It’s important to know what to do when you’re eligible for Medicare.
Who is eligible for Medicare?
Medicare is available to United States citizens and legal residents who have lived in the United States for at least 5 years in a row. Medicare is individual insurance. It doesn't cover spouses or dependents.
You may become eligible to receive Medicare benefits based on any one of the following.
- You are age 65 or older.
- You are younger than 65 with a qualifying disability. Medicare eligibility begins after 24 months of receiving Social Security disability benefits.
- Any age with a diagnosis of End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s Disease)
Medicare Initial Enrollment Period
Around your 65th birthday you'll have a 7-month window of time when you can sign up for Medicare. It's called your Initial Enrollment Period – or IEP for short. Your IEP includes your 65th birthday month, the 3 months before and the 3 months after.
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You still have a Medicare enrollment decision to make
If you plan to keep working or you have employer health coverage through a spouse, you have some options to consider when signing up for Medicare. Depending on your situation, you may or may not be able to delay Medicare enrollment.
Your Initial Enrollment Period (IEP) happens when you’re turning 65 whether you’re still going to work or not. Be sure to know your IEP dates and plan ahead.
You may be eligible for Medicare before age 65 if you have a qualifying disability. Eligibility usually starts after you’ve received disability benefits for 24 months. You will be automatically enrolled in Medicare Parts A and B. You may make other coverage choices during your IEP. Your 7-month IEP includes the month you receive your 25th disability check plus the 3 months before and the 3 months after.
After you become eligible for Medicare it’s time to enroll. You will need to enroll in Medicare Part A and/or Part B first before you can enroll in any additional coverage.
Some people are automatically enrolled in Original Medicare (Part A and Part B) once they’re eligible, but not everyone is.
You’ll be automatically enrolled in Original Medicare if:
- You’re receiving Social Security or Railroad Retirement Board benefits when you turn 65; or
- You’re eligible for Medicare because of a disability or medical condition.
You must enroll yourself in Medicare Part A and Part B if:
- You’re not receiving Social Security benefits when you become eligible for Medicare.
There are three ways to enroll yourself in Medicare:
- Online at www.SocialSecurity.gov.
- Call Social Security at 1-800-772-1213 (TTY users <1-800-325-0778>), Monday through Friday, from 7 AM to 7 PM.
- In-person at your local Social Security office.