Medicare eligibility: Who qualifies for Medicare coverage?
It's important to know what to do when you're eligible for Medicare.
Who can enroll in a private Medicare plan?
Who is eligible for Medicare Part D?
Medicare Initial Enrollment Period
What if I qualify for veterans’ benefits?
Do I need to be a U.S. citizen to apply?
I’m on disability. When will I be eligible for Medicare?
What do I need to do when I’m eligible for Medicare?
Who is eligible for Medicare?
Generally, you are eligible for Medicare when you turn 65. You may be working, not working or retired. Medicare is individual insurance. It’s your age that counts, not your spouse’s, even if you are both covered by the same employer insurance when one of you turns 65. Medicare is available to United States citizens and legal residents who have lived in the United States for at least 5 years in a row before applying.
You may become eligible to receive Medicare benefits based on any one of the following:
- You are age 65 or older
- You are younger than 65 with a qualifying disability (Medicare eligibility begins after 24 months of receiving Social Security disability benefits)
- You have a diagnosis of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig's disease) at any age
If you are — or your spouse is — a government employee or retiree who worked long enough and paid Medicare payroll taxes while working, you will qualify for Medicare Part A without a monthly premium as long as one of the above eligibility requirements are also met. Note: If you qualify for Medicare Part A at no cost, you’re also eligible to enroll in Medicare Part B by paying the monthly premium.1
Who qualifies for a private Medicare plan?
Once you're enrolled in Original Medicare Part A and Part B, you'll start to receive coverage from the federal government. At that point, you can also choose additional coverage from private insurance companies such as a Medicare Advantage (Part C) plan or Medicare Supplement insurance plan. To enroll in a Part D prescription drug plan, you must be entitled to Medicare Part A or enrolled in Part B.
How does income impact Medicare premium costs?
Medicare has set income limits for those filing individual tax returns, joint tax returns and individuals who are married or living with their spouse at any time during the year and file separate tax returns. In 2024, those with tax-reported incomes over $103,000 (single) and $206,000 (joint) must pay an income-related monthly adjustment amount (IRMAA) for Medicare Part B and Part D premiums.
See how income affects Medicare premiums
Who is eligible for Medicare Part D?
For most, eligibility begins at age 65 for Medicare coverage, including Part D. Prescription drug coverage is available through private insurers and can be obtained as a standalone Part D plan, or as part of a Medicare Advantage plan that includes prescription drug coverage.
What is the Medicare Initial Enrollment Period?
Around your 65th birthday you'll have a 7-month window of time when you can sign up for Medicare. It's called your Initial Enrollment Period (IEP). Your IEP includes your 65th birthday month, the 3 months before and the 3 months after.
Am I Medicare eligible if I work past age 65?
Generally, yes. However, if you plan to keep working or you have employer health coverage through a spouse, you may have some options to consider when signing up for Medicare. Depending on your situation, you may or may not be able to delay Medicare enrollment.
Understand your options for Medicare enrollment when working past 65
Your Initial Enrollment Period (IEP) happens when you're turning 65 whether you're still going to work or not. Be sure to know your IEP dates and plan ahead.
Are Medicare and Social Security eligibility the same?
Medicare is separate from Social Security benefits, and there are different eligibility requirements for each. Medicare eligibility begins at age 65 or under the conditions listed above. The age you may start receiving full Social Security benefits depends on the year you were born.
Get additional information about Social Security eligibility
Do I need to be a U.S. citizen to apply for Medicare?
Medicare is available to U.S. citizens and qualified legal residents who meet at least one of the eligibility requirements outlined above. To qualify as a legal resident, you must have lived in the United States for at least 5 years in a row before applying for Medicare coverage.
I'm on disability. When will I be eligible for Medicare?
You may be eligible for Medicare before age 65 if you have a qualifying disability. Eligibility usually starts after you've received disability benefits for 24 months. You will be automatically enrolled in Medicare Part A and Part B. You may make other coverage choices during your IEP. Your 7-month IEP includes the month you receive your 25th disability check plus the 3 months before and the 3 months after.
What do I need to do when I'm eligible for Medicare?
After you become eligible for Medicare it's time to enroll. You will need to enroll in Medicare Part A and/or Part B first before you can enroll in any additional coverage.
Some people are automatically enrolled in Original Medicare (Part A and Part B) once they're eligible, but not everyone is.
While enrolling in Medicare isn’t mandatory for everyone, you may need to opt out if you choose to delay your enrollment.
You'll be automatically enrolled in Original Medicare if:
- You're receiving Social Security or Railroad Retirement Board benefits when you turn 65; or
- You're eligible for Medicare because of a disability or medical condition.
You must enroll yourself in Medicare Part A and Part B if:
- You're not receiving Social Security benefits when you become eligible for Medicare.
There are three ways to enroll yourself in Medicare:
- Online at www.SocialSecurity.gov
- By calling the Social Security Administration at 1-800-772-1213 (TTY users 1-800-325-0778), 7 a.m. to 7 p.m. Monday through Friday
- In person at your local Social Security office
What are my coverage options after I have Medicare?
Next steps: Once you're enrolled in Original Medicare (Part A and/or Part B), you may be eligible to enroll in a Medicare Advantage plan or Part D prescription drug plan, or apply for a Medicare Supplement insurance plan. Some of these plans can work together.
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