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Who Is Eligible for Medicare?
The four ways people qualify, and what has to happen next.
Most people become eligible for Medicare at 65, but age is only one of the routes in. Eligibility also depends on your work history, your residency, and in some cases your diagnosis. Here is how to tell where you stand.
The Four Ways to Qualify
Turning 65
You become eligible the first day of the month you turn 65. You can sign up as early as three months before your birthday month, and enrolling early is what keeps your coverage from starting late.
Under 65 with SSDI
If you have received Social Security Disability Insurance for 24 months, you are enrolled in Medicare automatically. You do not need to apply, and the card arrives on its own.
ESRD or ALS at any age
End-Stage Renal Disease and ALS both qualify you regardless of age. For ALS, coverage begins the same month your disability benefits do, with no waiting period.
Citizenship and time in the U.S.
You must be a U.S. citizen or a lawfully admitted permanent resident who has lived in the country continuously for at least five years. This applies on top of one of the routes above.
Work Credits Change What You Pay, Not Whether You Qualify
These two things get mixed up constantly. Your work history does not decide whether you can get Medicare. It decides whether Part A comes with a premium attached.
If you or your spouse paid Medicare taxes for at least 10 years, which is 40 quarters, Part A costs you nothing each month. With fewer quarters, you can still enroll, but you buy into Part A at a monthly rate.
Part B works differently. Everyone pays a premium for it regardless of work history.
Part A premiums in 2026
- 40 or more quarters of work: $0 per month
- 30 to 39 quarters: $311 per month
- Fewer than 30 quarters: $565 per month
A spouse's work record can qualify you, which catches a lot of people by surprise in a good way.
Eligible Does Not Mean Enrolled
Some people are signed up automatically. Everyone else has to take action, and that difference is where problems start.
You do not need to do anything
If you already receive Social Security or Railroad Retirement benefits when you turn 65, you are enrolled in Parts A and B automatically. Your card arrives about three months before your birthday.
The same is true after 24 months of Social Security Disability Insurance.
You have to sign up yourself
If you have not started drawing Social Security, nothing happens on its own. You have to enroll during your Initial Enrollment Period, and no one sends a reminder.
This is the single most common reason people end up with a Part B late penalty.
The one window you cannot get back
When you turn 65 and enroll in Part B, a six-month Medigap Open Enrollment Period opens. During those six months you can buy any Medicare Supplement plan sold in your state, and no carrier can turn you down, charge you more, or exclude a condition because of your health.
After it closes, that protection is gone. Carriers in most states can require medical underwriting, which means a health history can raise your rate or get your application declined outright.
This window opens once. If a Supplement plan is something you may ever want, it is worth deciding while the door is still open rather than after.
What Happens After You Enroll
Getting Parts A and B is the starting point, not the finish. From there you choose how you want to receive your coverage.
Stay with Original Medicare
Keep Parts A and B, and optionally add a Medicare Supplement plan to help with deductibles and coinsurance, plus a Part D plan for prescriptions.
Choose a Medicare Advantage plan
Move to a private plan that bundles Parts A and B, usually includes drug coverage, and often adds dental, vision, and hearing benefits.
Both routes are explained side by side on our What Is Medicare page, and the deadlines that govern each one are on our Enrollment Periods page.
Keep Learning About Medicare
Medicare TPMO Compliance Statement
Complete Family Protection is not connected with or endorsed by any government entity or the federal Medicare program. Complete Family Protection represents Medicare Advantage HMO, PPO, and PFFS organizations, as well as standalone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. We have access to plan information nationwide and can help you search among many options, but we do not offer every plan available in your area. We search and recommend plans even when we do not directly offer them. Contact a licensed Complete Family Protection agent to find out the number of products available in your specific area. You may also contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.