This page contains information on Medicare Part A and Medicare Part B eligibility and enrollment. For more information about Medicare for people who are still working, go to our Employer page or I’m 65 and Still Working page.
Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) are available to the individuals below:
Most people get Part A for free, but some have to pay a premium for this coverage.
To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required is dependent on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person's working years. Most individuals pay the full FICA tax so the QCs they earn can be used to meet the requirements for both monthly Social Security benefits and premium-free Part A.
NOTE: Certain Federal, State, and local government employees pay only the Part A portion of the FICA tax. The QCs they earn can be used only to meet the requirements for premium-free Part A; they may not be used to meet the requirements for monthly Social Security benefits.
To be eligible for premium-free Part A on the basis of age:
An individual who is receiving monthly Social Security or RRB benefits, at least 4 months prior to turning age 65, does not need to file a separate application to become entitled to premium-free Part A. In this case, the individual will get Part A automatically at age 65.
An individual who is not receiving monthly Social Security or RRB benefits must file an application for Medicare by contacting the Social Security Administration.
Part A coverage begins the month the individual turns age 65, provided he or she files an application for Part A (or for Social Security or RRB benefits) within 6 months of the month in which he or she becomes age 65. If the application is filed more than 6 months after turning age 65, Part A coverage will be retroactive for 6 months.
NOTE: For an individual whose 65th birthday is on the first day of the month, Part A coverage begins on the first day of the month preceding their birth month. For example, if an individual's birthday is on December 1, Part A begins on November 1.
People who must pay a premium for Part A do not automatically get Medicare when they turn 65. They must:
To keep premium Part A, the person must continue to pay all monthly premiums and stay enrolled in Part B. This means that the person must pay both the premium for Part B and the premium for Part A timely to keep this coverage.
Premium Part A coverage begins the month following the month of enrollment.
A person who is entitled to monthly Social Security or Railroad Retirement Board (RRB) benefits on the basis of disability is automatically entitled to Part A after receiving disability benefits for 24 months. Disabled federal, state and local government employees who are not eligible for monthly Social Security or RRB benefits may get deemed entitlement to disability benefits and automatically entitled to Part A after being disabled for 29 months.
Individuals whose disability is Amyotrophic Lateral Sclerosis (ALS) are entitled to Part A the first month they are entitled to Social Security or RRB disability cash benefits. There is no waiting period.
SSA rules do not allow for child disability benefits to begin earlier than age 18. Therefore, Part A entitlement based on child disability benefit entitlement can never begin before the month the person attains age 20 (or age 18 if the individual’s disability is ALS).
Individuals are eligible for premium-free Part A if they receive regular dialysis treatments or a kidney transplant, have filed an application for Medicare, and meet one of the following conditions:
Part A coverage begins:
Individuals already receiving Social Security or RRB benefits at least 4 months before being eligible for Medicare and residing in the United States (except residents of Puerto Rico) are automatically enrolled in both premium-free Part A and Part B. People who are automatically enrolled have the choice of whether they want to keep or refuse Part B coverage. People living in Puerto Rico who are eligible for automatic enrollment are only enrolled in premium-free Part A; they must actively enroll in Part B to get this coverage.
Individuals who are not receiving a Social Security or RRB benefit are not automatically enrolled. Individuals who previously refused Part B, or who terminated their Part B enrollment, may enroll (or re-enroll) in Part B only during certain enrollment periods. In most cases, if someone does not enroll in Part B when first eligible, they will have to pay a late enrollment penalty for as long as they have Part B.
Part B is a voluntary program that requires the payment of a monthly premium for all parts of coverage. Eligibility rules for Part B depend on whether a person is eligible for premium-free Part A or whether the individual has to pay a premium for Part A coverage.
Individuals who are eligible for premium-free Part A are also eligible for enroll in Part B once they are entitled to Part A.
Individuals who must pay a premium for Part A must meet the following requirements to enroll in Part B:
NOTE: Individuals who were terminated from Part A 36 months after receiving a kidney transplant may be eligible for the Part B Immunosuppressive Drug benefit. Learn more about Part B Immunosuppressive Drug Coverage .
Individuals eligible for premium-free Part A, who are not automatically enrolled, can enroll in Part A at any time after they are first eligible for the coverage.
Individuals who want premium Part A, Part B or both may only enroll during certain enrollment periods that are outlined in law. The following enrollment periods apply to both premium Part A and Part B:
The IEP is a 7-month period that begins 3 months before the month a person turns 65, their birthday month and ends 3 months after the person turns 65. For someone under age 65 who becomes entitled to Medicare based on disability, entitlement begins with the 25 th month of disability benefit entitlement. For these individuals, the IEP begins 3 months before the 25 th month of disability benefit entitlement, includes the 25 th month, and ends three months after. The IEP for people with ESRD and ALS varies based on their situation.
Coverage will begin the month after a person enrolls during their IEP. Disabled individuals are automatically enrolled in Medicare Part A and Part B after they have received disability benefits from Social Security for 24 months.
NOTE: In most cases, if someone does not enroll in Part B or premium Part A when first eligible, they will have to pay a late enrollment penalty. The Part B penalty is assessed for as long as the person has Part B.
The GEP is a 3-month period that takes place from January 1 through March 31 of each year. Part B and premium Part A coverage will begin the month after a person enrolls during the GEP.
There are certain situations when a person can sign up for Part B (and Premium Part A) during a Special Enrollment Period without paying a late enrollment penalty. A Special Enrollment Period is only available for a limited time. If the person doesn’t sign up during their Special Enrollment Period, they’ll have to wait for the next General Enrollment Period and they might have to pay a monthly late enrollment penalty.
Coverage will begin the month after a person enrolls during their SEP.
Individuals who do not enroll in Part B or premium Part A when first eligible because they were covered under a group health plan based on their own or a spouse's current employment (or the current employment of a family member, if disabled) may enroll during this SEP.
The individual can enroll at any time while covered under the group health plan based on current employment, or during the 8-month period that begins the month the employment ends or the group health plan coverage ends, whichever comes first.
NOTE: Individuals with ESRD are not eligible to enroll using this SEP.
Individuals who do not enroll in Part B or premium Part A when first eligible because they were performing volunteer service outside of the United States for at least 12 months on behalf of a tax-exempt organization and had health insurance that provided coverage for the duration of the volunteer service may enroll using this SEP.
The SEP is a 6-month period that begins the earlier of the first day of the month following the month for which the:
Individuals who enroll in Part A based on disability or ESRD, but do not enroll in Part B because they were eligible for TRICARE standard or TRICARE prime, may enroll using this SEP.
Eligible individuals are those who are:
Eligible individuals may enroll:
Coverage begins:
If notified of Medicare entitlement during the IEP:
If notified of Medicare entitlement after the IEP:
If entitlement is based on ESRD, coverage begins
Individuals who do not enroll in Part B or premium Part A when first eligible due to having an emergency or disaster declared by a federal, state, or local government entity in their area may enroll using this SEP.
The SEP begins the date an emergency or disaster is declared, or the start date identified in the emergency declaration, whichever is earlier. The SEP ends six months after the later of:
Medicare benefits will be effective the first day of the month following enrollment.
Individuals who do not enroll in Part B or premium Part A when first eligible due to misrepresentation or reliance on incorrect information provided by their employer or group health plan (GHP), agents or brokers of health plans, or any person authorized to act on behalf of such entity may enroll using this SEP.
An eligible person must demonstrate (by documentation or written attestation) both of the following:
This SEP begins the day an individual notifies the Social Security Administration and ends six months later.
Medicare benefits will be effective the first day of the month following enrollment.
Individuals who do not enroll in Part B or premium Part A when first eligible because they were incarcerated may enroll using this SEP.
If a person is eligible because they are not enrolled in Medicare due to being incarcerated, they can sign up anytime within the first 12 months after their release from incarceration.
A person may be eligible if they have lost Medicaid entirely, missed a Medicare enrollment period and their Medicaid coverage was terminated on or after January 1, 2023.
NOTE: Individuals who still are eligible for Medicaid, including a Medicare Savings Program, and have not received notice of an upcoming Medicaid termination are not eligible for this SEP.
Individuals who do not enroll in Part B or premium Part A when first eligible because conditions beyond their control caused them to miss an enrollment period may enroll using this SEP. This SEP is available for individuals whose unique conditions do not qualify for other SEPs. An eligible person must demonstrate (by documentation or written attestation) that conditions outside of their control that occurred on or after January 1, 2023, caused them to miss an enrollment period.
An individual’s request for this SEP will only be granted in conditions that are truly exceptional in nature, and will not be used to grant individual’s enrollment due to forgetfulness, lack of knowledge, or failure to make premium payments.
SSA will determine when this SEP begins on a case-by-case basis, but the SEP will end no less than 6 months after it begins. Medicare benefits will be effective the first day of the month following enrollment.
CMS-18-F-5: Individuals who do not have Part A and wish to enroll should complete the CMS-18-F-5 form or contact Social Security at 1-800-772-1213. This form can be used to enroll in Part B at the same time. If applying for the SEP for the Working aged and Working Disabled, also complete the form CMS-L564.
CMS-40B: Individuals who have Part A, but not Part B, should complete form CMS-40B to enroll in Part B. If applying for the SEP for the Working aged and Working Disabled, also complete the form CMS-L564.
CMS-4040: Individuals who are NOT entitled to social security or railroad retirement board benefits should complete form CMS-4040 to enroll in Part B.
CMS-43: Individuals who have ESRD should complete form CMS-43 to enroll in Part A and Part B.
CMS-10797: Individuals who qualify for a special enrollment period due to exceptional conditions should complete the CMS-10797 to enroll in premium Part A and Part B.
CMS-L564: Individuals who are applying for the SEP for the Working Aged and Working Disabled should complete the form CMS-L564 along with the applicable Part A or Part B enrollment form.
Individuals entitled to premium-free Part A cannot voluntarily terminate their Part A coverage. This is not permitted by law. Generally, premium-free Part A ends due to:
There are special rules for when premium-free Part A ends for people with ESRD.
Premium Part A and Part B coverage can be voluntarily terminated because premium payments are required. Premium Part A and Part B coverage ends due to:
For individuals who want to disenroll from Premium Part A and Part B coverage, use form CMS-1763 in the downloads section of this page.
Premium Part A and Part B coverage requires payment of monthly premiums.
Individuals and married couples with an income over a certain limit must pay a higher premium for Part B and an extra amount for Part D coverage in addition to their Part D plan premium. This additional amount is called income-related monthly adjustment amount. Less than 5 percent of people with Medicare are affected, so most people will not pay a higher premium. Visit the Medicare Parts A & B Income Related Adjustment Amounts page for information about income limits.
If an individual did not enroll in premium Part A when first eligible, they may have to pay a higher monthly premium if they decide to enroll later. The monthly premium for Part A may increase up to 10%. The individual will have to pay the higher premium for twice the number of years the individual could have had Part A but did not sign up.
For individuals enrolling using the SEP for the Working Aged and Working Disabled, the premium Part A LEP is calculated by adding the months that have elapsed between the close of the individual’s IEP and the end of the month in which the individual enrolls. For enrollments after your IEP has ended, months where you had group health plan coverage are excluded from the LEP calculation.
For individuals enrolling using an Exceptional Conditions SEP or the International Volunteers SEP, no LEP will be applied.
If an individual did not sign up for Part B when first eligible, the individual may have to pay a late enrollment penalty for as long as the individual has Medicare. The individual’s monthly premium for Part B may go up 10% for each full 12-month period that the individual could have had Part B but did not sign up for it.
For individuals enrolling using the SEP for the Working Aged and Working Disabled, the Part B LEP is calculated by adding the months that have elapsed between the close of the individual’s IEP and the end of the month in which the individual enrolls. For enrollments after your IEP has ended, months where you had group health plan coverage are excluded from the LEP calculation.
For individuals enrolling using an Exceptional Conditions SEP, the International Volunteers SEP, or the SEP for Certain TRICARE Beneficiaries, no LEP will be applied.