Who Qualifies for Medicare?

elderly couple biking

All U.S. citizens and legal residents age 65 and up are eligible for Medicare, as well as people under 65 with a qualifying long-term disability, End Stage Renal Disease (ESRD), or Lou Gehrig's disease (ALS). When you enroll is an important piece and helps determine your premium costs and what options you have for Medicare Parts and Plans. 

Did you turn 65 prior to January 1, 2020?

If you answered yes, and haven’t enrolled in Medicare or purchased a Medicare Supplement Plan yet, you have options. When you are ready, you have several Medicare Supplement plan options—including C and F.

If you are newly Medicare eligible on or after January 1, 2020 —due to changes in federal law—you will no longer be able to enroll in Medicare Supplement Plan C or F, but you have other plan options.

When to enroll in Medicare

The best time for you to enroll in Medicare depends on several factors, including your age, whether you are still receiving health insurance through an employer and the size of your employer group. It is important to enroll in your Medicare plans at the right time. If you wait too long, you may have to pay a lifelong penalty on your premiums.

Initial Enrollment Period

Your Initial Enrollment Period is a 7-month window around your 65th birthday. It starts 3 months before your birth month and ends 3 months after the month you turn 65.

For example, if you turn 65 in February 2022, your Initial Enrollment Period runs from November 1, 2021 through May 31, 2022. You should enroll in Medicare during your Initial Enrollment Period if you do not have any health insurance, are retired, are not employed or self-employed, or are receiving health coverage from a company with fewer than 20 employees.

If you enroll in the 3 months before your 65th birthday, your coverage will take effect on the 1st day of your birth month.​

Special Enrollment Period

If you will still be receiving health insurance through an employer with at least 20 employees when you turn age 65, you can wait until that coverage ends to enroll in Medicare. When your eligible employer coverage ends, you will have a limited time to enroll in Medicare without penalty. This limited time period is your Special Enrollment Period.

General Enrolment Period

If you do not enroll in Medicare during your Initial or Special Enrollment periods, you can enroll during the General Enrollment Period (January 1-March 31 annually). By not enrolling during the Initial or Special Enrollment periods, you may be subject to a lifelong enrollment penalty.