Medicare has age and citizenship rules that exclude some people

Not everyone can get Medicare. The program is primarily for people age 65 and older, but some younger people with specific conditions can join. You must also be a U.S. citizen or a permanent resident who has lived in the country for at least five years. If you do not meet these requirements, Medicare will not cover you, and you will need to look at other insurance options.

The rules are strict because Medicare is a federal program with defined may be able to access criteria. Understanding whether you may have access to takes only a few minutes, and knowing your status helps you plan for the coverage you actually need.

Key Takeaways

  • You can join Medicare at 65 if you are a U.S. citizen or permanent resident who has lived in the country for at least five years.
  • Some people under 65 can get Medicare if they receive Social Security Disability Insurance (SSDI) for at least 24 months, have end-stage renal disease, or have ALS.
  • If you do not meet Medicare's requirements, you may be able to buy coverage through the Affordable Care Act marketplace or find employer-based insurance.
  • Undocumented immigrants and people who do not meet the residency requirement cannot get Medicare, regardless of age or income.

The age requirement: 65 and older

The simplest path to Medicare is turning 65. On the first day of the month you turn 65, you become may be able to access to enroll. You do not have to wait until your birthday itself—the month matters, not the specific date.

You can enroll starting three months before the month you turn 65 and continuing for three months after. If you miss this window, you may face a permanent penalty on your premiums, so marking your calendar matters. The enrollment period is called your Initial Enrollment Period, and it lasts seven months total.

Who under 65 can get Medicare

Three groups of people younger than 65 are may be able to access for Medicare. The largest group is people who have been receiving Social Security Disability Insurance (SSDI) for at least 24 months. After two years on SSDI, you automatically become may be able to access for Medicare Part A (hospital insurance) even if you are 30 years old.

The second group is people with end-stage renal disease (ESRD)—permanent kidney failure requiring dialysis or a transplant. You can join Medicare as soon as you start dialysis or receive a transplant, with no age limit. The third group is people with ALS (amyotrophic lateral sclerosis), also called Lou Gehrig's disease. You become may be able to access for Medicare the month you are approved for SSDI because of ALS; you do not have to wait 24 months.

If you fall into one of these three categories, you will be contacted by Social Security or your dialysis center about Medicare enrollment. You do not have to do anything—the enrollment happens automatically.

Citizenship and residency requirements

You must be either a U.S. citizen or a lawful permanent resident (green card holder) to get Medicare. If you are a permanent resident, you must have lived in the United States for at least five consecutive years before you turn 65. Those five years do not have to be when ready before 65—they just have to be five years at some point in your life after you received your green card.

Undocumented immigrants cannot get Medicare, regardless of how long they have lived in the country or how old they are. Temporary visa holders (such as H-1B workers or student visa holders) also cannot get Medicare, even if they have worked and paid Medicare taxes. If you are not a citizen or permanent resident, you will need to look at other coverage options.

What happens if you do not meet Medicare requirements

If you are under 65 and do not have SSDI, ESRD, or ALS, you cannot get Medicare. If you are not a citizen or permanent resident, you cannot get Medicare. In either case, you have other options for health coverage.

The Affordable Care Act (ACA) marketplace is open to anyone, regardless of citizenship status (though undocumented immigrants cannot enroll). You can buy a plan directly from the marketplace in your state, and you may be able to lower your monthly cost if your income is below a certain level. You can also look for coverage through an employer, a spouse's employer, or a professional association. Some states offer Medicaid to people who do not meet Medicare requirements; the income limits and rules vary by state.

If you are a permanent resident waiting to meet the five-year residency requirement, you can use the ACA marketplace until you become may be able to access for Medicare.

How to confirm your Medicare may be able to access

You do not need to contact anyone to check whether you are may be able to access at 65—may be able to access is automatic based on your age and citizenship status. If you are unsure whether you are a citizen or permanent resident, or if you are not sure how long you have been a permanent resident, you can check your immigration documents or contact U.S. Citizenship and Immigration Services (USCIS).

If you are under 65 and think you might be may be able to access because of SSDI, ESRD, or ALS, Social Security will contact you. You do not have to do anything—the agency will handle the enrollment. If you have questions about your specific situation, you can call Social Security at 1-800-772-1213 or visit your local Social Security office.

Enrollment timing if you are may be able to access

If you are turning 65, your Initial Enrollment Period starts three months before the month you turn 65 and ends three months after. You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at a Social Security office.

If you miss your Initial Enrollment Period and you do not have other health coverage, you will face a late enrollment penalty added to your Part B premium for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but did not enroll. This penalty is permanent, so enrolling on time matters.

If you are may be able to access because of SSDI, ESRD, or ALS, Social Security or your medical provider will send you information about enrollment. You will have a window to enroll, and missing it can also result in penalties.

Frequently Asked Questions

Can I get Medicare if I am a permanent resident but have not lived in the U.S. for five years yet?

No, you must have lived in the United States for at least five consecutive years to be may be able to access for Medicare at 65. Until then, you can buy coverage through the ACA marketplace or look for employer-based insurance. Once you reach the five-year mark, you become may be able to access for Medicare.

If I am on SSDI, do I have to do anything to get Medicare after 24 months?

No. Social Security will automatically enroll you in Medicare Part A and Part B after you have been on SSDI for 24 months. You will receive a Medicare card in the mail. You do not need to take any action.

What if I am 64 and lose my job and my health insurance?

You can buy coverage through the ACA marketplace, which is open year-round if you have a may have access to life event like job loss. You can also look into COBRA coverage through your former employer, though it is usually expensive. When you turn 65, you will become may be able to access for Medicare.

Can I get Medicare if I worked in the U.S. but am not a citizen?

No. Working in the U.S. and paying Medicare taxes does not make you may be able to access for Medicare. You must be a U.S. citizen or a lawful permanent resident who has lived in the country for at least five years. If you are not a citizen, the ACA marketplace is your main option for health coverage.

What if I am a permanent resident and turn 65 before I have lived here five years?

You cannot get Medicare until you have completed five years of residency. You can use the ACA marketplace for coverage until you meet the five-year requirement. Once you do, you become may be able to access for Medicare at your next enrollment period.