Are You Eligible for Medicare? A Colorado Guide

You are generally eligible for Medicare at 65 if you are a U.S. citizen, or a lawful permanent resident who has lived in the United States for at least five years in a row. Part A comes without a premium if you or your spouse worked about 10 years (40 quarters) in jobs that paid Medicare taxes. You can also qualify before 65 if you have received Social Security or Railroad Retirement Board disability benefits for 24 months, or if you have End-Stage Renal Disease or ALS. Living in Colorado does not change federal eligibility, but it does shape the coverage you can add, so this guide covers both.

The three ways to qualify

Eligibility is federal. Your Medicare card, your Part A and Part B, and your enrollment rights are the same in Brighton as anywhere else. What changes by state is the private coverage you can add on top: Colorado Medigap rules, and which Medicare Advantage and Part D plans serve your county.

• Age: you are 65 or older and a U.S. citizen, or a lawful permanent resident who has lived here for at least five continuous years.
• Disability: you are under 65 and have received Social Security Disability Insurance or certain Railroad Retirement Board disability benefits for 24 months. Medicare usually starts automatically in month 25.
• Specific conditions: End-Stage Renal Disease (permanent kidney failure that needs dialysis or a transplant), or ALS (Lou Gehrig's disease). With ALS, Medicare starts the month your disability benefits begin.

When Part A is premium-free

You can get Part A at 65 without a premium if any of these apply:

• You already receive retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible for those benefits but have not filed for them yet.
• You or your spouse had Medicare-covered government employment.

Part B has a premium for almost everyone

The 2026 standard Part B premium is $202.90 a month, and the annual deductible is $283 (CMS, 2026). Higher earners pay more through IRMAA, which in 2026 starts above $109,000 of modified adjusted gross income for a single filer or $218,000 for a married couple filing jointly, based on the 2024 tax return.

If you receive Social Security, Railroad Retirement or Civil Service retirement benefits, the Part B premium comes out of your check. If you do not, Medicare bills you, usually every three months.

You can delay Part B in some situations, most often when you or your spouse are still working and covered by an employer group plan. Delaying without that kind of coverage can lead to a lifetime penalty of 10 percent for each full 12 months you could have had Part B and did not.

Automatic enrollment or signing up yourself

Under 65 on Medicare in Colorado

If you qualify for Medicare through disability, Colorado gives you more options than many states. The Colorado Division of Insurance Medigap guide says companies that sell Medicare Supplements in Colorado must also sell to beneficiaries under 65 who are disabled. Premiums can be higher than at 65, and when you do turn 65 you get a fresh guaranteed issue window, which is a good time to compare again.

Medicare Advantage plans and Special Needs Plans are also open to you. If you have both Medicare and Health First Colorado (Colorado Medicaid), a dual-eligible Special Needs Plan may fit: Adams County has 19 of them for 2027, according to the CY2027 CMS Landscape file.

What to have ready before you enroll

• Your Social Security number, and your Medicare card if it has already arrived.
• Details of any employer, retiree, COBRA, VA or TRICARE coverage you have now, and the date it ends.
• If you delayed Part B because you were working: form CMS-40B (Application for Enrollment in Part B) and form CMS-L564 (Request for Employment Information) completed by your employer.
• A list of your doctors and your prescriptions with doses, so you can compare plans the day you are eligible.

Moving to Colorado with Medicare

If you move to Brighton, Thornton or anywhere in Colorado already on Medicare, your Part A and Part B come with you; you only update your address with Social Security. Your private coverage may not. Medicare Advantage and Part D plans are tied to service areas, so a move opens a Special Enrollment Period to choose a plan that serves your new county. Start looking before you move if you can, because the window is time-limited.

Most standardized Medigap policies keep working anywhere in the country, though the company may adjust the premium to Colorado rates. If you have a Medicare SELECT policy with a network, moving out of its service area gives you a guaranteed issue right to buy a different policy.

Kidney failure (ESRD): when Medicare starts

End-Stage Renal Disease has its own timing, set out by CMS. Enrollment is not automatic, and Lisa files it with you. For people on dialysis, Medicare usually starts on the first day of the fourth month of dialysis, and the waiting period counts from your first treatment whether or not you have enrolled yet. If you take part in a Medicare-certified home dialysis training program during the first three months, coverage can begin as early as the first month of dialysis. For a kidney transplant, Medicare can begin the month you are admitted to a Medicare-certified hospital for the transplant, if the transplant happens that month or within the next two months.

If you also have an employer or union group health plan, CMS describes a 30-month coordination period: the group plan pays first and Medicare pays second for those 30 months, and then Medicare pays first. That timing affects when Part B is worth paying for, so ask the employer plan and Social Security before you decide.

Worked examples with dates and dollars

Three hypothetical people, not real clients, to show how the federal rules play out. Figures are 2026 CMS amounts.

A 2027 change: proof of citizenship or immigration status

The Medicare & You 2027 handbook lists a change on its What is new page: you must now meet certain citizenship, nationality or immigration status requirements to sign up for Medicare (page 9 of the 2027 edition). If you are a lawful permanent resident, have your green card and the dates you have lived in the United States ready, and Lisa confirms which documents your enrollment needs before she files it with you.

What I check, and questions to ask

When someone asks me whether they qualify, I start with the facts Social Security will use, then move to the choices that depend on them. These are the questions I work through, and they are the right ones to ask Social Security too:

• Do you have 40 quarters of work on your own record, or can you use the work record of a spouse, or in some cases a former spouse, for premium-free Part A? Your Social Security statement shows your credits, and Lisa checks it with you.
• Are you already collecting Social Security or Railroad Retirement benefits? If yes, you will be enrolled automatically; if not, when will you apply?
• Is there employer coverage from current work, through your own job or the job of your spouse, and how many employees does that employer have?
• Do you, or could you, qualify for Health First Colorado or a Medicare Savings Program? Adams County residents apply through Adams County Human Services at 720-523-2000, and our Medicare and Health First Colorado guide explains what each program pays.
• If you are under 65 on disability or dialysis, which Medigap, Medicare Advantage or Special Needs Plan options fit, and what changes when you turn 65?

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The bottom line

If you are 65, a citizen or long-term permanent resident, and you or your spouse worked about 10 years, you almost certainly qualify for premium-free Part A and can buy Part B. The real questions are timing and what you add on top. Check whether you will be enrolled automatically, decide whether you need Part B now, then compare the rest. Call us in Brighton if you want help confirming where you stand.