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Who's eligible for Medicare coverage?

Every American citizen becomes eligible for Medicare upon reaching 65 years old. Non-citizen permanent residents also qualify at the age of 65, as long as they have resided in the country for a minimum of five years.

If you are under 65, you might qualify for Medicare if:
  • You are permanently disabled and have received Social Security Disability benefits for at least 24 months
  • You have been diagnosed with end-stage renal disease (kidney failure)
  • You have been diagnosed with Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease) and are receiving Social Security Disability benefits

Like many extensive government programs, Medicare can appear daunting initially. To assist you in navigating the application process, annual enrollment, and other aspects, we have developed this guide.

When should you apply for Medicare?

Once you reach the age of 65, you qualify for Medicare. If you have already started receiving Social Security benefits by that age, you will be enrolled in Medicare automatically on your 65th birthday, receiving Parts A and B. To sign up for additional Medicare programs like Part C (Advantage) or Part D (prescription), you can consult a licensed insurance agent to explore these plan options.

If you have not yet started receiving Social Security benefits, you must apply for Medicare at age 65. The Initial Enrollment Period (IEP) starts three months before your 65th birthday, continues through your birthday month, and extends for three months after. This gives you a total of seven months to finalize your enrollment.

The only exception to the rule mentioned above is if your birthday is on the first day of the month, your IEP will start a month earlier.

It is advised to apply for Medicare at age 65, even if you are not yet claiming your Social Security benefits. It is crucial to apply for Medicare during this initial enrollment period to avoid higher premiums in the future. Delaying enrollment may lead to penalties that can increase premiums unless specific conditions apply that allow for enrollment postponement without penalties.

What if you miss the Initial Enrollment Period?

The Medicare General Enrollment Period, from January 1 to March 31 each year, allows those who missed their IEP to enroll in Medicare.

Apart from qualifying for a Special Enrollment Period following a life event, this is the sole opportunity to enroll in Original Medicare after your Initial Enrollment Period.

When you sign up for Original Medicare during the General Enrollment Period, your coverage will begin on the first day of the month following your enrollment. For example, if you enroll on March 3rd, your coverage would start on April 1st.

Important Note: The General Enrollment Period is not a “safety net” for missing your IEP. This enrollment period should only be used as a backup if you miss your Initial Enrollment Period. Late penalties could apply if you enroll during the General Enrollment Period, so make sure you budget for those additional fees.

For additional information, please visit Medicare.gov.

Have You Watched Our Medicare Essentials Video Quick-Course?

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