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When Am I Eligible for Medicare?


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Medicare is the government health insurance program for people 65 and over and people with permanent disabilities.

When you are eligible for Medicare depends mostly on:

  • when your birthday is
  • when your disability benefits started
  • what type of disability you have

When am I eligible for Medicare if I qualify through age?

The age for Medicare is 65. If you are already receiving Social Security benefits, you usually will be automatically enrolled in Medicare Part A and Part B when you are eligible for Medicare because of age. Medicare Part A is hospital insurance and Medicare Part B is medical insurance. Together these are called “Original Medicare.” If you want additional coverage, you may be able to get plans from private insurance companies including:

  • Medicare Part D to cover prescription drugs
  • Medicare Advantage to cover routine dental, routine vision, prescription drugs and more*
  • Medicare Supplement to cover Medicare out-of-pocket costs such as copayments, coinsurance and deductibles, depending on the Medicare Supplement plan.

*Not all Medicare Advantage plans includes these benefits.

When am I eligible for Medicare Part D, Medicare Advantage and Medicare Supplement?

You are first eligible for Medicare Part D and Medicare Advantage during your Initial Enrollment Period. This is a 7-month period that begins three months before you turn 65, includes the month you turn 65, and continues for three months after you turn 65. If you miss your Initial Enrollment Period but you have Medicare Part A and Part B, you can usually sign up for Medicare Part D or Medicare Advantage during the Medicare Open Enrollment Period, which is October 15-December 7 each year.

Your Medicare Supplement Open Enrollment Period lasts for six months and automatically starts the month you’re both 65 and enrolled in Medicare Part B. If you miss this enrollment period, you may not be able to buy a Medicare Supplement insurance policy or you may have to pay more.

When I am eligible for Medicare if I have ALS (Lou Gehrig’s disease)?

If you have ALS (Lou Gehrig’s disease) you are eligible for Medicare and will generally get Medicare Part A and Part B benefits the month your disability benefits begin. At this time you can also choose to enroll in a Medicare Advantage plan or stand-alone Medicare Part D Prescription Drug Plan. If you miss your Initial Enrollment Period, you can also enroll in Medicare Advantage or Medicare Part D in the Medicare Open Enrollment Period, which is October 15-December 7 each year.

If you have ALS and are under 65, you may not be eligible for a Medicare Supplement plan. The federal government does not require private insurance companies that sell Medicare Supplement insurance plans to sell them to people under 65.

When am I eligible for Medicare if I have end-stage renal disease (ESRD)?

If you are eligible for Medicare because you have end stage renal disease and you’re on dialysis, your Medicare coverage usually will begin on the first day of the fourth month of your dialysis treatment. Your Medicare coverage may start on the first month of dialysis under certain conditions.

When you become eligible for Medicare because of ESRD you also usually can sign up for Medicare Part D prescription drug coverage. However, you may not be eligible for Medicare Advantage (Medicare Part C) or Medicare Supplement (Medigap). Medicare Advantage plans generally exclude people with ESRD and Medicare Supplement plans generally exclude people under 65. If you miss your Medicare Initial Enrollment Period, you can usually sign up for Medicare Part D in the Medicare Open Enrollment Period, which is October 15-December 7 each year.

When am I eligible for Medicare if I have another disability?

If you are eligible for Medicare because you have a disability other than ALS or ESRD, there is generally a two year waiting period. Once you have been getting disability benefits from Social Security for 24 months or certain disability benefits from the Railroad Retirement Board for 24 months, you may be automatically enrolled in Medicare Part A and Part B. You’ll get your Medicare card in the mail three months before your 25th month of disability. You can also sign up for a Medicare Advantage plan or a Medicare Part D Prescription Drug Plan at this time. Your Medicare Open Enrollment Period is three months before you first get Medicare, includes your 25th month of receiving disability, and extends three months after your 25th month of getting disability. If you miss your Medicare Initial Enrollment Period, you can sign up for a Medicare Advantage plan or a Medicare Part D Prescription Drug Plan during the Medicare Open Enrollment Period, which is October 15-December 7 each year.

If you are younger than 65 and are eligible for Medicare because of a disability, you may have to wait until you are 65 to enroll in a Medicare Supplement insurance plan. Federal law does not require the private insurance companies that sell Medicare Supplement to offer these plans to people under 65.

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