Medicare is a government health insurance program for people age 65 and older or who qualify for the program based on disability. Most people pay no premium for Part A because they or their spouse paid Medicare payroll taxes while working.
If an individual does not sign up for premium Part B when first eligible, they will have to pay a penalty that lasts as long as they have Medicare. Medicaid programs administered by states offer financial assistance to low-income Medicare beneficiaries.
Age Requirements
In general, people become eligible for Medicare at age 65. However, there are a few situations when you might be able to get Medicare earlier than that.
If you or a spouse worked for at least 40 quarters of work, you may qualify for premium-free Part A (Medicare's hospital insurance) when you turn 62. That's especially true if you or your spouse have amyotrophic lateral sclerosis, or ALS. In such cases, you may be able to enroll in Medicare during a special enrollment period, or SEP, that begins the month after your employer-sponsored health plan coverage ends, your employment is terminated or you retire.
Generally, most people who are eligible for Medicare sign up during their Initial Enrollment Period, or IEP, which is seven months long and starts three months before your birthday, includes your birthday month and ends three months after. This means that you should apply for Medicare at least three months before your 65th birthday, so that you have enough time to enroll and avoid late enrollment penalties.
The majority of people who receive Medicare benefits under the age of 65 are enrolled in a Part D prescription drug plan, either as stand-alone Part D or in a Medicare Advantage drug plan. This compares with just over half of Medicare beneficiaries who are older than 65, who are enrolled in a Part D plan.
Whether you're applying for Medicare as an adult or as a disabled person, there's a lot to consider. It's helpful to talk to a Medicare professional about your situation. You can find one in your local area using our free locator tool. NerdWallet writers are subject matter experts who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked and carefully edited. For more information, read our full editorial guidelines.
Disability Requirements
Medicare is a nationwide health insurance program administered by the government for people over 65. It also provides coverage for certain disabled individuals. It pays most of the costs associated with hospital stays and doctor visits. Some of the other things covered include diagnostic testing, prescription medications, and durable medical equipment. To qualify for medicare, individuals must meet age and disability requirements.
Generally, to qualify for Medicare you must be 65 or older and have paid Social Security or Railroad Retirement Board benefits for at least 10 years. Individuals can enroll during their Initial Enrollment Period (IEP). In addition, individuals with disabilities may be able to enroll in Medicare before age 65. These individuals are defined as those who have received Social Security Disability payments for 24 months, have End Stage Renal Disease and require dialysis or a kidney transplant, or have Amyotrophic Lateral Sclerosis (ALS).
The eligibility requirements for Medicare Part B differ from those for Part A. Those who choose to pay a premium for Part B can enroll during the General Enrollment Period (GEP) each year from January through March. In some cases, individuals who were on active duty or a family member of an active duty servicemember who was on TRICARE Standard or TRICARE Prime can use the SEP to sign up for Part B and avoid paying a late enrollment penalty.
Individuals who are released from prison may also be eligible for a Special Enrollment Period. This SEP starts the day after an individual is released from custody and ends the last day of the 12th month after that date. Individuals who are enrolled in an employer's group health plan or are on Medicare Advantage plans can use this SEP to sign up for Part B and can opt for up to 6 months of retroactive coverage. Individuals who were on a foreign military mission and did not enroll in Part B or premium Part A when first eligible can use an International Volunteer SEP to enroll.
