Who is eligible for Medicare in Ohio?

Who qualifies at 65?

You can enroll in Medicare at 65 if you're a U.S. citizen, or a lawful permanent resident who has lived in the U.S. for at least 5 continuous years. Where you live in Ohio doesn't matter; Medicare eligibility is federal. Your 7-month Initial Enrollment Period starts 3 months before the month you turn 65. See Medicare enrollment periods and turning 65 in Ohio.

Whether you pay a premium for Part A depends on how long you or your spouse paid Medicare taxes:

A current, former (married 10 years or more) or deceased spouse's work record can give you premium-free Part A even if you never worked enough yourself. Part B has no work requirement; almost everyone pays the Part B premium.

Ohio public employees who didn't pay Social Security

Most Ohio teachers, school employees, state and local government workers, police officers, firefighters and state troopers are covered by one of Ohio's five public retirement systems (OPERS, STRS Ohio, SERS, OP&F and HPRS) instead of Social Security for that work. That doesn't keep you out of Medicare:

• Hired after March 31, 1986: federal law requires public employers to withhold the Medicare tax, so your public job earns quarters toward premium-free Part A.
• Hired before April 1, 1986 and never changed employers: your public job may not have paid the Medicare tax. You may still get premium-free Part A through other work or a spouse's record. If not, you can buy Part A.
• You won't be enrolled automatically at 65 if you aren't getting Social Security benefits. You must sign up through Social Security yourself.

Ohio's retirement systems set their own Medicare rules. OPERS says Medicare-eligible benefit recipients must enroll in Parts A and B, and it reimburses the Part A premium for those who don't qualify for premium-free Part A. STRS Ohio's rule (OAC 3307:1-11-03) requires its medical plan enrollees to take Part B and to take Part A if it's premium-free. See Ohio public retirement systems and Medicare.

Medicare before 65 because of a disability

If you get Social Security Disability Insurance (SSDI) or a Railroad Retirement disability annuity, Medicare starts automatically after 24 months of benefits. Social Security mails your card about 3 months before. You can then keep Part B or turn it down. If your disability benefits stop because you go back to work, your Medicare can usually continue for years under the work incentive rules; ask Social Security how long. See Can I get Medicare before 65 in Ohio?

ALS (Lou Gehrig's disease)

People with ALS get Medicare Part A and Part B the month their Social Security disability benefits begin, with no 24-month wait. You apply for disability benefits through Social Security, and Medicare follows.

Kidney failure (end-stage renal disease)

You can get Medicare at any age if your kidneys no longer work, you need regular dialysis or have had a kidney transplant, and you (or your spouse or a parent) have paid Medicare taxes long enough or get Social Security or Railroad Retirement benefits. You must apply through Social Security; it isn't automatic.

• In-center dialysis: Medicare usually starts the first day of the fourth month of dialysis.
• Home dialysis training: coverage can start the first month of dialysis.
• Kidney transplant: coverage can start the month you're admitted for the transplant, or up to 2 months earlier if the transplant is delayed.

People with ESRD can join Medicare Advantage plans. Medicare covers immunosuppressive drugs after a transplant; if your Medicare would end 36 months after a transplant, a separate immunosuppressive-drug benefit may continue drug coverage. See Medicare.gov's ESRD page in the sources.

What if I also have other coverage?

• Job-based coverage from current work may let you delay Part B without a penalty. See working past 65.
• Ohio Medicaid: if you qualify for both, you're dual eligible. See Ohio Medicaid and Medicare and MyCare Ohio.
• TRICARE or VA care: see veterans, TRICARE and military retirees in Ohio.
• Federal (FEHB) or postal (PSHB) coverage: see FEHB and Medicare in Ohio.

How do I check my eligibility?

1. Look at your work record. Create a my Social Security account at ssa.gov/myaccount to see your earnings record and Medicare-covered quarters.
2. Ask Social Security. Call 1-800-772-1213 (TTY 1-800-325-0778) or visit an Ohio Social Security office. Ask about a spouse's record if your own falls short.
3. Check your retirement system's rules. If you'll retire from an Ohio public job, ask your system what it requires before your Medicare starts.
4. Plan your coverage. When you're ready, you can request a call from a licensed insurance agent to review plans from the companies they work with.

Sources

• Social Security — Medicare eligibility
• Social Security — Sign up for Medicare
• Social Security — Mandatory Medicare coverage for state and local government employees (hired after March 31, 1986)
• Medicare.gov — End-stage renal disease (ESRD)
• Medicare.gov — When does Medicare coverage start?
• CMS — 2026 Medicare Parts A and B premiums and deductibles
• eCFR — 42 CFR Part 406, hospital insurance eligibility and entitlement
• OPERS — 2026 Health Care Program Guide (Medicare enrollment and Part A reimbursement)
• Ohio Administrative Code 3307:1-11-03 — STRS Ohio medical plan (Medicare Part A and B enrollment)
• Ohio Administrative Code 3901-8-08 — Medicare supplement (open enrollment at 65)

Frequently asked questions

Medicare in your Ohio county

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