You generally need to be 65 to get Medicare. That’s the standard eligibility age, and it hasn’t changed since the program launched in 1966. But age isn’t the only path in. People younger than 65 can qualify through disability benefits or specific medical conditions, sometimes with no age requirement at all.
The Standard: Age 65
Most Americans become eligible for Medicare when they turn 65. To qualify, you need to be a U.S. citizen or a permanent resident who has lived in the country for at least five continuous years. You also need enough work history to qualify for Social Security benefits, which means earning at least 40 work credits over your career. In 2026, you earn one credit for every $1,890 in covered earnings, up to four credits per year. So 40 credits takes a minimum of 10 years of work.
If you meet that 40-credit threshold, you get Part A (hospital insurance) with no monthly premium. If you don’t have enough work credits, you can still enroll at 65, but you’ll pay up to $565 per month for Part A in 2026.
Your Enrollment Window at 65
Your initial enrollment period lasts seven months: it starts three months before the month you turn 65 and ends three months after. Signing up during this window matters because enrolling late can result in permanent premium penalties on Part B.
If you’re still working at 65 and have employer-based health insurance, the situation gets more nuanced. Medicare recommends signing up for both Part A and Part B when you’re first eligible, even if you have job-based coverage. If you skip enrollment and don’t have qualifying employer coverage, you could face late penalties when you do sign up.
Qualifying Before 65 Through Disability
You don’t have to wait until 65 if you’re receiving Social Security disability benefits. After collecting disability payments for 24 consecutive months, you’re automatically enrolled in Medicare. There’s no application to fill out. Your coverage simply begins after that two-year waiting period.
The same 24-month rule applies to disabled railroad workers, though the timeline can differ slightly for those receiving benefits based on occupational disability rather than total disability. Disabled family members of railroad workers, including widows and children, can also qualify after the standard waiting period.
ALS: No Waiting Period
One major exception to the 24-month waiting period is ALS, commonly known as Lou Gehrig’s disease. If you’re diagnosed with ALS, Medicare coverage begins automatically the same month your disability benefits start. There is no waiting period at all. This applies whether your benefits come through Social Security or the Railroad Retirement Board.
Kidney Failure at Any Age
End-stage renal disease (permanent kidney failure requiring dialysis or a transplant) qualifies you for Medicare regardless of your age. The timeline depends on your treatment path.
- Dialysis: Coverage typically starts on the first day of the fourth month of dialysis treatments. That three-month waiting period begins counting even if you haven’t formally signed up yet.
- Home dialysis training: Coverage can start as early as the first month of dialysis if you’re enrolled in a home dialysis training program at a Medicare-certified facility and your doctor expects you to complete the training and manage dialysis at home.
- Kidney transplant: Coverage can begin the month you’re admitted to a Medicare-certified hospital for the transplant, as long as the transplant happens that same month or within the next two months.
If you qualify through kidney failure but don’t sign up right away, your coverage can be applied retroactively up to 12 months before the month you apply.
Family members with permanent kidney failure can also qualify based on a worker’s record, including spouses, divorced spouses, and children.
Will the Eligibility Age Change?
There has been ongoing policy debate about raising Medicare’s eligibility age from 65 to 67, which would align it with Social Security’s full retirement age. The Urban Institute has modeled what eliminating coverage for 65- and 66-year-olds would look like. But as of now, no legislation has been enacted to change the age. The eligibility threshold remains 65, where it has been for decades.