Who Qualifies for Medicare? Understanding Eligibility in Oregon and Washington

If you’re wondering whether you qualify for Medicare, you’re not alone. One of the most common questions we hear is: “When am I eligible for Medicare?”


This guide explains Medicare eligibility in clear, understandable terms. Whether you’re turning 65 soon or under 65 with a qualifying condition, we’ll help you understand your options and next steps.

Who Is Eligible for Medicare and When?

Eligibility at Age 65

You are eligible for Medicare if:


  • You are 65 or older
  • You are a U.S. citizen or legal permanent resident for 5+ years
  • You or your spouse worked at least 10 years in Medicare-covered employment

Eligibility Under Age 65

 You may also qualify before age 65 if:


  • You’ve received Social Security Disability Insurance (SSDI) for 24 months
  • You have End-Stage Renal Disease (ESRD)
  • You have ALS (Lou Gehrig’s disease)


If this applies to you, contact us. We’ll guide you through next steps and required documentation.

Medicare card delivery senior Oregon
An elderly couple is sitting on a couch talking to a man in a suit.

Who Gets Free Medicare Part A?

Most people don’t pay a premium for Part A (hospital coverage) if they or their spouse paid Medicare taxes for at least 10 years.



Those who don’t meet the work history requirement may still be eligible, but will pay a monthly premium. We can help calculate your costs and explore other plan options.

Enrollment Timelines: Know Your Medicare Clock

 If you're turning 65, your Initial Enrollment Period (IEP) is:

  • 3 months before your birthday month
  • Your birthday month
  • 3 months after

Enroll during this time to avoid penalties or delays in coverage. If you miss this window, you may need to wait for the General Enrollment Period or qualify for a Special Enrollment Period (SEP).


Still working at 65? If you have employer health insurance, you may be able to delay enrolling in Part B. But you need to understand how that works to avoid penalties. Contact us and we’ll help determine if your coverage counts as “creditable.”

Common Questions About Medicare Eligibility

  • Do I qualify for Medicare at 65 automatically?

    If you're already receiving Social Security, you’ll be enrolled automatically and receive your Medicare card in the mail. 


    If you are not yet receiving Social Security, you will need to sign up for Medicare yourself. If you would like help with this process, please contact us.


    Either way, you will want to fill in the gaps of Original Medicare by adding a Medicare Advantage Plan or a Supplement (Medigap) plan. 

  • What if I still have employer coverage?

    You may be able to delay Part B without penalty. But rules vary based on employer size and plan details. Contact us to review your situation.

  • Can I get Medicare if I never worked?

    Possibly. You might qualify through your spouse's work history. If not, you can still buy into Medicare. We can explain your options.

  • I’m under 65 and on disability. When do I get Medicare?

    After receiving SSDI for 24 months, you become eligible. Those with ALS or ESRD may qualify sooner.

Source Attribution:
This information was obtained from www.medicare.gov.