Overview

Turning 65 is the primary trigger for Medicare eligibility. You can also become eligible before age 65 if you receive Social Security Disability Insurance (SSDI), have amyotrophic lateral sclerosis (ALS), suffer from end-stage renal disease (ESRD), or receive Railroad Retirement Board (RRB) benefits.

    Benefit Period

    is the way the Original Medicare program measures your use of inpatient hospital and skilled nursing facility (SNF) services. It begins the day that you enter a hospital or SNF and ends when you have not received inpatient hospital or Medicare-covered skilled care in a SNF for 60 days in a row.
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  • How long do I have to have worked to qualify for Medicare?

    Short Answer:

    In order to get Medicare Part A (hospital insurance) for free, you, your spouse, or your ex-spouse must have earned 40 Social Security credits, or the equivalent of about 10 years of employment. If you, your spouse, or ex-spouse haven’t worked for that long, you can still get Part A, but you’ll have to pay a premium.

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    You earn Social Security credits by working and paying Social Security and Medicare taxes. You can earn a maximum of four credits each year, so it often helps to think of them as quarters.

    If you have earned fewer than 40 credits, you’ll pay a premium for Part A, which is calculated based on how many credits you have.

    Not everyone needs 40 quarters of Social Security credits to qualify for Part A for free. Those with disabilities, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS) do not need 40 Social Security credits to be eligible for Medicare.

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  • Can I receive Medicare benefits if I’m not a U.S. citizen?

    Short Answer:

    Yes, some non-U.S. citizens can get Medicare. You are eligible for Medicare if you also qualify to receive Social Security, Railroad Retirement Benefits, or disability insurance.

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    If you don’t qualify for any of the above reasons, you can still to apply for Medicare if you are a permanent legal resident and have lived in the U.S. for at least five years. But you will have to pay for both Part A and Part B.

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  • I have end-stage renal disease (ESRD) and am under 65. Am I eligible for Medicare?

    Short Answer:

    Yes. People with ESRD are eligible for Medicare regardless of age.

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    If you have ESRD, you need to sign up for Medicare. You will not be automatically enrolled.

    You can enroll in Medicare by signing up with the Social Security Administration, either at the website or by calling the agency at 800-772-1213.

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  • I have ALS and am under 65. Am I eligible for Medicare?

    Short Answer:

    Yes. If you have amyotrophic lateral sclerosis (ALS) and are under 65, you will automatically be enrolled in Original Medicare (Parts A & B) in the same month that your disability benefits begin.

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    Generally, you become eligible for Medicare when you turn 65. However, those with disabilities or certain diseases, including ALS, can receive Medicare before age 65.

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  • Am I eligible for Medicare because of my disability?

    Short Answer:

    If you are currently disabled and have been receiving Social Security disability benefits for 24 months or more, you are eligible for Medicare even if you’re under 65. This also applies to some recipients of disability benefits from the Railroad Retirement Board (RRB).

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    Once you’ve passed the 24-month mark, you’ll be enrolled in Original Medicare (Parts A & B) automatically. You can then decide if you want to switch to a Medicare Advantage (Part C) plan or add a Medicare Prescription Drug Plan (Part D).

    If you are under 65, disabled, and go back to work, you’ll keep your Medicare coverage for as long as you’re medically disabled. You also won’t have to pay a Part A premium for the first eight and a half years that you work while disabled.

    There are a couple of exceptions for people with amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD):

    • The 24-month waiting period doesn’t apply if you have ALS—you’ll be automatically enrolled in Original Medicare (Parts A & B) the same month that you begin receiving disability benefits.
    • If you have end-stage renal disease (ESRD), you’ll be eligible for Medicare no matter your age, but you’ll have to sign up by contacting the Social Security Administration. You can do that by phone at 800-772-1213 (TTY 1-800-325-0778) or by contacting your local Social Security office.

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  • Can I apply for Medicare without applying for Social Security?

    Short Answer:

    Yes. If you’re nearing age 65 but don’t want to start claiming Social Security benefits yet, you can apply just for Medicare.

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    Even though you don't want to claim Social Security benefits at this time, you still apply for Medicare by signing up with the Social Security Administration—either at the website, by calling 800-772-1213, or in person at your local Social Security office.

    If you are not yet receiving Social Security benefits you will be billed directly for your Medicare premiums. Once you sign up for retirement benefits, your Medicare premiums will be automatically deducted from your monthly Social Security checks.

     

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