Turning 65 is one way you become eligible for Medicare. You can also be under 65 and eligible for Medicare because you are receiving Social Security Disability Insurance, or SSDI. In most cases, you qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months. This 24-month period begins with the first month you receive an SSDI check and is also known as the two-year waiting period. You will be automatically enrolled in Medicare at the beginning of the 25th month that you receive an SSDI check.
If you receive SSDI because you have Amyotrophic Lateral Sclerosis, or ALS, Medicare automatically begins the first month that your SSDI benefits start. You do not have the 24-month waiting period.
Social Security, not Medicare, makes the determination of whether you qualify for SSDI checks and administers the program that provides the checks. For more information on the Social Security Disability Insurance program, it is best to contact your local Social Security Administration (SSA) office.
Note: Railroad workers should contact the Railroad Retirement Board for information about disability annuity and Medicare eligibility.
Another way that you can become eligible for Medicare is if you are under 65 with End-Stage Renal Disease, also known as ESRD or kidney failure.
You may qualify for Medicare if you have been diagnosed with ESRD and you:
- Are getting dialysis treatments or have had a kidney transplant
- apply for Medicare benefits (up to 12 months retroactively)
- And:
- You are eligible to receive SSDI
- You are eligible to receive Railroad Retirement benefits
- Or, you, a spouse, or a parent have paid Medicare taxes for a sufficient amount of time as specified by the Social Security Administration.
If you are under 65 and have ESRD, when your Medicare benefits begin depends on your specific circumstances, including when you apply for Medicare, whether you receive dialysis at home or at a facility, and whether you get a kidney transplant.
Note: If you are a railroad worker with ESRD, you must contact Social Security, not the Railroad Retirement Board, to find out if you are eligible for Medicare.
Because Social Security and Medicare eligibility rules are complex, you should call Social Security at 800-772-1213 to get the most accurate information regarding your particular situation.