Medicare Under 65: How to qualify

Eligibility for Medicare initially depends on age, which is 65 and over. While the qualification age for Medicare is still 65 and above, Medicare benefits are available to people under 65 who get Social Security Disability Insurance (SSDI) due to a disability. Those with specific health conditions, including end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), also generally qualify for Medicare benefits while under 65. 

In this article, we discuss the Medicare eligibility criteria for those under the age of 65.

Receiving Social Security for Disability

Some people have one form of disability that stops them from working. Those with disabilities are usually eligible for Social Security Disability benefits or Railroad Retirement Board (RRB) benefits. Once you receive these benefits for two years, you qualify for Medicare. Some of the disabilities that may qualify you for SSA or RRB include:

  • Bleeding disorders
  • Back injuries
  • Cancer
  • Speech disorders
  • Mental health disorders
  • Heart conditions
  • Severe respiratory illnesses
  • Sensory issues

End-Stage Renal Disease (ESRD)

You may be able to sign up for a Medicare plan irrespective of your age as long as you have end-stage renal disease and need regular dialysis. However, one of these conditions must apply to you:

  • You are eligible or currently receiving Railroad Retirement or Social Security benefits
  • You or your spouse have worked at least 40 quarters and paid Medicare taxes

Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease)

According to the Amyotrophic Lateral Sclerosis Association, the average age that most people receive the Amyotrophic Lateral Sclerosis diagnosis is 55. That means most people are diagnosed with Amyotrophic Lateral Sclerosis before reaching the Medicare eligibility age of 65.

This also means that you can automatically receive Original Medicare benefits the month your Railroad Retirement Board or Social Security disability benefits start. Those eligible for Medicare due to Lou Gehrig’s disease will generally have Medicare coverage for the rest of their life.

Contact Generations Insurance to speak with an experienced agent and discuss your Medicare eligibility based on your specific situation.