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Medicare Eligibility: Do You Qualify?

Adults age 65 and older — and those in certain situations — can enroll in Medicare

5.5-minute read

Article 2 out of 15 in Medicare Basics

Kimberly Lankford,

Updated May 08, 2026

AARP

Reviewed by

Lok Samson, MHS, Ph.D.

En español

Updated May 08, 2026

woman in front of a blue background with a medicare card

AARP (Source: Getty Images (4))

Key takeaways

Most 65-year-olds in the U.S. are eligible.
But most aren’t enrolled automatically.
Premium-free Part A is reward for 10 years’ work.
Almost everyone pays for Medicare Part B.
Certain people with disabilities get early Medicare.

Medicare enrollment hit the 70 million mark in January 2026, and more than 9 in 10 of the people taking part in the federal health insurance program are age 65 or older.

If you’re approaching 65 and wondering whether you’re eligible for Medicare, you probably are. Nearly 99 percent of the 65-and-older population had Medicare coverage in 2022, the U.S. Census Bureau estimated, the most recent information available.

When President Lyndon B. Johnson signed Medicare, along with Medicaid, into law in 1965, it was designed to be a health care plan for people 65 and older no matter their income or health. Today you’re eligible at age 65 if you’re:

A U.S. citizen, or
A permanent legal resident, better known as a green card holder, who has lived continuously in the U.S. for at least five years, or
A member of a few immigrant groups specifically named in federal law — certain people from Cuba, Haiti or the small Pacific island nations of Marshall Islands, Micronesia and Palau whom the U.S. government has allowed to live in this country under special immigration rules

The law regarding the Medicare eligibility of other legal immigrants changed in mid-2025. People without legal status have never been eligible for Medicare benefits.

Eligibility doesn’t equal enrollment

But don’t confuse eligibility with coverage. Medicare doesn’t kick in automatically when you turn 65.

If you’re not receiving Social Security or Railroad Retirement Board benefits yet, you generally need to sign up for Medicare during your seven-month initial enrollment period, which runs three months before and three months after the month you turn 65. If you’ve been getting your monthly checks for at least four months by your 65th birthday, the government will enroll you.

As full retirement age for Social Security has crept up to 67 for this year’s 65-year-olds, the percentage of retirees filing for Social Security benefits before 65 has declined steadily. In 2024 it was about 40 percent, according to AARP calculations of Social Security Administration data.

Most 65-year-olds qualify for premium-free Part A

For many people, signing up for Medicare Part A at 65, even if they’re employed, is appealing because they don’t have to pay a monthly premium. They’ve earned the right to it by working 40 quarters, 10 years total, and paying Medicare taxes into the Medicare trust fund.

But each person’s circumstances vary: For instance, if you’ve been putting away money tax free in a health savings account (HSA) because you have a high-deductible health insurance plan from your employer and want to continue contributing, you should wait to sign up for Part A. Doing both simultaneously could set you up for an IRS penalty.

Part A helps cover inpatient stays in hospitals and skilled nursing centers, some home care and some end-of-life hospice care. But it can be quite expensive if you have to make the premium payments yourself.

If you have other insurance through your job or your spouse’s, Part A may help after that private plan pays, potentially picking up costs the employer policy doesn’t. That can reduce what you pay out of pocket.

If you haven’t worked for 40 quarters, you can qualify for premium-free Part A through the work record of:

Your spouse if you’ve been married for at least one year, or
Your former spouse if you were married for at least 10 years, or
Your deceased spouse if you were married for at least nine months before the death

Your spouse or ex must be eligible for Social Security benefits, whether through retirement or disability, even if not yet receiving them. The same standard applies to a deceased husband or wife: If your spouse died young, your partner must have worked enough quarters to have been eligible to file for Social Security Disability Insurance (SSDI) payments, even if that never happened.

You must be single to qualify for benefits through a former or deceased spouse.

Even if you can’t get premium-free Part A, any citizen eligible for Medicare can buy Part A, but you must also get Part B or face a late enrollment penalty. If you — or your spouse or former spouse if you’re qualifying that way — have 30 to 39 quarters of work, the Part A premium is $311 a month; for 29 or fewer quarters, it’s $565.

If you continue working until you reach 40 credits, you’ll be able to get free Part A premiums.

Green card holders without enough work credits for premium-free Part A can purchase coverage for the same price. But they also must have five years of continuous residence in the U.S. immediately before applying for Medicare.

Almost everyone with Part B pays a premium

Everyone with Medicare Part B has to pay a monthly premium unless their income and assets are so limited that they receive financial assistance. Three of the four types of Medicare Savings Programs are designed to help with Part B costs.

Part B covers doctors’ services, diagnostic screenings, lab tests, outpatient care and preventive services, plus some medical equipment and transportation. The 2026 standard premium is $202.90, but what you’re charged may be higher depending on your income.

About a quarter of Part B’s total expected costs are financed through Medicare enrollees’ premiums, which means the rates usually rise every year as health care spending and the number of Medicare participants grow. Where does the remainder come from? The federal budget’s general fund.

You don’t have to enroll in Part B and Part A at the same time, but eligibility starts at 65. After your initial enrollment period at age 65, you could face a permanent late penalty if you don’t qualify for a special enrollment period.

If you get your health insurance from an employer with fewer than 20 workers, you should sign up for both Part B and Part A at 65 because your private plan won’t pay first. That could leave you without any coverage when you need it.

Parts A and B are called original Medicare or traditional Medicare, and together they form the foundation for additional Medicare coverage.

Disability can qualify you for Medicare before age 65

Almost 1 in 10 people now on Medicare are younger than 65. They’re eligible because of a disability, coverage that Congress added in 1972.

To receive Medicare early, you must be:

Entitled to either Social Security Disability Insurance (SSDI) or Railroad Retirement Board disability payments for at least 24 months beforehand, or
Diagnosed with Lou Gehrig’s disease, also known as amyotrophic lateral sclerosis (ALS) — you get Medicare automatically when the Social Security Administration approves you for disability benefits — or
Experiencing permanent kidney failure, also called end-stage renal disease. That means you need regular dialysis or a kidney transplant to stay alive. Medicare coverage can start on the first day of the fourth month of dialysis treatments, sometimes earlier.

ALS and kidney-failure patients who get early Medicare have to have worked long enough and recently enough to qualify for SSDI. But they don’t have to wait 24 months for coverage.

If you’re on SSDI now, you don’t have to apply separately for Medicare. When the required time has passed, you’ll get your Medicare card in the mail.

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Contributing: Dena Bunis and Linda Dono

This story, originally published Dec. 5, 2022, was updated with 2026 information about Medicare enrollment and premiums as well as the law passed in 2025 that changed Medicare eligibility for some migrants.

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About the author

Kimberly Lankford is a contributing writer who covers Medicare and personal finance and writes about insurance for The Wall Street Journal | Buy Side. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and The Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.

About the reviewer

Lok Samson, a Medicare policy and research manager at the AARP Public Policy Institute, previously worked at the federal Department of Health and Human Services and the nonprofit National Committee for Quality Assurance. She earned her master’s degree in health sciences and her doctorate in health services research and health care policy from Johns Hopkins University Bloomberg School of Public Health.