There are three ways you can get Medicare coverage if you are under 65 years of age.

You are eligible for Medicare if you are a U.S. citizen or have your resident visa, have lived in the U.S. for five years in a row; and

1. You have a disability and have been receiving Social Security Disability Insurance (SSDI) for more than 24 months. Your eligibility begins during the month you receive your 25th SSDI check. You do not need to contact anyone. Social Security should automatically mail you your Medicare card three months before you become eligible.

Note: If you are receiving railroad disability annuity checks, whether you are eligible for Medicare and when you get it depend on how your disability has been classified by the Railroad Retirement Board.

To find out more about your eligibility for Medicare if you are entitled to a railroad disability annuity, click on the link in the Related Questions box.

Or

2. You have been diagnosed with End-Stage Renal Disease (ESRD) and you
• are getting dialysis treatments or have had a kidney transplant;
• apply for Medicare benefits (up to 12 months retroactively);and
• you
• are eligible to receive SSDI;
• are eligible to receive railroad retirement benefits; or
• are otherwise considered to be “fully” or “currently” insured by Social Security, as defined by the length of time you have worked and the amount of money you have made (you need a certain amount of Social Security “work credits” depending on how long you have worked).

To find out how to be considered insured through Social Security work credits, see "What is a work credit?" in the Related Questions box, below.

Note: Because Social Security and Medicare eligibility rules are complex, you should call Social Security at 800-772-1213 to get the most accurate information regarding your particular situation.

Note: If you are a railroad worker with ESRD, you must contact Social Security, not the Railroad Retirement Board, to find out if you are eligible for Medicare because you have been diagnosed with ESRD.

When your Medicare benefits begin depends on the circumstance.

• If you are getting dialysis, Medicare begins after a three-month waiting period. For example, if you start dialysis in May, Medicare begins August 1st.
• If you are getting dialysis and start a self-dialysis training program during the waiting period, Medicare begins the same month as the program. You must be expected to finish the training program and continue to do self-dialysis after it is over.
• If you are getting a kidney transplant, Medicare begins the month you go into a Medicare-approved hospital for either the transplant or the health care services you need before getting the transplant, as long as you get the transplant within three months. For example, if you go into the hospital in August and want your Medicare to start in August, you must get the transplant by the end of October. If the transplant is delayed more than two months after you go into the hospital, your Medicare coverage is also delayed—Medicare begins two months before the transplant actually happens. So, if you go into the hospital in August but don’t get the transplant until March, Medicare begins in January.

Or

3. You have been diagnosed with Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig’s Disease. You will automatically be enrolled in Medicare the first month you receive SSDI or, if you are a railroad worker, the first month you receive a railroad disability annuity check.

For more information on enrolling in Medicare, click on the links in the GO TO box.

To learn more about railroad disability annuities or to contact your local Railroad Retirement Board field office, click on the links in the LINKS box.

To learn how Medicare from the Railroad Retirement Board differs from Medicare from Social Security, click on the link in the GO TO box.