By the Kryder Cares Data Desk · Reviewed by Kris Kryder, licensed agent · Updated
Key points
- Most people become eligible at 65; work history decides whether Part A has a monthly premium.
- With 40 quarters (about 10 years) of Medicare-taxed work, most people pay no Part A premium.
- Social Security disability benefits make you eligible after 24 months; ALS qualifies you right away.
- If you already get Social Security at least 4 months before 65, you’re enrolled in Parts A and B automatically.
The short answer: three ways to qualify
Medicare is federal health insurance, and eligibility comes down to age or a qualifying health condition. CMS describes it as coverage for people 65 or older who meet the program’s U.S. residency rules, plus younger people with a disability, End-Stage Renal Disease (ESRD — permanent kidney failure that needs dialysis or a transplant) or ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease).
Being eligible isn’t the same as being enrolled. Some people are signed up automatically and some have to apply, and the timing matters because there are penalties for signing up late. Our guide to Medicare enrollment periods covers the windows in detail.
- Age 65: the most common path. Your Initial Enrollment Period is the 7 months around your 65th-birthday month.
- Disability: after you’ve received Social Security (or Railroad Retirement Board) disability benefits for 24 months, Medicare starts automatically.
- ALS: if you get disability benefits, Parts A and B start automatically without the 24-month wait.
- ESRD: you may qualify before 65; CMS has a separate sign-up path for people with kidney failure.
Does everyone get Part A without a premium?
No, though most people do. Part A (hospital insurance) has no monthly premium if you or your spouse paid Medicare taxes for at least 40 quarters, which is about 10 years of work. A spouse’s work record can count, which is why many people who stayed home for years still qualify.
If you have fewer quarters, you can still buy Part A. For 2026, CMS set the Part A premium at $311 a month with 30–39 quarters and $565 a month with fewer than 30 quarters. Part B (medical insurance) has a monthly premium for nearly everyone — $202.90 a month in 2026 for most people. The 2027 Part A and Part B amounts haven’t been announced yet; CMS usually publishes them in the fall.
| Medicare-taxed work (you or spouse) | 2026 Part A premium |
|---|---|
| 40 or more quarters | $0 a month |
| 30–39 quarters | $311 a month |
| Fewer than 30 quarters | $565 a month |
Will you be enrolled automatically?
It depends on whether you’re already collecting Social Security. If you start retirement or disability benefits from Social Security (or the Railroad Retirement Board) at least 4 months before you turn 65, you’re enrolled in Part A and Part B automatically. Your Medicare card arrives in the mail about 3 months before coverage starts.
If you’re waiting past 65 to claim Social Security — common for people still working in Perrysburg, Toledo and across northwest Ohio — Kris files your Part A and B application with Social Security with you. Our turning-65 checklist walks through the steps month by month.
Your Medicare card shows your Medicare Number and the dates Part A and Part B start. You’ll need those dates to join a Medicare Advantage, Medigap or Part D plan.
Medicare before 65: disability, ALS and kidney failure
People under 65 who receive Social Security Disability Insurance get Medicare after a 24-month waiting period, counted from the first month of disability benefits. The card is mailed before coverage begins, so you don’t have to apply separately.
ALS is the exception to the waiting period: if you have ALS and get disability benefits, you get Parts A and B automatically without the 24-month wait. People with ESRD follow a separate path, and the timing depends on their treatment, so Kris checks your start date with you.
One thing catches families off guard: federal law doesn’t require insurance companies to sell Medigap (Medicare Supplement) policies to people under 65. Some states do require it, so ask what’s available in your state before you decide between Original Medicare and a Medicare Advantage plan.
What if you have other coverage at 65?
Being eligible doesn’t always mean you should take Part B right away. If you or your spouse are still working for an employer with 20 or more employees, the job-based plan usually pays first and you can often wait to sign up for Part B without a penalty. With fewer than 20 employees, Medicare usually pays first, so you’ll generally want Part B on time.
Other coverage has its own rules. Retiree plans, COBRA and Marketplace plans generally don’t let you delay Part B without risk. Our guide to working past 65 explains each situation.
What if you have limited income?
Eligibility for Medicare doesn’t depend on income, but help paying for it does. Medicare Savings Programs can pay the Part B premium and sometimes more, and Extra Help lowers drug costs. If you also qualify for Medicaid, you may be eligible for a Dual Eligible Special Needs Plan. See our guide to Medicaid, Medicare Savings Programs and Extra Help.
How Kris helps
Kris Kryder meets people at her Perrysburg office, by phone or by video to sort out exactly when Medicare starts for you, whether you need Part B now and which plans fit your doctors and prescriptions. It’s a no-cost, no-obligation conversation. Start with her Medicare planning page or the answers on our Medicare FAQ.
Your next step
Have questions about your own situation? Contact Kris or schedule a no-cost meeting. You can also read more about Medicare Advantage and Medicare Supplement (Medigap).
Sources
- CMS — Get started with Medicare
- CMS — How do I sign up for Medicare?
- CMS — When can I sign up for Medicare?
- CMS — 2026 Medicare Parts A & B premiums and deductibles (fact sheet)
- CMS — Medicare costs
- CMS — Get ready to buy a Medigap policy
- CMS — Which insurance pays first
We do not offer every plan available in your area. Currently we represent 14 organizations which offer 119 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. This is a proprietary website and is not associated, endorsed or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program please visit the Official U.S. Government Site for People with Medicare located at www.medicare.gov.
This guide is general education, not a recommendation for any specific plan or policy. Figures were current as of October 19, 2026; plan details and government amounts change every year.