At What Age Are You Eligible for Medicare?
Key Takeaways
- The standard age for Medicare eligibilitySome health plans require you to meet minimum requirements before you can enroll. is 65 years old.
- These days, fewer people are automatically enrolled in Medicare at age 65 because they draw Social Security benefits after 65. If you do not receive Social Security benefits, you will not auto-enroll in Medicare.
- At what age can you get Medicare before 65? Medicare offers exceptions without age restrictions.
- You can be eligible for Medicare before 65 if you meet specific requirements, e.g., receive a pension from the Railroad Retirement Board, have permanent kidney failure, or other exceptions specified by Medicare.
- If you receive coverage through MedicaidMedicaid is a state-based health insurance program for individuals that qualify. Unlike Medicare, Medicaid does not have age restrictions for members. when you turn 65, you may be dual-eligibleDual eligible individuals qualify for both Medicare and Medicaid. and enroll in Medicare and keep your Medicaid.
How old do you have to be to enroll in Medicare? For most people, Medicare eligibility begins at 65 years old. But there are a few exceptions that allow for earlier enrollment, such as disability.
Understanding Medicare eligibility and the age requirements for enrollment will not only help you plan for your future healthcare needs, but also ensure a smooth transition into this federal health insurance program. Take a look at our Medicare eligibility age chart to help determine when it’s your time to enroll.
Find the Medicare Plan that works for you.
Medicare Eligibility Age Chart
| Your Birth Year | Your Medicare Eligibility Year |
|---|---|
| Before 1960 | You are already eligible |
| 1960 | 2025 |
| 1961 | 2026 |
| 1962 | 2027 |
| 1963 | 2028 |
| 1964 | 2029 |
| 1965 | 2030 |
| 1966 | 2031 |
| 1967 | 2032 |
| 1968 | 2033 |
| 1969 | 2034 |
| 1970 | 2035 |
| 1971 | 2036 |
| 1972 | 2037 |
| 1973 | 2038 |
| 1974 | 2039 |
| 1975 | 2040 |
| 1976 | 2041 |
| 1977 | 2042 |
| 1978 | 2043 |
| 1979 | 2044 |
| 1980 | 2045 |
Knowing your Medicare eligibility year will help you prepare for your enrollment period, avoid any late enrollment penalties, and ensure you have the healthcare coverage you need when you need it.
Of the 67.7 million Americans enrolled in Medicare, nearly 90% are 65 or older. This chart will help you plan ahead as you approach 65. It’s important to note that those living with a disability or certain health conditions may be able to enroll before they turn 65.
Other Medicare Eligibility Criteria
Many Americans qualify for Medicare when they turn 65. However, there are a few reasons someone might qualify for Medicare at or before the standard Initial Enrollment Period. You are generally eligible for Medicare if you meet at least one of these requirements:
- Being age 65 or older
- Living with End-Stage Renal Disease (ESRD)
- Living with Amyotrophic Lateral Sclerosis (ALS)
- Receiving Social Security Disability Insurance (SSDI)
Enrolling in Medicare Under 65
While most people enroll in Medicare during their 7-month Initial Enrollment Period surrounding their 65th birthday, there are a few exceptions. You may qualify for Medicare Parts A and B if you are:
- Living with End-Stage Renal Disease (ESRD): You are Medicare eligible at any age if you have ESRD and meet the necessary qualifications.
- Living with Amyotrophic Lateral Sclerosis (ALS): Regardless of age, you are automatically enrolled in Medicare the same month you start receiving Social Security benefits.
- Receiving Social Security Disability Insurance (SSDI): You are eligible for Medicare if you are under 65 and have been receiving Social Security or Railroad Retirement Board benefits for 24 months.
These standards for early Medicare enrollment make sure people who have significant health needs get the support they require when they need it most.
What to Expect for Medicare Enrollment
Enrolling in Medicare isn’t always as simple as turning 65. Knowing what’s involved in the enrollment process can help you avoid delays, penalties, or a lapse in coverage. Whether you need to actively enroll in Medicare or qualify for automatic enrollment depends on your situation.
Medicare Enrollment Is Not Always Automatic
Some people automatically get Medicare at age 65. If you’re already receiving benefits from Social Security or the Railroad Retirement Board at least four months before your turn 65, you’ll be enrolled in Medicare Parts A and B automatically.
If you are automatically enrolled, you will receive a “Welcome to Medicare” kit about three months before turning 65. It will include instructions on how to decline enrollment in Part A, Part B, or both if you don’t want to begin your Medicare journey yet. For example, if you are still working and have employer-sponsored health insurance, you may opt to keep that as your health coverage instead of enrolling in Medicare.
If you don’t qualify for automatic enrollment, your Initial Enrollment Period will be your opportunity to sign up for Medicare.
How to Enroll in Medicare
To start taking advantage of Medicare, you need to sign up during your Initial Enrollment Period. This is a 7-month window that begins three months before your 65th birthday, includes your birthday month, and ends three months after. For example, if your birthday is in April, your Initial Enrollment Period would be from January to July.
You can enroll in Medicare Parts A and B through the Social Security Administration online, by phone, or in person. Before you start the enrollment process, make sure you have the following important documents ready:
- Social Security Number
- Birth certificate
- Medicaid number (if you have one)
- Current health insurance information
These documents will help the Social Security Administration verify who you are and your health insurance history. If you sign up during one of the months before your 65th birthday, your coverage will begin on the first day of the month you turn 65 (or one month before your birthday if you were born on the first day of the month).
If you are interested in enrolling in Medicare Advantage, you may do so after first enrolling in Original Medicare. Afterwards, you may work online, over the phone, or in person with a trusted licensed insurance agent or broker to complete enrollment in a Medicare Advantage plan.
Medicare Costs to Expect
Staying aware of primary Medicare costs will help you plan your budget and avoid surprises. Your costs may vary depending on the type of Medicare coverage you choose. Here are the key expenses you may encounter with Medicare:
- Premiums: The monthly amount you pay to have Medicare coverage. Most people do not have to pay a premium for Medicare Part A. The Part B premium in 2025 is $185.
- Deductibles: Your out-of-pocket cost before Medicare kicks in. If you have a hospital stay in 2025, the Part A deductible is $1,676 per benefit period. The Part B deductible is $257 in 2025.
- Copays and coinsurance: After meeting your deductible, you will likely pay a portion of the costs for healthcare services. Copays are a fixed amount, such as $20 per visit. Coinsurance is a percentage of the total cost, likely 20% of the total cost for outpatient visits.
- Out-of-pocket maximums: Medicare Parts A and B do not have an out-of-pocket maximum. Many people cap their spending by enrolling in one of the Medigap plans with an out-of-pocket maximum benefit or in a Medicare Advantage (Part C) plan. All Medicare Advantage plans have an out-of-pocket maximum.
Original Medicare vs. Medicare Advantage: Which Should You Get?
The choice between Original Medicare (Parts A and B) and Medicare Advantage (Part C) depends on your healthcare needs, lifestyle, and budget.
If your prescription costs are limited and you prefer the flexibility of seeing any doctor who accepts Medicare, Original Medicare may be right for you. Medicare Advantage plans require you to seek care within its network of providers for coverage. However, Original Medicare only includes Parts A and B. If you are interested in prescription drug coverage, you would need to add an additional Part D plan or choose a Medicare Advantage Prescription Drug plan.
While Original Medicare is run by the federal government, Medicare Advantage is run by private insurance companies and acts as a substitute for Original Medicare. Part C matches Original Medicare’s coverage and often includes additional services like Part D and other benefits. In addition to potential extra benefits, many Medicare Advantage plans have out-of-pocket maximums, limiting the amount you’ll spend each year.
Putting It All Together
Understanding how Medicare works will help you plan your healthcare coverage with confidence. Knowing when and how to enroll, what costs you can expect, and the differences between Medicare Parts A, B, and C will ensure that you make an informed choice that suits your health needs and lifestyle.
Find the Medicare Advantage plan that meets your needs.
