In the news, you may often hear about the possibility of lowering the age of Medicare eligiblity to 62, or even 60.
Currently, Medicare eligibility starts at age 65 for most people. However, you can get Medicare before age 65 in certain situations.
Keep reading to learn more about how you can qualify for Medicare at different ages.
The eligibility age for Medicare is 65 years old for most people. This applies whether or not you’re still working at the time of your 65th birthday.
The age when you retire does not factor into Medicare eligibility.
If you have insurance through your employer when you apply for Medicare, it will remain your primary insurance and Medicare will be considered secondary insurance.
You’re first eligible to apply for Medicare 3 months before the month you turn age 65, during the month you turn age 65, and up to 3 months after your 65th birthday.
This gives you a total of 7 months to enroll.
You may apply for Medicare at any age if you meet one of the following criteria:
- your receive Social Security disability or Railroad Retirement Board (RRB) disability insurance
- you have specific medical conditions, such as amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD)
- a family member is enrolled in Medicare
Social Security disability
If you’re under age 65 and have been receiving Social Security disability benefits for 24 months, you qualify for Medicare.
You can enroll in your 22nd month of receiving these benefits, and your coverage will begin in your 25th month of receiving them.
If you’re entitled to monthly benefits based on an occupational disability and have been granted a disability freeze, you become eligible for Medicare on the 30th month after the date of the freeze.
RRB disability
If you receive a disability pension from the RRB and meet certain criteria, you may be eligible for Medicare before age 65.
Specific health conditions
You may be eligible for Medicare if you have either:
- ALS. If you’ve been diagnosed with ALS, also known as Lou Gehrig’s Disease, you become immediately eligible for Medicare upon collecting Social Security disability insurance (SSDI) benefits.
- ESRD. If you have ESRD, also known as end stage kidney disease, and need regular dialysis or a kidney transplant, you’re eligible for Medicare and your coverage can begin shortly after your first dialysis treatment.
Family relationship
Under certain circumstances, and typically following a 24-month waiting period, you may be eligible for Medicare under age 65 based on your relationship with a Medicare recipient, including:
- disabled widow(er) under age 65
- disabled surviving divorced spouses under age 65
- disabled children
To qualify for Medicare under any circumstances, including reaching age 65 and those outlined above, you’ll need to meet the following eligibility requirements:
- U.S. citizenship. You must be a citizen, or you must have been a legal resident for a minimum of 5 years.
- Address. You must have a stable U.S. address.
- HSA. You can’t contribute to a health savings account (HSA); however, you can still use existing funds in your HSA.
In most cases, you’ll need to receive care within the U.S.
If you’re imprisoned, generally the correctional facility will provide and pay for your care, not Medicare.
Medicare is the U.S. government’s health insurance program for people aged 65 or older. You could be eligible for Medicare before you reach age 65 if you have:
- Social Security disability
- RRB disability pension
- specific health conditions
- family relationship
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Q: Do I need to sign up for Medicare at 65 if I’m still working?
A: Medicare eligibility begins at age 65, and signing up on time can help you avoid premium surcharges. But if you’re working at 65, you get a bit more leeway.
Medicare eligibility starts at age 65. Your initial window to enroll is the seven-month period that begins three months before the month of your 65th birthday and ends three months after it. Seniors are generally advised to sign up on time to avoid penalties that could prove quite costly over the course of retirement.
Specifically, if you fail to sign up for Medicare on time, you’ll risk a 10 percent surcharge on your Medicare Part B premiums for each year-long period you go without coverage upon being eligible. (Since Medicare Part A is usually free, a late enrollment penalty doesn’t apply for most people.) If you’re still working at age 65, however, a different set of rules applies.
Time to sign
up for Medicare?
Find Medicare Advantage and Medicare supplement insurance plans in your area.
No need to double up on coverage
Many seniors are no longer employed at age 65, and thus rush to sign up for Medicare as soon as they’re able. But if you’re still working at 65, and you have coverage under a group health plan through an employer with 20 employees or more, then you don’t have to enroll in Medicare right now. But if your employer has less than 20 employees, you need to take Medicare Parts A and B, because that will be your primary insurance. If you don’t enroll, your employer plan may pay less – or nothing at all – for your care when it finds out.
That said, it often pays to enroll in Medicare Part A on time even if you have health coverage already. It won’t cost you anything, and this way, Medicare can serve as your secondary insurance and potentially pick up the tab for anything your primary insurance (in this case, your work health plan) doesn’t cover.
The only exception is if you’re contributing to a health savings account and wish to continue doing so. Medicare enrollees are not allowed to contribute to an HSA, even if they continue to have coverage under an employer’s HSA-qualified high-deductible health plan.
Your Medicare special enrollment period
If your employer has at least 20 employees and you’re still working and covered under that plan when you turn 65, you can delay your enrollment in Medicare (specifically in Medicare Part B, which allows you to avoid the Part B premium while you’re covered under your employer’s plan). In that case, you’ll get an eight-month special enrollment period to sign up for Medicare if and when you leave your job or your employer stops offering coverage. It will start the month after you separate from your employer, or the month after your group health coverage ends – whichever happens sooner.
Sign up during those eight months, and you won’t have to worry about premium surcharges for being late. And the eight-month special enrollment period is also available if you’re delaying Part B enrollment because you’re covered under your spouse’s employer-sponsored plan, assuming their employer has at least 20 employees.
But note that in either case, it has to be a current employer. If you’re covered under COBRA or a retiree plan, you won’t avoid the Part B late enrollment penalty when you eventually enroll, and you won’t have access to a special enrollment period to sign up for Part B — you’ll have to wait for the general enrollment period instead.
Run the numbers
Though you don’t need to enroll in Medicare at age 65 if you have coverage through a qualified group health plan, doing so might make sense if that plan isn’t heavily subsidized by your employer. Figure out what you’re paying for group health coverage and what your benefits look like under that plan, and then compare it to what you’ll pay under Medicare, taking into account the cost of everything from premiums to coinsurance to deductibles to copays.
Keep in mind that for comprehensive coverage under Medicare, you’ll need a Part D drug plan to accompany Parts A and B. Still, you might find that signing up for Medicare at 65 makes the most sense financially, even if you’re entitled to a special enrollment period later on.
Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.
Tags: enrollment, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D