When Do You Get Medicare?
Most people become eligible for Medicare at age 65. However, you may qualify before 65 if you have a disability or certain conditions such as ALS (Lou Gehrig’s Disease) or End Stage Renal Disease (ESRD).
You may also be considered new to Medicare if you delayed enrollment because you were still working past age 65 and stayed on an employer health plan.
No matter your situation, starting Medicare can bring up questions like what to do next or whether there are penalties for not enrolling on time.
Medicare is a widely used health insurance program that helps millions of people access affordable coverage. Choosing a Medicare plan should feel simple and clear, not stressful or confusing, and having the right guidance can make the process much easier.
We make it Clear…We make it Easy
Who Can Get Medicare?
To qualify for Medicare, you must be a U.S. citizen or a permanent resident who has lived in the United States for at least five continuous years, including the five years right before applying.
You may be eligible for Medicare if you meet one of the following requirements:
- Age 65 or older
- Under 65 with a qualifying disability
- Any age with ALS (Lou Gehrig’s Disease) or End Stage Renal Disease (ESRD)
What Are The Parts of Medicare?
Part A
– Helps pay for hospital stays, inpatient care, hospice, and skilled nursing.
Part B
– Helps pay for doctor visits, testing and outpatient care
Parts A& B are commonly known as “Original Medicare”
Part C
– Combines Part A and B of Medicare into one plan and is offered by private companies. These plans usually include prescription drug coverage.
Part D
– Helps pay for prescription drugs. Can be accessed as a “stand alone” plan with Original Medicare (A&B) or as part of a Medicare Advantage Plan (Part C).
How Do I Enroll?
If you are already receiving Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Medicare when you become eligible, and your Medicare card will be mailed to you.
If you are not receiving these benefits, you will need to sign up for Medicare yourself once you are eligible. You can enroll online, by phone, or by visiting your local Social Security office.
What Does Medicare Cost?
Part A
Most people do not pay a monthly premium for Medicare Part A because they worked and paid Medicare taxes during their career. About 99% of people qualify for premium free Part A.
To qualify, you usually need 40 quarters of work, which is about 10 years. If you do not meet that requirement, you will pay a monthly premium. In 2026, the cost is up to $518 per month if you worked fewer than 30 quarters, and about $283 per month if you worked 30 to 39 quarters.
Part B
Medicare Part B costs are based on income. In 2026, most people pay a standard monthly premium of $202.90. This is usually taken out of your Social Security check if you are receiving benefits. If not, you will be billed every three months.
Some people pay more based on income. Medicare uses your Modified Adjusted Gross Income from your tax return two years ago to determine the amount.
Part D
Medicare Part D helps cover prescription drug costs. In 2026, monthly premiums typically range from about $15 to over $100 depending on the plan and coverage.
The right plan depends on your medications and needs. Higher income individuals may also pay more for Part D based on income.
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- Medicare.gov Plan Comparison
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