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Medicare eligibility

This page covers some helpful questions to ask about eligibility for a Medicare plan. See the answers to each one below.

You must meet certain criteria to enroll in Medicare. Below are a few common examples of how people qualify. You may be eligible for Medicare if:

  • You are age 65 or older.
  • You have a qualifying disability for which you have been receiving Social Security Disability Insurance (SSDI) for more than 24 months.
  • You have been diagnosed with end-stage renal disease (permanent kidney failure requiring a kidney transplant or dialysis).
  • You have been diagnosed with ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease).  

Once you are enrolled in Medicare Part A or Medicare Part B, you are also eligible for Medicare Part D. You are encouraged to enroll in a Medicare prescription drug plan unless you have other creditable prescription drug coverage. If you don’t enroll during your Initial Enrollment Period, and do not have creditable prescription drug coverage, Medicare may add a Part D late enrollment penalty to your monthly Part D premium.

If you have limited income and resources you may qualify for the Extra Help program to pay for your prescription drug costs. Extra Help members do not pay any late enrollment fee.

Your Initial Enrollment period is a 7-month window that starts 3 months before you’re first eligible. As an example, you can first sign up for Medicare during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

If you sign up for Medicare during the first 3 months of your Initial Enrollment Period, in most cases, your coverage starts the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month.

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