Medicare Eligibility Requirements

If you’re a U.S. citizen or a permanent legal resident who has lived in the U.S. for at least five years — you’ve met the chief requirement to be eligible for Medicare. However, this isn’t the only requirement.

If you pay Medicare payroll taxes for 10 full years, which equals to 40 work credits, you won’t have to pay premiums for Medicare Part A, which covers hospital care.

Unlike Part A, you don’t need the work credits to qualify for Medicare Part B, which covers doctor visits or outpatient services, and Medicare Part D, which covers prescription drugs. Everyone pays premiums for both regardless of work history.

If you are still working at 65, you don’t have to sign up for Medicare — but there are benefits to signing up while still employed. Similarly, if you have never worked, you can still get Medicare. However, it may be more expensive depending on your spouse’s work history.

Your age also plays a role in your eligibility for Medicare. While most people apply for Medicare when they turn 65, there are other exceptions.

If you meet the Medicare eligibility and enrollment requirements listed above and are 65 years old — you are eligible for Medicare. Typically, people sign up for Medicare one to three months before or after their 65th birthday.

If a disability qualifies you for Medicare before you turn 65, you still need a certain amount of work credits depending on your disability. The younger you are, the less credits you need in order to qualify.

For example, if you’re 34 years old and you have Lou Gehrig’s disease, then you only need 20 work credits instead of the usual 40 to qualify for Medicare.

If you’re signing up your parent for Medicare, you should confirm how many work credits they have to determine whether they’re eligible for benefits.

If you’re under 65 years old, you can still be eligible for Medicare if you have certain costly medical conditions or disabilities. Your eligibility status also depends on the amount of work credits you have, which is broken down in the chart above.

If you’re under 65 years old and you don’t have any disabilities — you won’t be eligible for Medicare.

In other scenarios, you can still sign up for Medicare, but you won’t be eligible for free Part A premiums if you don’t meet certain criteria.

For example, if you or your spouse haven’t worked long enough in employment covered by Social Security or Medicare — you could be lacking enough work credits to be eligible for premium-free Part A coverage.

In 2024 the Part A premium is $505. If you or your partner spent some time in the workforce, your premium could be reduced to $278.

If you don’t qualify for free Part A Medicare coverage, there are still other ways to get coverage by breaking up parts of Medicare and paying for premiums separately.

For example, if you don’t want to pay for Part A premiums, you are allowed to sign up for Part B coverage without being signed up for Part A.

If you have Part B coverage, you can then enroll in Part D prescription drug coverage. You can have Medicare Part B and D coverage without Part A.

This way, you don’t have to pay for the costly $505 Part A premium, while still having outpatient and prescription drug coverage.

In 2024, the Part B premium is $174.70 and the average Part D premium is $55.50.

While you can enroll in Part B without paying for Part A, you can’t buy Part A without enrolling in Part B. This would also mean you can’t enroll in a Medicare Advantage or Medigap plan, since you need to be enrolled in both Part A and B to qualify.