Medicare Eligibility Requirements and Qualifications

Medicare has provided health coverage to Americans with disabilities and people over 65 for over 50 years. But that does not mean every is automatically qualified for the program.

Aside from the standard requirements such as being a US citizen, these are some of the requirements to be eligible for the federal health care coverage program:

You may qualify for full Medicare benefits if you are under 64 AND

1. You have received Social Security Disability benefits for 24 consecutive or nonconsecutive months.
2. You receive a disability pension from the Railroad Retirement Board.
3. You have Lou Gehrig’s disease or End-Stage Renal Disease (ESRD).
   
   

You may qualify to enroll in a Medicare plan during your Initial Election Period if you are 64 AND

1. It is 3 months before your 65th birthday on the month of your 65th birthday and the 3 months after your 65th birthday
2. Even if you don’t qualify for full benefits, you can still enroll in Original Medicare at a premium.

You may qualify for Medicare and can enroll during the General Election Period if you are over 65 and there is also a Special Enrollment Period where certain qualifications or circumstances allow you to enroll outside of Open Enrollment. 

Need help finding out what you are eligible for?