Who is eligible for Medicare in Florida?

Who qualifies at 65?

You can enroll in Medicare at 65 if you're a U.S. citizen or national, or a lawful permanent resident who has lived in the U.S. for at least 5 continuous years. Where you live in Florida doesn't matter; Medicare eligibility is federal, and there's no state role in signing up. Your 7-month Initial Enrollment Period starts 3 months before the month you turn 65. Many Floridians delay Social Security, and if you aren't getting benefits yet, you must sign up yourself. See Medicare enrollment periods and turning 65 in Florida.

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. See do I have to pay for Part A? and can I buy Part A if I never worked in the U.S.?

The new citizenship and immigration rule

Section 71201 of Public Law 119-21, signed July 4, 2025, added section 1899C to the Social Security Act and narrowed who can get Medicare. Only these four groups can now be entitled to or enrolled in Medicare:

• U.S. citizens and nationals;
• lawful permanent residents (green card holders);
• Cuban and Haitian entrants, as defined in section 501(e) of the Refugee Education Assistance Act of 1980; and
• people lawfully living in the U.S. under a Compact of Free Association.

Before the law, other lawfully present immigrants, such as refugees, asylees and some parolees, could qualify. CMS's final rule of November 9, 2026 says people who were enrolled on or before July 4, 2025 and aren't in one of the four groups keep Medicare through the end of January 2027; their coverage ends February 1, 2027. Social Security sends a preliminary notice and then a termination notice that lists the qualifying categories and explains appeal rights. If you get one, respond with proof that you're in an eligible group, such as a green card or your entrant documents. Lawful permanent residents still need 5 years of continuous U.S. residence to buy Part A or enroll in Part B on age alone. See Medicare eligibility changes for immigrants in 2027 and Medicare for permanent residents in Florida.

Florida public employees

Most of Florida's public workforce pays into Social Security: in 2023, 88.5% of the state's state and local government employees had Social Security coverage on their jobs, and 11.4% didn't, according to the Congressional Research Service. Public employees hired after March 31, 1986 pay the Medicare tax even in jobs without Social Security, which earns quarters toward premium-free Part A.

Retiree health coverage has its own rules. If you keep State Group Insurance after you become eligible for Medicare, the State plan pays after Medicare, as if you had Part B, even if you don't sign up for it. The State's group Medicare Advantage (MA-PD) plans require Part A and Part B, and People First must receive your Medicare card before you can enroll. See Florida state retirees 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 Medicare before 65 in Florida.

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. Florida dialysis patients should also know their ESRD Network for help during hurricanes; see hurricanes and Medicare in Florida.

What if I also have other coverage?

• Job-based coverage from current work at an employer with 20 or more employees may let you delay Part B without a penalty. See working past 65.
• Florida Medicaid: Florida hasn't expanded Medicaid, and MEDS-AD, its program for aged and disabled adults, generally excludes people with Medicare unless they're in a nursing home, hospice or home and community-based services. Many people with Medicare and low incomes qualify instead for a Medicare Savings Program, which pays the Part B premium. See Florida Medicaid and Medicare.
• TRICARE or VA care: TRICARE For Life requires Part A and Part B. Florida has the second-largest veteran population of any state. See military, veterans and TRICARE in Florida.
• Indian Health Service or tribal care, including Seminole Tribe of Florida and Miccosukee clinics: you can have Medicare too, and IHS, tribal and urban Indian care counts as creditable drug coverage. See Seminole, Miccosukee and Medicare.

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 a Social Security office. Ask about a spouse's record if your own falls short.
3. Check your retiree coverage rules. If you'll have State Group Insurance, a local government plan or other retiree coverage, ask 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)
• Federal Register — CY 2027 Physician Fee Schedule final rule, provisions on limiting Medicare coverage of certain individuals (November 9, 2026)
• Medicare.gov — End-stage renal disease (ESRD)
• Medicare.gov — When does Medicare coverage start?
• CMS — 2026 Medicare Parts A and B premiums and deductibles
• Congressional Research Service — Social Security Coverage of State and Local Government Employees (R46961), Table 1
• Florida Statutes — s. 627.6741, Medigap open enrollment (disability and ESRD)
• MyBenefits (Department of Management Services) — Retirees FAQ
• MyBenefits — Medicare Advantage and Prescription Drug (MA-PD) plans
• DCF ESS Program Policy Manual — Chapter 2000, MEDS-AD (PDF)
• TRICARE — TRICARE For Life
• U.S. Census Bureau — ACS 2024, Veteran Status (Florida)
• CMS — Your Guide to Medicare Drug Coverage (Indian health care as creditable coverage)

Frequently asked questions

Medicare in your Florida county

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