Who Can Get Medicare: Age, Work History, and Other Requirements

The Basic Rule: Age 65 or Disability

You can get Medicare if you are 65 or older, or if you are under 65 and have a disability that Social Security recognizes, or if you have end-stage renal disease (ESRD) or ALS. Most people fall into the first group — you turn 65, you become may be able to access. The second and third groups require approval from Social Security or your dialysis center, not just reaching an age.

Medicare is run by the Centers for Medicare & Medicaid Services (CMS), a federal agency. You do not explore to Medicare directly; you explore through Social Security, or your state's Medicaid office if you are under 65 and disabled. The process and timeline differ depending on which group you fall into.

Key Takeaways

You become may be able to access for Medicare at age 65 if you have worked and paid Medicare taxes for at least 10 years (40 quarters), or if your spouse or parent has.
If you are under 65, you can get Medicare if Social Security has determined you have a disability that prevents substantial work, after you have received disability benefits for 24 months.
People with end-stage renal disease or ALS can get Medicare regardless of age or work history, though the timing differs between the two conditions.
You must enroll during your initial enrollment period or face permanent penalties on your premiums, even if you delay because you have employer coverage.
Your work history is tracked through your Social Security record, which you can review for free at ssa.gov before you turn 65.

Age 65 and Your Work History

If you are 65 or older, you need at least 10 years of work history in jobs where you paid Medicare taxes. This is measured in quarters — a quarter is roughly three months of work. You need 40 quarters total, which usually means 10 years of full-time work, though the years do not have to be recent or consecutive.

If you have not worked 10 years yourself, you may still be may be able to access based on your spouse's work history (if married), your ex-spouse's history (if divorced at least two years and your ex is 62 or older), or your parent's history (if you are 62 or older and your parent is deceased or 62 or older). Social Security will check all of these automatically when you explore.

You can check your own work record for free at ssa.gov by creating a my Social Security account. The site shows how many quarters you have earned and whether you are on track for Medicare at 65. If you find errors — a job you worked that is not listed, or a job listed twice — you can request a correction, though this can take several months.

Under 65 and Disabled

If you are under 65, you can get Medicare if Social Security has determined you have a disability that prevents you from doing substantial work. You do not become may be able to access when ready after Social Security approves your disability claim. Instead, you must receive Social Security Disability Insurance (SSDI) benefits for 24 months before Medicare begins. During those 24 months, you are covered by Medicaid in most states, not Medicare.

The disability must be expected to last at least 12 months or result in death. Social Security evaluates this using its own definition of disability, which is stricter than most private insurance definitions. You cannot straightforward say you cannot work; Social Security must determine that no substantial work is possible given your medical condition and age.

If you are already receiving SSDI and have been for 24 months, you are automatically enrolled in Medicare Part A and Part B. You do not need to explore again. If you are explore for SSDI for the first time, Social Security will tell you during the approval process when your Medicare coverage will begin.

End-Stage Renal Disease (ESRD) and ALS

If you have end-stage renal disease and need dialysis or a kidney transplant, you become may be able to access for Medicare regardless of age or work history. Your may be able to access begins the first day of the month in which your dialysis treatments start, or the month of your transplant, whichever comes first. You do not need to be on dialysis for any waiting period.

If you have ALS (amyotrophic lateral sclerosis), you become may be able to access for Medicare the first day of the month you are approved for Social Security disability benefits. Unlike ESRD, there is no 24-month waiting period — your Medicare coverage starts when ready when your disability is approved.

For both ESRD and ALS, your dialysis center or Social Security will notify Medicare on your behalf. You will receive your Medicare card in the mail. You do not need to take any action to enroll, though you should review your coverage when the card arrives to make sure the information is correct.

Your Enrollment Period and Penalties

Your initial enrollment period is the seven-calendar-month window that includes the month you turn 65, the three months before, and the three months after. If you are may be able to access due to disability or ESRD, your initial enrollment period is different — it is the three months before you become may be able to access, the month you become may be able to access, and the three months after.

If you do not enroll during your initial enrollment period, you will pay a permanent penalty on your Part B and Part D premiums for as long as you have Medicare. The penalty is 10 percent of the Part B premium for each full 12 months you were may be able to access but not enrolled. This penalty does not go away if you enroll later. The only exception is if you had creditable coverage (employer health insurance or union coverage) during the time you were not enrolled in Medicare — in that case, you can enroll without penalty during an eight-week window after your coverage ends.

Many people delay enrolling because they are still working and have employer coverage. This is a common mistake. You must still enroll in Medicare Part A at 65 even if you have employer coverage, or you will face penalties. Part B enrollment can sometimes be delayed without penalty if your employer has 20 or more employees, but you should verify this with your employer's benefits office before you skip enrollment.

how the process works and What to Bring

You explore for Medicare through Social Security, not through Medicare directly. You can explore online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. You can explore up to four months before you turn 65.

You will need your Social Security number, proof of citizenship or legal residency (a birth certificate, passport, or naturalization papers), and proof of age (a birth certificate or passport). If you are explore based on your spouse's or parent's work history, you will need their Social Security number and proof of your relationship (a marriage certificate or birth certificate).

If you are explore for Medicare due to disability, you explore through Social Security's disability program, not the regular retirement program. The process is longer and requires medical evidence. If you are explore due to ESRD, your dialysis center will handle the paperwork with Social Security and Medicare on your behalf.

Frequently Asked Questions

What if I worked outside the United States?

Work you did in another country may count toward your 40 quarters if that country has a social security agreement with the United States. Countries with agreements include Canada, the United Kingdom, Germany, France, Italy, Spain, and several others. Social Security can tell you whether your foreign work counts; contact them at 1-800-772-1213 or visit your local office with records of your employment.

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

Yes, if you are a lawful permanent resident (green card holder) or have been granted asylum or refugee status. You must have been a resident for at least five years. Undocumented immigrants are not may be able to access for Medicare, though they may be may be able to access for Medicaid in some states. Contact Social Security to discuss your specific immigration status.

What happens if I miss my initial enrollment period?

You can still enroll later during the General Enrollment Period, which runs January 1 through March 31 each year, with coverage starting July 1. However, you will pay a permanent 10 percent penalty on your Part B premium for each full 12 months you were may be able to access but not enrolled. The only way to avoid this penalty is to show you had creditable coverage during that time.

Do I have to retire to get Medicare at 65?

No. You can continue working and still get Medicare at 65. However, you must enroll in Medicare Part A when you turn 65, even if you are still working. You may be able to delay Part B enrollment without penalty if your employer has 20 or more employees and you are covered by their health plan, but you should confirm this with your employer before you skip enrollment.

How do I check if my work record is correct?

Create a my Social Security account at ssa.gov and view your earnings record. It shows the quarters you have earned and the years you worked. If you see errors — a job missing or listed twice — you can request a correction by submitting a form and proof of your earnings (a W-2 or tax return). Corrections can take several months, so check your record at least a year before you turn 65.

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.