Medicare Eligibility

It's important to know what to do when you're eligible for Medicare.

Who is eligible for Medicare?

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. Medicare is individual insurance. It doesn't cover spouses or dependents.

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.
• Any age with a diagnosis of End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig's Disease)

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.

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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—or IEP for short. Your IEP includes your 65th birthday month, the 3 months before and the 3 months after.
 

Learn more about enrolling in Medicare for the first time at age 65  

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What if I work past age 65?

You still have a Medicare enrollment decision to make.

If you plan to keep working or you have employer health coverage through a spouse, you 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.

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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 Parts A and 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.

Learn more about Medicare eligibility due to disability  

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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.

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 Original Medicare if:

• You're not receiving Social Security benefits when you become eligible for Medicare.

There are three ways to enroll yourself in Medicare:
 

1. Online at www.SocialSecurity.gov  .
2. Call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7 a.m. to 7 p.m.
3. In-person at your local Social Security office.

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Next steps: Learn about the different Medicare coverage options

Once you're enrolled in Original Medicare Part A and/or 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 plan, Part D prescription drug plan or Medicare supplement insurance plan. Take a look at the next page, Coverage Choices, to learn more about Original Medicare, Medicare Advantage, Part D and Medicare supplement insurance plans, as well as how these different choices can work together.