Three ways people become eligible
Medicare eligibility is not only about turning 65. There are three separate routes in, and which one applies to you changes when your coverage can start and what you pay for it.
Being eligible is not the same as being enrolled. Some people are enrolled automatically, and some have to sign up in a specific window. Missing that window is what creates a lifelong penalty, which is why the two ideas are worth keeping apart.
- Age: you are 65 or older, and you or your spouse paid Medicare taxes for long enough to qualify.
- Disability: you have received Social Security disability benefits for 24 months.
- A specific diagnosis: end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), each with its own rules that do not require the 24-month wait in the same way.
What makes Part A premium free
Most people pay no monthly premium for Part A. That is not a universal benefit: it is earned through work credits, measured in quarters of Medicare-taxed employment. You can qualify on your own record or on a spouse’s.
If you do not have enough quarters, Part A is still available to buy. The premium depends on how many quarters you did earn, which is why there are two prices rather than one.
| Quarters of Medicare-covered employment | Monthly Part A premium in 2026 |
|---|---|
| 40 or more | $0 (premium free) |
| 30 to 39 | $311 |
| Fewer than 30 | $565 |
Source: CMS, 14 November 2025
Part B is available to everyone eligible, and always has a premium
If you are eligible for Part A, you can take Part B. Unlike Part A, Part B always carries a monthly premium: $202.90 in 2026 for most people, with a higher amount for higher incomes under IRMAA.
CMS has not yet published the 2027 Part B premium or deductible. Figures circulating for 2027 are projections from the Medicare Trustees Report, not final amounts, and this site does not quote them as though they were settled.
Eligible, and then what
Once you know which route applies to you, the next question is timing. Your enrollment window depends on whether you are turning 65, leaving employer coverage, or coming onto Medicare through disability.
If you are still working at 65 and covered by an employer plan, do not assume you should delay. Whether delaying is safe depends on how many employees your employer has.
Frequently asked questions
Do I have to be retired to get Medicare?
No. Medicare eligibility depends on age, disability or diagnosis, not on whether you have stopped working. Many people are enrolled in Medicare while still employed, and some delay Part B because their employer coverage lets them.
Can I get Medicare before 65?
Yes, in specific circumstances. People who have received Social Security disability benefits for 24 months become eligible, and people with end-stage renal disease or ALS have their own rules. Turning 65 is the most common route, not the only one.
Is Part A really free?
Part A has no monthly premium for people with at least 40 quarters of Medicare-covered employment, on their own or a spouse record. It is earned, not automatic. With 30 to 39 quarters the 2026 premium is $311 a month, and below 30 quarters it is $565.
What are the 2027 Part A and Part B premiums?
CMS had not published them when this guide was last reviewed. The 2027 Part D figures are out, but Parts A and B usually follow in the autumn. Any 2027 Part B figure you see before then is a projection from the Trustees Report rather than a final amount.
Sources
This guide explains officially published rules and figures. It is not an insurance quote and not an eligibility determination. Only HealthCare.gov, Medicare.gov, Social Security or the carrier can determine your eligibility and your actual price.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program.
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