The basic rules
Medicare eligibility is set by federal law and handled by the Social Security Administration. You qualify in one of four ways:
Age 65
You're 65 or older and a U.S. citizen, or a lawful permanent resident who has lived in the United States continuously for at least 5 years.
Disability
You're under 65 and have received Social Security disability benefits, or certain Railroad Retirement disability benefits, for 24 months. Medicare starts automatically in month 25.
End-stage renal disease
You have permanent kidney failure that needs regular dialysis or a transplant, and you or a family member has enough work history under Social Security.
ALS
You have amyotrophic lateral sclerosis (Lou Gehrig's disease). Medicare starts the same month your Social Security disability benefits start, with no 24-month wait.
Eligible for Medicare versus paying a Part A premium
Being eligible for Medicare and owing a Part A premium are separate questions. You get Part A with no premium if you or your spouse worked and paid Medicare taxes for at least 40 quarters (about 10 years). If you have fewer quarters you can still get Medicare by buying Part A, at $311 a month in 2026 with 30 to 39 quarters or $565 a month with fewer than 30. Part B is open to anyone eligible, for the standard premium of $202.90 a month in 2026. A spouse's work history can count once you're 62 or older and married for at least a year, and in some cases a divorced or widowed spouse's record can count too. See Part A.
Citizenship and lawful presence
U.S. citizens qualify at 65. Lawful permanent residents (green card holders) qualify once they've lived in the U.S. for 5 continuous years. People who aren't citizens and have earned enough work credits may qualify for no-premium Part A on their own record if they are lawfully present. Social Security verifies citizenship or lawful presence when you apply, so have your documents ready. Medicare generally doesn't pay for care outside the U.S., which matters to Arizonans who live part-time across the border; see does Medicare work in Mexico?
Automatic enrollment or signing up yourself
Automatic: if you get Social Security or Railroad Retirement benefits at least 4 months before you turn 65, you're enrolled in Parts A and B automatically. People on disability benefits are enrolled automatically in their 25th month. Your card comes in the mail. You can decline Part B if you have other coverage that lets you delay it, such as insurance from your own or your spouse's current employer.
Signing up: if you're not getting Social Security yet, which is common because full retirement age is 67 for anyone born in 1960 or later, you need to sign up yourself during your 7-month Initial Enrollment Period around your 65th birthday. Apply at ssa.gov, call 1-800-772-1213, or visit a Social Security office in Arizona. If you sign up in the 3 months before your birthday month, coverage starts the first day of your birthday month.
People with ESRD always have to apply; enrollment isn't automatic. Medicare usually starts in the fourth month of dialysis, or earlier if you train for home dialysis or get a transplant.
Tip: If you're still working at 65, read working past 65 and do I need Part B if I'm still working? before you turn down Part B. Retiree coverage, COBRA and marketplace plans don't let you delay Part B without a penalty.
Arizona situations
Retirees who move to Arizona from another state
Your Medicare goes with you. What you need to check is the private coverage you've added:
- Original Medicare works the same with any provider in Arizona that accepts Medicare.
- A Medigap policy generally stays in force when you move, as long as you keep paying the premium, though the price may change. Ask your insurer.
- A Medicare Advantage or Part D plan is tied to a service area. A permanent move to Arizona gives you a Special Enrollment Period to choose a new plan, usually starting the month before you move and lasting 2 months after. Update your address with Social Security first.
Seasonal residents and winter visitors
Many people spend winters in Arizona and keep a permanent home elsewhere. Medicare eligibility doesn't depend on which state you live in, but your plan's network does. If you're on a Medicare Advantage plan from your home state, check what it covers in Arizona beyond emergencies and urgent care. Our page on snowbirds and seasonal residents and the question can snowbirds keep their Medicare plan? go through the options.
People living on tribal lands
American Indians and Alaska Natives qualify for Medicare under the same rules as everyone else. Using the Indian Health Service, a tribal health program or an urban Indian health program doesn't replace Medicare: IHS isn't insurance, and these facilities can bill Medicare for your care, which brings money back into local clinics. IHS isn't job-based coverage, so it doesn't let you delay Part B without a penalty. See tribal nations and IHS and can I use IHS and Medicare?
People who have AHCCCS
If you're an AHCCCS member when you become eligible for Medicare, you can have both ("dual eligible"). Medicare becomes your main coverage and pays first, Medicare Part D covers your prescriptions, and AHCCCS pays after Medicare for services it covers. Depending on your income, AHCCCS may pay your Part B premium, and sometimes your deductibles and coinsurance, through a Medicare Savings Program. People with full AHCCCS or a Medicare Savings Program automatically qualify for Extra Help with drug costs. Tell AHCCCS when your Medicare starts. See AHCCCS and Medicare.
Veterans
VA health care and Medicare are separate programs, and veterans who are eligible for both can use either. Military retirees who want TRICARE For Life must have Part B. See veterans and military.
Next steps
Once you know when you're eligible, look at your enrollment periods and 2026 costs. To talk through your situation, a licensed insurance agent with Benefits Life can help at no cost to you: (602) SENIORS (602-736-4677), TTY 711. For official answers about your own eligibility, contact Social Security or 1-800-MEDICARE.
Sources
- Medicare.gov — Get started with Medicare
- Medicare.gov — When does Medicare coverage start?
- Medicare.gov — End-stage renal disease (ESRD)
- Medicare.gov — Special Enrollment Periods
- Social Security Administration — Medicare
- Social Security Administration — Medicare eligibility
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- AHCCCS Eligibility Policy Manual — 409 Medicare Savings Program
- Indian Health Service
Frequently asked questions
Will I be enrolled in Medicare automatically at 65?
Yes, if you already get Social Security or Railroad Retirement benefits at least 4 months before you turn 65. Your Medicare card is mailed about 3 months before your birthday, and coverage starts the first day of your birthday month. If you're not getting benefits yet, you have to sign up with Social Security yourself.
I just moved to Arizona. Do I need to re-apply for Medicare?
No. Medicare is a national program, so your Parts A and B move with you. Update your address with Social Security. If you have a Medicare Advantage or Part D plan, a permanent move out of its service area gives you a Special Enrollment Period to choose a plan that serves your new Arizona address.
Can I have Medicare and AHCCCS at the same time?
Yes. Many Arizonans qualify for both. Medicare pays first and AHCCCS pays after Medicare. Depending on your income, AHCCCS may also pay your Medicare premiums through a Medicare Savings Program, and you'll usually qualify for Extra Help with drug costs.
Do I get Medicare if I use Indian Health Service?
Yes, if you meet Medicare's usual age, disability or ESRD rules. IHS isn't health insurance, so using IHS or tribal health programs doesn't replace Medicare. You can use both, and IHS and tribal facilities can bill Medicare for the care they give you.
Can I get Medicare before 65?
Yes, in three situations: after you've received Social Security disability benefits (or certain Railroad Retirement disability benefits) for 24 months, if you have end-stage renal disease needing dialysis or a kidney transplant, or if you have ALS, in which case Medicare starts the month your disability benefits begin.
