Medicare Eligibility And Qualification Requirements

Is It Mandatory To Go On Medicare When You Turn 65?


You’re not required to enroll in Medicare when you turn 65. However, if you don’t enroll when you’re first eligible you might be subject to Part A, Part B, and Part D late enrollment penalties. Knowing when you qualify for the different parts of Medicare is important since it lets you know when you can enroll. Let’s start with Original Medicare (Part A and Part B).

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Do I Automatically Receive Medicare When I Turn 65?


If you’re receiving Social Security or Railroad Retirement Board benefits four months prior to your 65th birthday, you’ll be automatically enrolled in Original Medicare (Parts A and B).


You’re eligible for Original Medicare (Parts A and B) if you’re a U.S. citizen or you’ve been a legal permanent resident1 for at least 5 continuous years, and one of the following applies to you:


   You’re 65 or older


   You're under 65, permanently disabled and you’re receiving disability benefits from Social Security or the Railroad Retirement Board


   You have end-stage renal disease (ESRD) or ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s Disease


Most people qualify for Original Medicare (Parts A and B) when they turn 65. But the rules about Medicare eligibility and when you can enroll for Parts A and B are quite complex. They’re based on your age, whether you’re retired or still working. Learn more about Medicare Eligibility/Enrollment to find out exactly when you should enroll.

How Do You Qualify For Medicare Under 65?


If you’re permanently disabled and you’ve been receiving Social Security Disability Insurance (SSDI) benefits for 2 years, you’re eligible for Medicare and you’ll be automatically enrolled in Medicare Parts A and B.


If you have End-Stage Renal Disease (ESRD), you’ll qualify for Original Medicare (Parts A and B), no matter how old you are. You’ll need to sign up for Medicare when you first become eligible, as enrollment is not automatic. Contact Social Security  or visit your local Social Security office for more information on signing up for Medicare if you have ESRD.


If you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, you’ll be automatically enrolled in Medicare Parts A and B the month your disability benefits begin – whatever your age is.

How Do You Become Eligible For Medicare Part C, Part D And Medicare Supplement Plans?


You must be enrolled in Medicare Part A and Part B before you can purchase a Medicare Advantage, or a Medicare Supplement plan. You can’t be enrolled in both a Medicare Advantage (Part C) plan and a Medicare Supplement plan at the same time.


You must be enrolled on Medicare Part A or Part B before you can purchase a Part D plan.


If you’re ready to start shopping, we can help you find a plan in your area that’s based on doctors you’d like to see, prescription drugs you’ll need, and other preferences.

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Read Our Other Medicare Articles

Original Medicare: Part A (Hospital Insurance) and Part B (Medical Insurance).


1A legal permanent resident of the U.S. is a green card holder.


Anthem Blue Cross and Blue Shield is a Medicare Advantage plan with a Medicare contract. Anthem Blue Cross and Blue Shield is a D-SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal.


For Medicare Supplement only: Not connected with or endorsed by the U.S. government or the federal Medicare program.