How Old Do You Really Have To Be To Get Medicare?

By: Edward Neeman
Published: Wednesday, January 30 2019
Last Updated: 10 months ago

With Medicare, age is not the only prerequisite for eligibility. While it’s true, the program is designed for American seniors who are 65 years or older, there are other factors that may qualify you for Medicare at an earlier age. We’re going to take a deeper dive into what those factors are, but if you’re curious to learn whether or not you're eligible for the federal health program, you can head on over to our Medicare eligibility check tool.

At What Age Can You Get Medicare

If you’ve ever read up on Medicare, then you may have heard about a few different loopholes that will qualify you for the government healthcare program. So, how old do you have to be to get Medicare? Well, that really depends on your situation.

Most healthy Americans will need to wait until their 65th birthday before they can enroll in Medicare. Of course, that does come with its own set of prerequisites as well. The truth of the matter is, you may qualify for Medicare as early as 18 years old, although it’s not as common. Lou Gehrig's Disease (ALS), End-Stage Renal Disease (ESRD), kidney dialysis, and Social Security Disability Insurance (SSDI) can trigger a person's eligibility.

Can I Get Medicare at Age 62?

For the most part no, you will not be eligible for Medicare at 62 unless you meet the disability requirements. If you think you may have read that 62 is the eligibility age for Medicare, you haven’t gone completely crazy. When most people are talking about Medicare at 62, they are usually referencing a little known provision that allows a spouse to shift from paying a premium for Medicare Part A, to premium-free Medicare Part A when their spouse who has worked and paid Medicare taxes for 10 years turns 62 years old. In this scenario, you do also have to be an American citizen.

Exceptions to the Rule

So, if you’re still asking yourself what age can I get Medicare, there’s no straightforward answer. As with any rule, there are always restrictions and exceptions that need to be taken into account. Medicare is government-sponsored, taxpayer-funded health insurance that has legal limitations and exclusions. The following may result in early Medicare eligibility.

End-Stage Renal Disease (ESRD)

Eligibility for ESRD can be complicated, but usually, premium-free qualification requires regular dialysis or kidney transplant, a Medicare application, and one of the following:

  • Meets the minimum work requirement under the Social Security Administration (SSA), Railroad Retirement Board (RRB), or government employee.
  • Eligible for or receiving SS or RRB benefits.
  • Dependent child or spouse of a recipient of one of the above individuals.

Part A premium-free individual enrollment can begin anytime after the eligibility requirements get met. Both Part A & B, and many supplement requirements have prerequisites determined by law. You might be required to sign up during the Initial Enrollment Period (IEP), general or special enrollment periods.

IEP is a seven-month period close to Medicare age, which starts three months before, includes the birth month, and the three months after a person’s 65th birthday. If you do not accept Medicare during the IEP, you may have to pay penalties, which might get added to your premium.

Lou Gehrig's Disease

The New England Journal of Medicine defines Amyotrophic Lateral Sclerosis (ALS), more commonly referred to as Lou Gehrig's disease as a progressive, paralytic disorder characterized by degeneration of motor neurons in the brain and spinal cord.

Those ALS eligible individuals who receive SSDI benefits are eligible for Part A immediately. This no waiting applies for RRB disability recipients also. But, Medicare benefits are restricted to age 20, and even for ALS patients who are 18 years of age or older.

Social Security Disability

The correlation between SSDI and Medicare qualifications for most recipients there is a waiting period of two years (24 months). However, as with every other government program, there are exceptions and restrictions, and you must familiarize yourself with these. This is especially true for those with dependent children or spouses.

Some SSDI eligible individuals may have a 24 or 29 month waiting period to receive Medicare. In most cases, those receiving SSDI benefits for 24 months get automatically entered into Medicare Part A. Federal, State, and city government workers are eligible after 29 months.

Dependent children might not be eligible for Medicare but may qualify for Medicaid or Children's Health Insurance Program.

Kidney Dialysis Patients

The qualifications for kidney dialysis patients mirror most of the requirements for ESRD. However, these timelines apply, and coverage will begin:

  • Three months after a regular dialysis course begins,
  • The first month after regular dialysis when the patient was a participant in self-dialysis training,
  • The month of a kidney transplant, or
  • Up to two months before a transplant for inpatient transplant preparation.

The NY Times article, Patient Voices: Kidney Disease discusses many of the causes and treatments used by kidney dialysis patients.

See If You're Eligible with FirstQuote Medicare

To see if you qualify for Medicare conduct our free online eligibility check. There is a wealth of information here, so feel free to spend all the time you need. We strive to provide you with the latest material from the top industry providers and Medicare quotes.

So, there you have it. We hope this clarifies all your questions about Medicare age. If not, you can always get more answers by entering your zip code, and speaking to one of our experienced agents. They are available to answer any and all questions you may have.