Who Qualifies for Medicare? Learn who qualifies and what the limitations are for Medicare eligibility.
A person qualifies for Medicare through any one of the following conditions:
- Upon reaching 65 years of age, and a citizen of the United States or legal resident for 5 years (continuous), and them or there spouse has paid Medicare taxes for a minimum of 10 years.
- For individuals under 65 years old and disabled, and receiving Social Security or Railroad Retirement Board disability benefits for a minimum of 24 months from the date of first receiving disability payments.
- Receive continuing dialysis for kidney disease (progressive loss of renal function) or are in need of a kidney transplant as a result of a gradual progressive loss of kidney function over months or years.
- Receive Social Security Disability Insurance as a result of being unable to work because of a disability and have Lou Gehrig’s disease (ALS).
The 2 year exclusion for disabled individuals means they must wait 2 years before receiving Medicare insurance coverage unless they meet the conditions above or qualify for Medicaid.
Although full retirement age for Social Security is currently 67, eligibility for who qualifies for Medicare still remains age 65. So a person can qualify for Medicare when not yet eligible for Social Security. You do have to meet the requirement of paying Social Security taxes for a minimum of 10 years or be eligible on your spouse’s (or former spouse’s) earnings. Even if a person doesn’t meet those requirements, Part A Medicare coverage can still be obtained by paying the monthly premium for U.S. citizens or qualified aliens who have legally resided in the U.S. for at least 5 years.
Anyone who is a U.S. citizen or lawful alien (with 5 years of United States residency) and age 65 can apply for Medicare Part B – but must pay the monthly premium.
Part B enrollment can begin during the 7-month period beginning 3 months before age 65. If a person is eligible and decides not to enroll in Part B, but changes their mind later, they can enroll during the annual General Enrollment Period between January 1 through March 31.