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Summary

You are eligible for Medicare if you are in one of the following groupings:

  • People who are age 65 and older
    • It doesn't matter whether you have ever been employed.
    • Social Security considers your age to change on the day before your birthday. That can be particularly important if your birthday is on either the 1st or 2nd of the month. If you were born on September 1, your age changed in the month of August for Medicare and Social Security purposes.
  • People who have received Social Security Disability Income (SSDI) benefits for at least twenty-four months.
  • People with End-Stage Renal Disease (ENRD).  ENRD is permanent kidney failure treated with dialysis or a transplant. 
  • People diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's Disease.
  • NOTE: If your spouse is covered under your health insurance when you apply for Medicare: If you enroll in Medicare based on age at 65 and your spouse is not yet 65, coverage will not begin for your spouse until he or she turns 65. (Therefore make sure you continue the present coverage for your spouse, even if it is from COBRA. )

If you are age 65 or older, even if you don't qualify, you can purchase Medicare A and B for a fee. The only question is how much you pay for the coverage. See Medicare-Premiums.  

If you are eligible for Original Fee-For-Service Medicare, you are likely also eligible for a Medicare Advantage plan. To learn about Medicare Advantage plans, see: Medicare Advantage - Eligibility.

When you can enroll: You can enroll in Medicare Part A at any time. You can only enroll in Parts B and D at limited times. If you are receiving Social Security or Railroad Retirement benefits, enrollment is automatic. For additional information, see: When Can I Enroll In Medicare Parts A, B and/or D?  3749

For information about how to enroll, see: Original Fee-For-Service Medicare: How To Enroll.

When coverage is effective depends on when you sign up. To learn more, see Original Fee-For Service Medicare: Effective Date Of Coverage.

When Can I Enroll In Medicare Parts A, B and/or D?

Part A - Hospital Insurance

You may apply for Medicare Part A at any time you are eligilble.

Coverage may be retroactive for up to six months.

If you are already receiving monthly benefit payments from Social Security or a Railroad Retirement Benefit, Medicare coverage will automatically start on the date you become eligible. For example, if you have been getting Social Security Disability Income (SSDI) for 24 months, you will automatically receive Medicare. Likewise, if you take early retirement before age 65, Medicare will also automatically start when you turn 65.

Parts B and D - Medical Insurance

Parts B and D - Medical and Drug coverages are optional or voluntary coverage that can be obtained during an "Initial Enrollment Period," during a "Special Enrollment Period" or during a ""General Enrollment Period." The rules differ with respect to each enrollment period. See Medicare -- Schedule of Benefits for a description of what Parts B and D cover. See Medicare Premiums for a discussion of the cost of Parts B and D, and help in paying that cost.

Initial Enrollment Period is the four months before and three months after the month that you turn 65.

General Enrollment Period is available January 1 through March 31 each year if you did not enroll during the Initial Enrollment Period or declined it when you were automatically enrolled. People who enroll during this period generally must pay a penalty. To learn more, see: Medicare Premiums.

Special Enrollment Period is available when you did not enroll in Part B Medical Insurance because you were covered by an employer or union group health plan when you declined Part B coverage.

There is generally no penalty added to the premiums for enrolling in Part B during the Special Enrollment Period.

If you weren't a member of an employer or union group health plan, and decided not to take Part B or dropped it, you can only get Part B during a General Enrollment period, and will probably have to pay a penalty.

Under the Special Enrollment Period, you may enroll:

  • Anytime you are still covered by the employer or union group health plan through you or your spouse's current or active employment, or
  • Within 8 months of the date when the employer or union group health plan coverage ends, or the employment ends, whichever is first. The 8 month period is counted starting the month after coverage or employment ends, whichever ends first. For example, if your group coverage stops on June 10, 2010 the 8 month enrollment period will end the end of February 2011, which is 8 months from July 1, 2010. (To avoid a gap in coverage, you can apply for Medicare up to 3 months before you become eligible.)

Your right to a Special Enrollment Period lasts as long as you are covered under an employer group health plan. For example, if you originally enrolled in Part B and later realized you didn't need it because of your employer group coverage, you can drop Part B and still have a guaranteed right to add it back without penalty just before the employer group coverage ends.