Eligibility & Enrollment for Medicare
You’re likely to qualify for Medicare when you turn 65 as long as you meet the eligibility requirements. There are some exceptions, such as certain disabilities, that can qualify you for Medicare sooner. Your initial enrollment is open for seven months, but there are other windows for Medicare enrollment as well.
- Written by Lindsey Crossmier
Lindsey Crossmier is an accomplished writer with experience working for The Florida Review and Bookstar PR. As a financial writer, she covers Medicare, life insurance and dental insurance topics for RetireGuide. Research-based data drives her work.Read More
- Edited ByLamia Chowdhury
Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.Read More
- Reviewed ByMichael Jones
Medicare Expert and Owner of Grand Anchor Insurance Solutions
Michael Jones is a licensed insurance agent who manages his own agency called Grand Anchor Insurance Solutions. In addition to being a Medicare expert, Michael specializes in other insurance products such as voluntary benefits for employees of businesses.Read More
- Published: April 28, 2020
- Updated: March 6, 2023
- 5 min read time
- This page features 5 Cited Research Articles
Medicare Eligibility & Enrollment Resources
Medicare eligibility can be complicated — there are specific rules to qualify, exceptions for select individuals and potential additional premium costs if you haven’t worked long enough. Learning about eligibility requirements can help you have an easy Medicare enrollment process or even allow you to apply before you turn 65 in specific instances.
Remember, there are different enrollment periods depending on when you sign up. However, you can’t just sign up at any time. Find out when your enrollment period is before trying to sign up for Medicare.Don't Leave Your Health to ChanceFind a local Medicare plan that fits your needs by connecting with a licensed GoHealth insurance agent.Be sure to give yourself enough time for your coverage to become active. It can take up to six weeks for Social Security to process your application for Medicare A & B.
Medicare Eligibility & Enrollment Basics
Frequently Asked Questions About Medicare Eligibility & EnrollmentWho is eligible for Medicare?You’re typically eligible for Medicare when you turn 65 if you are a U.S. citizen or permanent legal resident. You can become eligible at a younger age if you have certain rare conditions or disabilities like amyotrophic lateral sclerosis (ALS) or end-stage renal disease. To qualify for premium-free Part A, you must have worked and paid Medicare payroll taxes for at least 10 years.When are you eligible for Medicare?You have a window to enroll in Medicare that begins three months before the month of your 65th birthday and ends three months after. You may be automatically enrolled at 65 if you are already receiving Social Security benefits.Does income affect eligibility for Medicare?Income does not affect your eligibility for Medicare but may impact how much you pay for it. Your Part B premium, which is typically $164.90 in 2023, can increase depending on your level of income.Is Medicare enrollment automatic at age 65?Medicare enrollment is automatic only if you are already receiving Social Security benefits. If you have not received Social Security benefits, you must enroll for Medicare online, by phone or in person at your local Social Security office.Is enrolling in Medicare mandatory?You are not required to sign up for Medicare when you turn 65 — it’s optional. But if you wait until after you turn 65 to sign up, you could face penalties later.What happens if I miss my Medicare enrollment?If you miss your initial or special enrollment periods, you can still enroll in Medicare during the next open enrollment period. But you may face additional monthly penalties, which are added to your Medicare Part B and Part D premiums.When will I get my Medicare card?If you manually enroll, you will get your Medicare card in your welcome package about two weeks after you sign up. If you are already receiving Social Security benefits before you turn 65, you’ll be automatically enrolled, and your Medicare card will be mailed to you before your 65th birthday.How do I check the status of my Medicare enrollment?You can check the status of your Medicare enrollment online through your My Social Security account on the Social Security website or the “Check Enrollment” section of your MyMedicare.gov account. You can also call the Social Security Administration at 1-800-772-1213 or go to a local office near you.When is the Medicare open enrollment period?The Medicare open enrollment period is Oct. 15 to Dec. 7 each year. You will be able to enroll in Medicare coverage during that time if you didn't enroll during your initial or special enrollment period.
Key Eligibility & Enrollment Terms
Learn about these key terms to better understand eligibility and enrollment for Medicare.
- Annual Enrollment Period
- Medicare’s annual enrollment period is Oct. 15 – Dec. 7. The annual enrollment period is for those who already have signed up for Medicare before and are looking to change or update coverage.
- You are automatically enrolled in Medicare if you’ve already been receiving benefits from Social Security for at least 24 months.
- The beneficiary is the person who receives Medicare benefits.
- Dual Eligibility
- If you have dual eligibility, then you’re eligible for both Medicare and Medicaid.
- Facilitated Enrollment Notice
- A facilitated enrollment notice — also known as a GREEN notice — informs you that if you qualify for Extra Help, you’ll be automatically enrolled in a Part D drug plan if you don’t enroll in one or decline coverage.
- Initial Enrollment Period
- Your initial enrollment period begins three months before your 65th birthday and ends 3 months after. This is for beneficiaries looking to enroll in Medicare for the first time.
- Late Enrollment Penalty
- If you don’t sign up for Medicare once you’re eligible, you could face a Part A, Part B or Part D late enrollment penalty, which increases your premium cost.
- Special Enrollment Period
- A special enrollment period is for individuals who missed their original enrollment period for Medicare. There are specific instances to qualify for a special enrollment period.
Check Out Our Eligibility & Enrollment Specialty GuidesDon't Leave Your Health to ChanceFind a local Medicare plan that fits your needs by connecting with a licensed GoHealth insurance agent.
Explore More Eligibility & Enrollment ResourcesLast Modified: March 6, 2023Share This Page
5 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2023). “Welcome to Medicare” Package (Not Automatically Enrolled). Retrieved from https://www.medicare.gov/basics/forms-publications-mailings/mailings/signing-up/welcome-to-medicare-package
- U.S. Centers for Medicare & Medicaid Services. (2023). Medicare. Retrieved from https://www.ssa.gov/pubs/EN-05-10043.pdf
- U.S. Centers for Medicare & Medicaid Services. (2023). How Do I Sign Up for Medicare? Retrieved from https://www.medicare.gov/basics/get-started-with-medicare/sign-up/how-do-i-sign-up-for-medicare
- U.S. Centers for Medicare & Medicaid Services. (2023). Facilitated Enrollment Notice. Retrieved from https://www.medicare.gov/basics/forms-publications-mailings/mailings/help-with-costs/reminder-join-drug-plan
- Joseph, C. (2022, October 1). Unpacking Medicare: What You Need to Know About Medicare Enrollment Periods (and When You Can Change Your Plan). Retrieved from https://www.aetnamedicare.com/en/understanding-medicare/medicare-enrollment-periods-what-to-know.html
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