Who Can Get Medicare: Age, Disability, and Other Paths to Coverage

The Main Routes to Medicare Coverage

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). You do not have to be retired to get Medicare at 65 — you just have to reach that age. If you are not yet 65 and do not fall into the disability or disease categories, you cannot get Medicare through the standard routes, though you may be able to buy coverage through the Health Insurance Marketplace instead.

Medicare is a federal program run by the Centers for Medicare & Medicaid Services (CMS). It is not means-tested, meaning your income and savings do not determine whether you can join. Your citizenship or immigration status does matter: you must be a U.S. citizen or a lawful permanent resident who has lived in the country for at least five years.

Key Takeaways

You become may be able to access for Medicare at age 65 regardless of your work history or income, as long as you are a U.S. citizen or lawful permanent resident of five years or more.
If you are under 65, you may may have access to through SSDI (after 24 months of payments), end-stage renal disease, or ALS diagnosis.
You must sign up during your enrollment window or face a permanent penalty on your premiums, even if you have other insurance.
Medicare has four parts — A (hospital), B (doctor visits), D (prescriptions), and C (private alternative) — and you choose which ones you need based on your situation.
Enrollment happens through Social Security, Medicare.gov, or your local Social Security office, not through a separate Medicare process.

Medicare at Age 65

The moment you turn 65, you become may be able to access for Medicare Part A (hospital insurance) and Part B (medical insurance covering doctor visits, outpatient care, and some preventive services). You do not have to stop working, and your work status does not affect your may be able to access. Part A is free for most people because you or your spouse paid Medicare taxes while working. Part B requires a monthly premium, which varies by income but starts around $175 per month for 2024.

You must sign up during your enrollment window, which begins three months before the month you turn 65 and ends three months after. If you miss this window and do not have other may have access to coverage (such as employer health insurance), you will pay a permanent 10 percent surcharge on your Part B premium for as long as you have Medicare. This penalty does not go away, so timing your enrollment matters even if you plan to delay coverage.

If you are still working at 65 and have health insurance through your employer, you may be able to delay Part B without penalty, but you must tell Medicare about your employer coverage. The rules differ depending on the size of your employer, so check with your HR department or call Medicare at 1-800-MEDICARE to confirm your situation before you skip enrollment.

Disability Before Age 65

If you are under 65 and receiving SSDI payments, you become may be able to access for Medicare after you have been on SSDI for 24 consecutive months. The 24 months starts from the month you first receive a payment, not from the month you applied. Once you hit that mark, Medicare Part A and Part B begin automatically — you do not have to sign up separately.

SSDI is a work-based program: you must have worked long enough and recently enough to may have access to, and your condition must prevent you from working for at least 12 months or be expected to result in death. The Social Security Administration (SSA) determines SSDI may be able to access, not Medicare. If you are denied SSDI, you do not get Medicare through this route, though you may have other options.

Some people receive Supplemental Security Income (SSI) instead of SSDI. SSI is a needs-based program for people with low income and resources. SSI recipients do not automatically get Medicare; you must be 65 or older, or blind, or disabled and have been receiving SSI for at least 24 months. The 24-month rule is the same as SSDI, but SSI has stricter income and resource limits.

End-Stage Renal Disease and ALS

If you have end-stage renal disease (ESRD) — meaning your kidneys no longer work well enough to sustain life and you need dialysis or a transplant — you become may be able to access for Medicare regardless of age. You do not have to be on SSDI or SSI. Your may be able to access begins the month after you start dialysis treatment or, if you receive a transplant, the month of the transplant. If you are already on Medicare for another reason, your ESRD coverage begins when ready upon diagnosis.

If you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you become may be able to access for Medicare when ready upon approval for SSDI, without waiting the usual 24 months. This is a one-time exception to the standard SSDI waiting period. You must be approved for SSDI based on an ALS diagnosis; the disease itself does not automatically trigger Medicare may be able to access.

How to Sign Up for Medicare

Most people sign up through Social Security, either online at ssa.gov, by phone at 1-800-772-1213, or in person at a local Social Security office. You will need your Social Security number, proof of citizenship or lawful permanent resident status, and proof of age (such as a birth certificate). If you are explore for SSDI or SSI and later become may be able to access for Medicare through those programs, the SSA will handle the Medicare enrollment automatically.

If you prefer to enroll directly with Medicare, you can visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Medicare.gov also lets you compare plans, see what your costs will be, and find providers in your area. You can enroll in Part D (prescription drug coverage) and Part C (Medicare Advantage, a private alternative to Original Medicare) at the same time you enroll in Parts A and B, or you can add them later during the annual enrollment period (October 15 to December 7 each year).

If you miss your initial enrollment window, you can still sign up, but you may face late penalties. The Part B penalty is permanent, as noted above. The Part D penalty is also permanent: you pay an extra amount each month for as long as you have Part D coverage. There is no penalty for delaying Part A if you have employer coverage, but you should confirm your situation with Medicare before you skip enrollment.

What Happens If You Do Not may have access to

If you are under 65 and do not have SSDI, ESRD, or ALS, you cannot get Medicare. You may be able to buy health insurance through the Health Insurance Marketplace (Healthcare.gov or your state's marketplace) or through a private insurer. If your income is low, you may may have access to for Medicaid, which is a separate federal-state program. Medicaid rules vary by state, so check your state's Medicaid office to see what income and resource limits explore where you live.

Some people may have access to for both Medicare and Medicaid — these are called "dual may be able to access" beneficiaries. If you are 65 or older and have low income and resources, you may may have access to for both programs. Medicaid can help pay your Medicare premiums and cover costs that Medicare does not, such as long-term care. Each state runs its own Medicaid program, so the rules differ by location.

Frequently Asked Questions

Do I have to be a U.S. citizen to get Medicare?

You must be a U.S. citizen or a lawful permanent resident who has lived in the country for at least five years. Lawful permanent residents are people with a green card. If you are not yet a permanent resident, you cannot get Medicare, but you may be able to buy coverage through the Health Insurance Marketplace.

What if I am still working at 65?

You can get Medicare at 65 even if you are still working. If you have health insurance through your employer, you may be able to delay Part B without penalty, but you must notify Medicare about your employer coverage. The rules depend on your employer's size, so confirm with your HR department or Medicare before you skip enrollment.

Can I get Medicare if I am under 65 and not disabled?

No, unless you have end-stage renal disease or ALS. If you are under 65 and do not have one of these conditions, you cannot get Medicare. You can buy coverage through the Health Insurance Marketplace or check whether you may have access to for Medicaid in your state.

What is the difference between SSDI and SSI?

SSDI is based on your work history and is available to people of any age who are disabled. SSI is based on low income and resources and is available to people 65 or older, blind, or disabled. Both programs lead to Medicare after 24 months, but SSI has stricter income and resource limits.

What if I miss my enrollment window?

You can still sign up after your window closes, but you will face a permanent 10 percent surcharge on your Part B premium. If you have other may have access to coverage (such as employer insurance), you may be able to avoid the penalty, but you must tell Medicare about that coverage. Call 1-800-MEDICARE to discuss your situation.

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.