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Medicare if You’re Under 65

To enroll in Medicare, you generally have to be 65 years of age or over, and a United States citizen or permanent legal resident of at least five years in a row. However, in some cases, you might qualify for Medicare under the age of 65.

Whether you’re automatically enrolled in Medicare or you sign up manually, you’ll typically receive Original Medicare, Part A (hospital insurance) and Part B (medical insurance).

How you get Medicare under the age of 65

  • If you receive disability benefits from the Social Security Administration (SSA) or certain disability benefits from the Railroad Retirement Board (RRB), you’ll be enrolled in Medicare automatically after you’ve received disability benefits for 24 straight months.
  • If you have amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), you’ll be enrolled in Medicare automatically the same month that your disability benefits begin.
  • If you have end-stage renal disease (permanent kidney failure requiring regular dialysis or a kidney transplant, commonly abbreviated as ESRD), you might qualify for Medicare, but you need to sign up manually.

To sign up for Medicare, or to find out if your specific situation qualifies you for Medicare under the age of 65, contact the SSA in any of the following ways:

  • Go to the Social Security Administration website.
  • Call the agency at 1-800-772-1213 (TTY users can call 1-800-325-0778). Representatives are available Monday through Friday 7AM to 7PM.
  • Go to your local Social Security office.

If you worked for the Railroad Retirement Board, visit the agency’s website or call 1-877-772-5772 (TTY users call 1-312-751-4701) Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.

Once you’re enrolled in Original Medicare, did you know that you may have other coverage choices?* For example, you may be able to get your Original Medicare benefits through the Medicare Advantage (Medicare Part C) program. Medicare Advantage plans are available from private, Medicare-approved health insurance companies, and there are several different kinds (though not every type may be available where you live). The plans must include all your Medicare Part A and Part B benefits, besides hospice care, which is still covered under Medicare Part A. Many Medicare Advantage plans include extra benefits, like routine vision care, routine dental services, and prescription drug coverage. You must continue paying your monthly Medicare Part B premium, along with any premium the plan may charge you.

Or, you can stay with Original Medicare – which doesn’t cover prescription drugs in most situations – and add a stand-alone Medicare Part D Prescription Drug Plan. These are also available from private, Medicare-approved health insurance companies.

* If you have ESRD, you might not qualify for most Medicare Advantage plans; you might qualify for a Medicare Special Needs Plan.

Feel free to call one of eHealth’s licensed insurance agents at the number listed below.