Medicare 101 · 03

Am I eligible?

You qualify for Medicare at age 65 regardless of work history if you're a U.S. citizen or have been a permanent legal resident for at least five years. You can also qualify before 65 if you've received Social Security Disability for 24 months, have end-stage renal disease (ESRD), or have ALS (Lou Gehrig's disease). Here are the exact rules for each path in.

Door #1 — You're turning 65

If you're a U.S. citizen or have been a legal resident for 5+ years, you're eligible the month you turn 65. Your Initial Enrollment Period is a 7-month window: 3 months before your birthday month, the birthday month itself, and 3 months after.

• If you've worked 10+ years (40 quarters) and paid Medicare taxes—you qualify for premium-free Part A.
• If your spouse worked 10+ years—you qualify through their record.
• If neither—you can still get Part A by paying a monthly premium ($311 or $565/month in 2026).

Door #2 — You're under 65 with a qualifying disability

If you've been receiving Social Security Disability (SSDI) for 24 months, you're automatically enrolled in Medicare on the 25th month—no application needed. Your card just shows up.

Two exceptions skip the 24-month wait:

• ALS (Lou Gehrig's disease): Coverage starts the same month SSDI does.
• End-stage renal disease (ESRD): Eligible after 3 months of dialysis or after a transplant. (Door #3, see below.)

Door #3 — End-stage renal disease

You're eligible regardless of age if you have ESRD and meet the work-credit requirement (yourself or a spouse). Coverage typically starts the 4th month of dialysis—or the month of a transplant.

What if you're still working past 65?

If you (or your spouse) are still actively working and covered by an employer plan with 20+ employees, you can usually delay Part B without penalty—but you must enroll within 8 months of losing that coverage to avoid the late penalty. Talk to a broker before you delay; the rules are precise.

Citizens, residents, and the 5-year rule

Lawful permanent residents who haven't been here 5 years are not eligible. Once they hit 5 years of continuous residency, the same age/work-credit rules apply.

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