforward starts when you enroll, with no retroactive coverage.

If you are buying into Medicare before 65, you also do not face a late-enrollment penalty, because you are not yet in the automatic enrollment age. However, if you delay enrolling in Part B and later become may be able to access for Medicare at 65 through age, you may face a penalty if you did not enroll when you first became may be able to access to buy in. The safest approach is to enroll as soon as you know you are may be able to access, whether through a condition or by choice. This prevents any gaps in coverage and avoids confusion about when your coverage actually begins.

What happens when you turn 65 if you already have Medicare

If you have been on Medicare before age 65 through SSDI, ESRD, ALS, or by buying in, your coverage continues without interruption when you turn 65. You do not have to re-enroll or take any action. Your Medicare status straightforward continues as it has been.

If you have been buying into Medicare and want to switch to coverage based on your work history (which may have a lower premium), you can contact Social Security or Medicare to update your record. This usually happens automatically if you have enough work credits, but it is worth confirming to make sure you are paying the correct premium. Some people find that their Part A premium drops once they turn 65 and become may be able to access based on age rather than purchase, so checking your premium after your birthday is a good idea.

Frequently Asked Questions

Can I get Medicare at 55 if I have a disability?

Yes, if you are receiving SSDI. After 24 months on SSDI, you become may be able to access for Medicare regardless of your age. If you have ESRD or ALS, you can enroll when ready upon diagnosis. If you do not fall into one of these categories, you can buy into Medicare at any age, though you will pay the full premium.

What if I am on SSDI but have not been for 24 months yet?

You are not yet may be able to access for Medicare. You will become may be able to access automatically once you reach 24 months on SSDI. You can contact Social Security to confirm your may be able to access date, and Medicare will enroll you automatically when the time comes.

Do I have to tell my employer I have Medicare before 65?

No, but you should check your employer's health plan rules. Some employers require you to enroll in their plan even if you have Medicare. If you have both, Medicare is usually the secondary payer. Talk to your employer's benefits department about how your coverage coordinates.

What if I miss the important date to enroll in Medicare when I become may be able to access?

If you become may be able to access through SSDI, ESRD, or ALS, there is no enrollment important date—you can enroll whenever you are ready, and your coverage will start when you enroll. If you are buying into Medicare before 65, there is also no important date. However, once you turn 65, late-enrollment penalties explore, so it is better to enroll sooner rather than later.

Can I have both Medicare and Medicaid at the same time?

Yes. If your income is low enough, you may be covered by both programs. Medicare is federal health insurance; Medicaid is a state program for people with low income. You can contact your state Medicaid office to see if you may have access to. Having both is sometimes called "dual coverage" or being "dual may be able to access."

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.