Medicare eligibility for those under 65

When you are under 65, you become eligible for Medicare if:

1. You have received Social Security Disability Insurance (SSDI) Social Security Disability Insurance (SSDI) Social Security Disability Insurance (SSDI) is a monthly benefit provided through the Social Security Administration for people who are unable to work because of a severe medical impairment (disability). People who receive SSDI for 24 months are eligible for Medicare.  checks for at least 24 months
2. Or, you have been diagnosed with End-Stage Renal Disease (ESRD) End-Stage Renal Disease (ESRD) End-Stage Renal Disease (ESRD) is a kidney disease that requires you to be on dialysis or have a kidney transplant. Patients with ESRD may qualify for Medicare coverage regardless of age.

Eligibility for Medicare due to a disability

You may qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months, also known as the two-year waiting period. The two-year waiting period begins the first month you receive an SSDI check. You will be automatically enrolled in Medicare at the beginning of the 25th month that you receive an SSDI check.

If you receive SSDI because you have Amyotrophic Lateral Sclerosis, or ALS, Medicare automatically begins the first month that your SSDI benefits start. You do not have the two-year waiting period.

Social Security—not Medicare—makes the determination of whether you qualify for SSDI checks and administers the program that provides the checks. For more information on the Social Security Disability Insurance program, it is recommended that you contact your local Social Security Administration (SSA) office.

Note: Railroad workers should contact the Railroad Retirement Board for information about disability annuity and Medicare eligibility.

Eligibility for ESRD Medicare

You may qualify for ESRD Medicare if you have been diagnosed with kidney failure and you:

• Are getting dialysis dialysis Dialysis is the treatment used to artificially cleanse your blood of toxins when your kidneys no longer work. treatments or have had a kidney transplant
• And:
  • You are eligible to receive SSDI
  • You are eligible to receive Railroad Retirement benefits
  • Or, you, a spouse, or a parent have paid Medicare taxes for a sufficient amount of time as specified by the Social Security Administration

If you are under 65 and have ESRD, when your Medicare benefits begin depends on your specific circumstances, including when you apply for Medicare, whether you receive dialysis at home or at a facility, and whether you get a kidney transplant. If you are eligible for ESRD Medicare, you can enroll in Parts A and B together at any time. Part A will be retroactive up to 12 months, but it cannot start earlier than the first month you were eligible for ESRD Medicare.

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 Social Security and Medicare eligibility rules are complex, it is recommended that you call Social Security at 800-772-1213 to get the most accurate information regarding your particular situation.