At What Age Are You Eligible for Medicare?

How old do you have to be to get Medicare?

The magic number is 65.

Even so, that’s not the only number you need to know.

In the summer of ‘65, President Lyndon Johnson signed Medicare into law, establishing the age of eligibility at 65. The eligibility age for Medicare remains the same to this day.

Outside of a few exceptions, age 65 is the first opportunity for U.S. citizens to turn to the government program for healthcare in their later years, utilizing a program they helped fund through employment taxes.

Most older adults are familiar with Medicare. You can qualify for Medicare Part A and Medicare Part B by:

• Being age 65 or older

• Living with a qualifying disability

• Living with certain health conditions, like end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)

Individuals under 65 and already receiving Social Security or Railroad Retirement Board benefits for 24 months are eligible for Medicare. Still, most beneficiaries enroll at 65 when they become eligible for Medicare.

Some people automatically get Medicare at age 65, but those numbers have declined as the Medicare and Social Security ages have continued to drift apart.

Most people who automatically get Medicare at age 65 do so because they have been receiving Social Security benefits for at least four months before turning 65. Traditionally, Medicare premiums are deducted from your Social Security check. For the longest time, you could retire with full Social Security benefits at 65 and start on Medicare at the same time.

You are still automatically enrolled in Medicare Part A and Part B at 65 if you’re drawing Social Security, but not as many people draw Social Security that early these days because of changes to the eligibility age for full Social Security benefits.

In 2000, the Social Security Amendments of 1983 began pushing back the standard age for full Social Security benefits. The progressive changes are nearing their conclusion: Beginning in 2022, the standard age for full benefits became 67 for anyone born after 1960.

Besides the Medicare eligibility age of 65, what remains unchanged is that you can opt to begin drawing partial Social Security benefits as early as age 62. So, if you opt for accepting partial Social Security benefits before age 65, you are automatically enrolled in Medicare.

A smaller group of people also automatically get Medicare at age 65: people who receive Railroad Board benefits for at least four months before 65.

If you are automatically enrolled, you will receive a “Welcome to Medicare” kit about three months before turning 65. It will include instructions on how to decline enrollment in Part A, Part B, or both if you don’t yet want to begin your Medicare journey.

What if I’m Not Automatically Enrolled at 65?

If your Medicare enrollment at 65 is not automatic, but you want to enroll, here are some more magic numbers.

Three and seven.

To start taking advantage of Medicare at 65, you need to sign up during the three months before the birthday month you turn 65. Those are the first three months of your seven-month Initial Enrollment Period.

Unless your birthday is on the first day of the month, your Initial Enrollment Period includes the three full months before turning 65, the month you turn 65, and the three months after you turn 65. If you were born on the first day of the month, IEP is the four months before your birth month, along with your birthday month and the two months after.

If you sign up during one of the months before your 65th birthday, your coverage will begin on the first day of the month you turn 65 (or one month before your birthday if you were born on the first day of the month).

While Medicare Part B has a standard monthly premium, 99 out of 100 people don’t have to pay a premium for Medicare Part A. Still, no part of Medicare can genuinely be called “free” because of associated costs you have to pay, like deductibles, coinsurance, and copays.

How Much Does Medicare Cost at Age 65?

The standard premium for Part B modestly increases year over year. Part A costs also can increase, including the annual deductible and other coinsurance. Known as hospital insurance, Part A doesn’t require a monthly premium as long as you have paid Medicare taxes through employment for at least 10 years.

Part B, known as medical insurance, typically pays 80% of the covered cost while you pay the deductible and then 20%.

No, but while the standard age of eligibility remains 65, some call for lowering it. In a GoHealth survey, among respondents age 55 and older who weren’t on Medicare and had heard about proposals to lower the age of eligibility, 64% favored lowering the age.

Can a 55-Year-Old Get Medicare?

While 65 has always been Medicare’s magic number, there are a few situations where the Medicare age limit doesn’t apply, and you may be able to get Medicare before 65.

• You qualify for Medicare regardless of age once you have received Social Security Disability benefits for 24 months.

• You also qualify if you have end-stage renal disease or amyotrophic lateral sclerosis (ALS).

While some specific circumstances can impact at what age you are eligible for Medicare, most people must wait until 65 as things currently stand.

Full retirement age is the age you begin to receive full Social Security benefits. If you start to draw your Social Security benefits before reaching your full retirement age, the payment you receive will be less.

An easy way to think about full benefits and retirement age is:

• Social Security will reduce your payments if you choose to receive your benefit before full retirement age. The percentage of reduced amount is highest at age 62 and decreases until you reach full retirement age.

• If you choose to receive Social Security payments when you reach full retirement, you will get the total amount.

• Suppose you choose not to receive Social Security payments when you reach full retirement and delay your benefit. In that case, you can increase the amount of your payment by earning delayed retirement credits.

If you’re not sure when you reach full retirement age, our table provides the years and months you need to know for full retirement.