Who is eligible for Medicare?
Age 65 is the usual route. It isn't the only one.
Most people qualify for Medicare when they turn 65. Younger people can qualify through a disability, ALS or permanent kidney failure. Whether you pay a premium for Part A is a separate question, answered by your work history.
Age 65
You're eligible at 65 if you're a US citizen or national, or a lawful permanent resident who has lived in the US continuously for at least 5 years. Your Initial Enrollment Period starts 3 months before the month you turn 65.
A 2025 federal law narrowed eligibility for some other lawfully present non-citizens, such as refugees, asylees and people with temporary protected status. Our guide to Medicare for non-citizens explains who is affected and when.
Under 65 with a disability
If you get Social Security Disability Insurance (SSDI) or certain Railroad Retirement disability benefits, you're usually enrolled in Medicare automatically after 24 months of benefits. People with ALS (Lou Gehrig's disease) get Medicare as soon as their disability benefits start, without the 24-month wait.
End-Stage Renal Disease (ESRD)
People of any age with permanent kidney failure who need regular dialysis or have had a kidney transplant can qualify, provided they (or a spouse or parent) have enough work history or are getting certain benefits. Coverage usually starts on the first day of the fourth month of dialysis, or earlier if you train for home dialysis.
Premium-free Part A
You get Part A without a premium if you or your spouse paid Medicare taxes for at least 40 quarters (about 10 years). A current, former or deceased spouse's record can count in some cases, such as a marriage of at least 10 years before a divorce. If you don't qualify, you can buy Part A: $311 a month with 30 to 39 quarters or $565 a month with fewer, in 2026.
Eligibility isn't the same as enrollment
Being eligible doesn't always mean you're signed up. If you're not already getting Social Security or Railroad Retirement benefits, you need to apply, and missing your window can cost you a lifelong penalty. Our enrollment period calculator shows your exact window.
Common questions
Not because of retirement alone. Before 65, Medicare is available only through disability, ALS or ESRD. Early retirees usually need other coverage, such as COBRA, a retiree plan or a Marketplace plan, until 65.
No. Each person qualifies on their own, usually at their own 65th birthday. You may be able to use your spouse's work record for premium-free Part A once you're eligible.
No. The 40 quarters decide whether Part A is premium-free. If you have fewer, you can usually still get Medicare by paying a premium for Part A, if you meet citizenship or residency requirements.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Getting Medicare before 65 / automatic enrollment, Medicare.gov. Checked September 29, 2026.
- 2026 Medicare Parts A & B Premiums and Deductibles, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- Medicare Coverage of Kidney Dialysis & Kidney Transplant Services, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- Public Law 119-21, section 71201, U.S. Government Publishing Office. Checked September 29, 2026.
- CY 2027 Physician Fee Schedule proposed rule (91 FR, 16 Jul 2026), Federal Register. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.