Medicare Eligibility

Jump to a section:

• Who is eligible for Medicare?
• Medicare checklist
• When can I enroll
• Changing your current Medicare coverage

Before you get started, here are some important words you should know:

When can I enroll in Medicare?

If you are turning 65 and will be eligible, you have seven months to enroll in Medicare Parts A and B. Your Medicare enrollment timeline includes:

• Three months before the month of your 65th birthday.
• The month of your 65th birthday.
• Three months after the month of your 65th birthday.

If you currently get your health care benefits through your employer, make sure to talk to your employer. Your employer can help you understand what you need to do before you retire.

If you don’t sign up for Medicare when you’re first eligible and don’t have creditable coverage, such as employer coverage, you may face late enrollment penalties later. This can include higher premiums for Medicare Part B and Part D for as long as you have Medicare.

Who is eligible for Medicare?

Medicare is a federal health insurance program. To qualify, you must be a U.S. citizen or lawfully present in the United States. This means that Medicare eligibility depends on your status as a lawful resident as of the date your coverage begins. Medicare plans cannot deny enrollment based on citizenship or lawful presence–only the federal government determines eligibility and provides that information to the plans. Many people qualify based on work history and Social Security taxes, but lawful residency is still a requirement. Different rules apply to noncitizens, depending on their immigration status and work history.

You must also meet at least one of the following conditions: 

• You are age 65 or older. 
• You are under age 65 with certain disabilities. 
• You have permanent kidney failure requiring dialysis. 

Not everyone qualifies the same way. Keep reading for more details based on age, disability status, and retirement. 

Medicare eligibility age

Most people can get Medicare when they turn 65 years old. This includes Medicare Part A (hospital) and Part B (doctor). You can sign up as soon as three months before your 65th birthday. However, you may qualify for Medicare before turning 65 if you have certain disabilities or have permanent kidney failure that requires dialysis.

Sometimes Medicare enrollment happens without you needing to sign up, and sometimes you must sign up yourself.

You will be automatically enrolled in Medicare Part A and Part B if you already receive Social Security or Railroad Retirement benefits at least 4 months before turning 65. If you qualify for Medicare based on disability, you will be automatically enrolled after 24 months of Social Security Disability Insurance coverage. If you have ALS, automatic enrollment begins as soon as you receive disability benefits.

You must manually enroll if you are not already getting Social Security or Railroad Retirement benefits when you first become eligible.

How to apply for Medicare

You can apply for Medicare through the Social Security Administration:

• Online: Visit SSA.gov and complete the application online. You’ll need personal information such as your Social Security number, date of birth, and contact information.
• By phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778) Monday through Friday from 8 a.m. to 7 p.m. to enroll by phone or ask questions.
• In person: Visit your local Social Security office to complete the application in person if you prefer face-to-face.

Documents you may need

• Social Security number
• Proof of age (such as a birth certificate)
• Proof of U.S. citizenship or lawful residency
• Information about current health coverage

Social Security may request additional documentation in certain circumstances.

Medicare Checklist

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What if I am already enrolled in a Medicare plan and need to change my coverage?

If you are already enrolled in Medicare, there are only certain times of the year when you can change your Medicare Advantage coverage. 

• Annual Enrollment Period: Oct. 15 – Dec. 7 You can add or drop Part D prescription drug coverage, change to a Medicare Advantage plan, or change to Original Medicare. Your coverage will be effective Jan. 1. 
• Special Enrollment Period: Varies. You can change your Medicare coverage following a qualifying life event. Your coverage will be effective on the 1st of the next month. 
• Open Enrollment Period: Jan. 1 – March 31 If you are on a Medicare Advantage plan, you can make ONE change to your coverage. You can add or drop Part D prescription drug coverage or change to a different Medicare Advantage plan or to Original Medicare. Your coverage will be effective on the 1st of the next month. 
• Lock-In Period:  
  • April 1 – Oct. 14  
  • Dec. 8 – Dec. 31
  • You cannot make a plan change after March 31 unless you qualify for a Special Election Period (SEP) or have Medical Assistance coverage.

Learn more about when to enroll

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Frequently asked questions about Medicare eligibility

Do you have to be retired to qualify for Medicare?

No. You don’t have to be retired to qualify for Medicare. Most people become eligible at age 65 regardless of their employment status. If you are not yet receiving Social Security benefits, you can apply during your Initial Enrollment Period starting three months before your 65th birthday.

Can you get Medicare if you’re still working?

Yes. You can still get Medicare if you’re working. Your eligibility and enrollment depend on age and disability requirements, not employment status. If you are eligible for Medicare and have employer-based coverage that is considered creditable, you may choose when to enroll in Medicare Parts A and B based on your needs.  

Does Medicare eligibility mean automatic enrollment?

Not always. Automatic enrollment typically happens if you are already receiving Social Security or Railroad Retirement benefits by the time you become eligible. If you’re not already receiving those benefits, you will need to enroll yourself during your Initial Enrollment Period.