Medicare Eligibility and Qualification Requirements

Is It Mandatory To Go On Medicare When You Turn 65?


Knowing when you qualify for the different parts of Medicare is important since it lets you know when you can enroll. Let’s start with Original Medicare (Part A and Part B). 

Do I Automatically Receive Medicare When I Turn 65?


Generally, you’re eligible for Original Medicare (Parts A and B) if you’re a U.S. citizen or you’ve been a legal permanent resident permanent resident for at least 5 continuous years, and one of the following applies to you:

  • You’re 65 or older and eligible for Social Security

  •  You’re under 65, permanently disabled and you’re receiving disability benefits from Social Security or the Railroad Retirement Board

  • You have end-stage renal disease (ESRD)

  • You have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s Disease


Most people qualify for Original Medicare (Parts A and B) when they turn 65. But the rules about Medicare eligibility and when you can enroll for Parts A and B are quite complex. They’re based on your age, whether you’re retired or still working, and whether or not you’re receiving Social Security benefits.  Learn more about Medicare Eligibility/Enrollment to find out exactly when you should enroll.



How Do You Qualify For Medicare Under 65?


If you’re permanently disabled and you’ve been receiving Social Security Disability Insurance (SSDI) benefits for 2 years, you’re eligible for Medicare and you’ll be automatically enrolled in Medicare Parts A and B.


If you have End-Stage Renal Disease (ESRD), you’ll qualify for Original Medicare (Parts A and B), no matter how old you are. You’ll need to sign up for Medicare when you first become eligible, as enrollment is not automatic. Contact Social Security or visit your local Social Security office for more information on signing up for Medicare if you have ESRD.


If you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, you’ll be automatically enrolled in Medicare Parts A and B the month your disability benefits begin – whatever your age is. 



How Do You Become Eligible for Medicare Part C, Part D and Medicare Supplement plans?


First, you’ll need to apply for Medicare Parts A and B. Once you’ve done that, you’re also eligible for Medicare Advantage (Part C), Prescription Drug (Part D), or a Medicare Supplement plan. Make sure that the plan you wish to sign up for is available in your area.


If you’re ready to start shopping, we can help you find a plan in your area that’s based on doctors you’d like to see and other preferences.



Find a Medicare plan that fits your needs. Explore your plan options.

Other Articles From "A Guide to Enrolling in Medicare"

 Original Medicare: Part A (Hospital Insurance) and Part B (Medical Insurance).


Empire BlueCross BlueShield is a Medicare Advantage plan with a Medicare contract. Empire BlueCross BlueShield is a SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Empire BlueCross BlueShield depends on contract renewal.