Who Can Get Medicare and What You Need to Know

The Basic Requirements for Medicare

You can get Medicare if you are 65 or older, or if you are under 65 and have been receiving Social Security Disability Insurance (SSDI) for at least 24 months, or if you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Most people become may be able to access the month they turn 65. If you were born on the first of the month, your coverage starts the month before.

You do not have to be retired to get Medicare at 65. You can still be working. Medicare is not based on income — it does not matter how much money you make. It is based on age or specific medical conditions.

You must also be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years. If you are not yet a citizen or permanent resident, you cannot get Medicare, even if you meet the age requirement.

Key Takeaways

• You become may be able to access for Medicare at 65 if you are a U.S. citizen or lawful permanent resident who has lived here for at least five years.
• You can get Medicare before 65 if you have received SSDI for 24 months, have end-stage renal disease, or have ALS.
• Medicare is not based on income or employment status — you can be working and still enroll.
• You must enroll during your initial enrollment period, which is the seven months centered on your 65th birthday, or face a permanent penalty on your premiums.
• If you delay enrollment and do not have other may have access to coverage, you will pay more for Part B and Part D for as long as you have Medicare.

Medicare at 65: Age-Based may be able to access

The most common path to Medicare is turning 65. You become may be able to access the month you turn 65, regardless of whether you have retired or are still working. Your age is the only factor that matters — not your job, your income, or your savings.

If you were born on the first day of a month, your coverage begins the month before you turn 65. For all other birthdays, coverage begins the month you turn 65. For example, if you were born on March 15, your coverage starts in March. If you were born on March 1, your coverage starts in February.

You do not automatically get Medicare at 65. You must enroll during your initial enrollment period. This period runs for seven months: three months before the month you turn 65, the month you turn 65, and three months after. If you miss this window and do not have other may have access to coverage, you will pay a permanent increase on your Part B premium and your Part D premium for as long as you have Medicare.

Getting Medicare Before 65 Due to Disability or Illness

You can get Medicare before 65 if you have been receiving SSDI for at least 24 months. The 24 months starts from the month you first became may be able to access for SSDI, not from the month you applied. If you are already on SSDI, you will be enrolled in Medicare automatically two months before the 24-month mark reaches.

You can also get Medicare at any age if you have end-stage renal disease (ESRD) — kidney failure that requires dialysis or a transplant. You must have ESRD and be a U.S. citizen or permanent resident. You can enroll in Medicare even if you are still working and earning income.

If you have amyotrophic lateral sclerosis (ALS), you do not have to wait 24 months on SSDI. You become may be able to access for Medicare when ready once you are approved for SSDI. ALS is the only condition with this exception.

Citizenship and Residency Requirements

You must be a U.S. citizen or a lawful permanent resident. Lawful permanent residents are people with a green card. If you are in the United States on a visa but are not a permanent resident, you cannot get Medicare, even if you are 65 or older.

If you are a lawful permanent resident, you must have lived in the United States for at least five consecutive years before you can enroll. The five years must be unbroken. If you left the country during that time, the clock restarts.

Citizenship is checked through the Social Security Administration. When you explore for Medicare, Social Security will verify your status. If there is a question about your residency or citizenship, Medicare will contact you.

Work and Income Do Not Affect Medicare may be able to access

You can be working full-time and still get Medicare at 65. Your job does not delay or prevent your may be able to access. You do not have to retire to enroll.

Your income does not affect whether you can get Medicare. There is no income limit. You can be wealthy or have no income — both can get Medicare at 65 if they meet the citizenship and residency requirements.

However, your income does affect how much you pay for Medicare premiums. Higher income means higher premiums for Part B and Part D. This is called Income-Related Monthly Adjustment Amount (IRMAA). Your premiums are based on your tax return from two years before, so if your income changes, your premiums will adjust two years later.

What Happens If You Miss Your Enrollment Period

If you do not enroll during your initial enrollment period and you do not have other may have access to coverage, you will face a permanent penalty. For Part B, the penalty is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. This penalty stays with you for life.

For Part D (prescription drug coverage), the penalty is 1 percent of the national base beneficiary premium for each month you were may be able to access but not enrolled. Like the Part B penalty, this is permanent.

There are exceptions. If you have other health coverage through an employer or union, you may not have to enroll right at 65. You can enroll later without penalty if you lose that coverage. You must enroll within 63 days of losing the coverage. Keep documentation of when your coverage ended.

How to Verify Your Medicare may be able to access

You do not need to do anything to check your may be able to access. Social Security tracks it automatically. When you turn 65, Social Security will send you information about Medicare enrollment about three months before your birthday.

You can also create an account on Medicare.gov to see your may be able to access status. You will need your Social Security number and date of birth. The website shows whether you are may be able to access and what parts of Medicare you can enroll in.

If you are on SSDI and have been for 24 months, Social Security will enroll you automatically. You will receive your Medicare card in the mail. If you do not receive it two months after your 24-month mark, contact Social Security to confirm your enrollment.

Frequently Asked Questions

Can I get Medicare if I am not a U.S. citizen?

You can get Medicare if you are a lawful permanent resident (green card holder) and have lived in the United States for at least five consecutive years. If you are on a visa or are undocumented, you cannot get Medicare, even at 65.

Do I have to be retired to get Medicare at 65?

No. You can be working full-time and still enroll in Medicare at 65. Your employment status does not affect your may be able to access. However, if you are covered by an employer health plan, you may want to delay Part B enrollment to avoid paying for two plans.

What if I was born on the first day of the month?

Your Medicare coverage begins the month before you turn 65. For example, if you were born on April 1, your coverage starts in March. You should still enroll during your normal seven-month initial enrollment period.

How long does it take to become may be able to access for Medicare on SSDI?

You must receive SSDI for 24 months before you become may be able to access for Medicare. The 24 months is counted from the month you first became may be able to access for SSDI, not from when you applied. Social Security will enroll you automatically two months before you reach 24 months.

What happens if I do not enroll when I turn 65?

If you do not enroll during your initial enrollment period and do not have other may have access to coverage, you will pay a permanent 10 percent penalty on your Part B premium for life. Part D has a 1 percent monthly penalty. These penalties do not go away, even if you enroll later.