Medicare Eligibility: Age, qualifications & requirements

Medicare is our country’s federal health insurance program for people age 65 and older, as well as some younger people with disabilities, or any age with end-stage renal disease (ESRD).

The rules for Medicare eligibility are the same for everyone, but when you can enroll may be different for many people.

Here are some details for Medicare eligibility.

• Who is eligible for Medicare?
• Do you automatically get Medicare at 65?
• Can you get Medicare if you never worked?
• Can you get Medicare if you’re still working?
• How much does Medicare cost?
• When should you enroll in Medicare?
• Eligibility for Medicare Part C, Part D & Medigap
• How to check if you qualify

Who is eligible for Medicare?

Original Medicare Part A (Hospital insurance) and Part B (Medical insurance) are available to people:

• Age 65 or older
• Younger than 65 with a qualifying disability
• With ESRD, permanent kidney failure requiring dialysis or a kidney transplant

To find out if you’re eligible and to calculate your Part B premium, try the Medicare.gov eligibility & premium calculator.

Qualifications for those age 65 or older

People age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare at if one of the following applies:¹

• You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB)
• Your spouse (living or deceased, including divorced spouses) receives or is eligible to receive Social Security or RRB benefits
• You or your spouse worked long enough in a government job where you paid Medicare taxes
• You’re the dependent parent of a fully insured deceased child

Qualifications for those under age 65

If you are under age 65, you may be eligible for Medicare if:²

• You’ve been entitled to Social Security Disability Insurance (SSDI) benefits for 24 months
• You receive a disability pension from the RRB and meet certain conditions
• You receive SSDI benefits because you have Lou Gehrig’s disease (amyotrophic lateral sclerosis)
• You worked long enough in a government job, paid Medicare taxes and have met the requirements of the SSDI program for 24 months
• You’re the child or surviving spouse age 50 or older (including a divorced surviving spouse) of a worker who has worked long enough under Social Security or in a Medicare-covered government job, and you meet the requirements of the SSDI program
• You have permanent kidney failure (end stage renal disease) and you receive maintenance dialysis or a kidney transplant, and 1 of the following applies:
  • You’ve worked long enough under Social Security or the railroad retirement system
  • You’ve worked long enough in a Medicare-covered government job
  • You’re the child or spouse (including a divorced spouse) of a worker (living or deceased) who has worked long enough under Social Security or in a Medicare-covered government job.

Here’s a quick look at the first year of Medicare eligibility based on birth year.

The month your coverage starts depends on when you sign up.

Do I automatically get Medicare when I turn 65?

Possibly. If you’re under 65 and start receiving Social Security retirement benefits or Railroad Retirement benefits at least 4 months before you turn 65, you’ll be automatically enrolled in Parts A and B.

If you’re under 65 and not receiving Social Security retirement benefits or Railroad Retirement benefits, you’ll need to actively enroll in Medicare.

Can I get Medicare if I never worked?

Yes, you can enroll in Medicare if you’ve worked fewer than 10 years in Medicare-covered employment. However, you’ll have to pay a monthly premium for Part A, sign up for Part B and pay the premium for Part B.

Also, if your spouse worked at least 10 years in Medicare-covered employment, you get Part A free and can sign up for Part B at age 65.

Can I get Medicare if I’m still working?

Yes, you can work past age 65 and keep the coverage under your employer’s group plan. But if you’ve been paying into Medicare via payroll deductions, you may want to enroll in Part A when you’re first eligible because you’ll pay no premium.

For Part B, most people need to enroll when they turn 65 to avoid a late-enrollment penalty. Learn about when to sign up for Medicare if you’re still working past 65 for more details.

Medicare premiums

Here’s a rundown of what you can expect to pay for Medicare premiums.

Medicare Part A cost

Part A typically helps cover inpatient services, such as hospital stays and care at a Skilled Nursing Facility (SNF). If you’ve worked and paid Medicare taxes for at least 10 years, you don’t pay a premium for Part A. If you (or your spouse) did not pay Medicare taxes while you worked, you may be able to buy Medicare Part A. In 2023, the Part A premium can be up to $506/month.

Medicare Part B cost

Part B helps cover medically necessary services, outpatient care and some preventive services. Everyone enrolled in Part B pays a monthly premium. In 2023, the standard Part B premium is $164.90 (or higher depending on your income). Social Security will tell you the exact amount you’ll pay for a Part B premium.

For a look at more Medicare costs including coinsurance, copayments and deductibles, see how much Parts A, B, C and D cost in 2023.

When to enroll in Medicare

You can first enroll in Original Medicare 3 months before the month of your 65th birthday and up to 3 months after your 65th birthday. If you don’t sign up during this initial enrollment period, you may face a late enrollment penalty.

To learn more, including about enrolling in a Medicare Advantage plan (Part C), a stand-alone prescription drug plan (Part D) or Medicare Supplement insurance plan, explore this information on Medicare enrollment periods.

Who is eligible for Medicare Part C, Part D and Medicare Supplement plans?

Once you have Medicare Parts A and B, you’re eligible for Part C, Part D and Medicare Supplement insurance plans. If you’re new to these plans, here’s some additional details:

• What is Medicare Advantage (Part C)?
• What is Medicare Part D (prescription drug plan)?
• What is a Medicare Supplement plan?

Do I qualify for Medicare?

To see if you qualify for Medicare, try 1 of these methods:

1. Visit Medicare.gov to verify your eligibility.
2. Call 800-MEDICARE (800-633-4227) (TTY: 877-486-2048), 24 hours a day, 7 days a week.

Before you call, be sure to have the following information ready:

• Your date of birth
• Number of years you worked and paid Medicare taxes
• U.S. state or territory of residence
• Current health benefits through an employer (if you have them)
• Disability status

For more information on the costs, coverage and types of Medicare plans, check out our library of Medicare articles.