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Original Medicare Eligibility & Enrollment

Learn about eligibility requirements and enrollment processes for Original Medicare.

Most people become eligible for Medicare when they turn 65. Some may become eligible earlier if they have a qualifying disability or health condition.

 

Have additional questions?
Our Medicare Resources hub can help answer them.Return to Medicare Resources Hub

Eligibility—Original Medicare

Your current age is the first factor to help determine your eligibility.

Reminder: Original Medicare include Medicare Part A (inpatient hospital coverage) and Medicare Part B (medical coverage for office visits, etc.).

I am 65 or older.

You're eligible for Medicare Part A at no cost and to purchase Part B for a premium if:

  • You've been a U.S. permanent resident for at least five consecutive years, and
  • You are receiving (or eligible to receive) Social Security or Railroad Retirement benefits.
I am younger than 65.

If you've been covered by Social Security Disability Insurance (SSDI) for 24 months, or are receiving a disability pension from the Railroad Retirement Board, you might be eligible.

Additionally, specific conditions like Lou Gehrig’s disease, also known as amyotrophic lateral sclerosis (ALS), or permanent kidney failure may also provide Medicare eligibility.

Other options for Medicare eligibility

If you don’t qualify for Medicare on your own or through your spouse’s work history, but meet the U.S. citizenship and residency requirements, you can buy into Medicare when you turn 65 by paying premiums for Part A.

You can also enroll in Part B by paying premiums, but if you buy Part A, you’ll have to buy Part B as well. And, if you’re interested in Medicare Advantage, you’ll have to be enrolled in both A and B.

Alternatively, if you or your spouse worked long enough in a government job where you paid Medicare taxes, you're eligible. 

 

Enrollment—Original Medicare

Enrollment periods

If you are eligible for Original Medicare and are not automatically enrolled, there are set windows of time when you can enroll, called "enrollment periods." For most people, there are two periods in which you can enroll in Original Medicare for the first time.


star icon  Initial Enrollment Period (IEP)

The Initial Enrollment Period (IEP) is your first chance to sign up for Medicare.

Enrolling during the IEP helps you avoid late enrollment penalties.

Timing: For most people, the seven-month IEP period includes the three calendar months before the month in which you turn 65, the month you turn 65, and ends three calendar months after your birthday month.

Example: If your 65th birthday is on May 15, your IEP would start on February 1 and end on August 31.

Enrollment Timeline IEP

 

star icon  Special Enrollment Period (SEP)

If you're still working at 65 and have health insurance through your or your spouse's employer, you can delay signing up for Medicare Part B without penalty.

Timing: The SEP begins when you stop working or your employer health coverage ends, whichever happens first. You then have eight months to sign up for Medicare Part B without penalty.

Example: If you retire on August 31 and your employer coverage ends on that day, your SEP to enroll in Medicare Part B starts on September 1 and ends on April 30 of the following year.

Enrollment Timeline SEP

 


A Note on Special Enrollment Periods

Special Enrollment Periods also allow you to change your coverage when certain events happen. If you are eligible for Original Medicare and any of these apply to you, you may be able to enroll in a plan at any time:

  • Moving to a new address that is outside your current plan’s service area, or a new location that offers new plan options
  • Losing your current coverage (from Medicaid, from your employer or union, from a drug plan)
  • Your plan’s contract is affected due to a decision from Medicare
  • Being eligible for both Medicare and Medicaid
  • Qualifying for Extra Help—a Medicare program to help with Part D Prescription Drug costs


Other enrollment periods

Annual Enrollment Period (AEP)
October 15 – December 7


The Annual Enrollment Period (AEP) happens every year from October 15 to December 7. During this time, you can change, drop, or start new Medicare health or prescription coverage.

If you’re on a Medicare Advantage (Part C) plan, you can choose a new plan, or switch back to Original Medicare for the next year.

If you make a change during this time, it will usually become effective January 1 of the following year.

General & Open Enrollment Periods
January 1 - March 31


The General Enrollment Period (GEP) is the time for those who missed their IEP to enroll in Medicare Part A and/or Part B. During this time, you can sign up for a plan and coverage would start the following month. However, there may be a late enrollment penalty involved.

If you are enrolled in a Medicare Advantage plan, this time period is known as the Open Enrollment Period (OEP). During this time, you can change your Medicare Advantage plan or go back to Original Medicare (you can change only once during this period).


It's important to enroll in Original Medicare on time.

If you delay your enrollment, you may have to pay penalties for as long as you are enrolled in Medicare. For additional information and resources regarding enrollment periods and late enrollment penalties, visit Medicare.gov.

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