Do you only get Medicare is you retire at age 65 and up.
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LandmarkWealth is correct. The only thing to remember, that if you get Medicare early because of a disability, your spouse will not be eligible until she is 65 or develops a disability.
Additionally even when you're disabled Medicare does not kick immediately except with certain circumstances. I believe end stage renal failure is an immediate qualifier. There are a few others.
Actually in most cases if you qualify for SSDI you have to wait 2 years for Medicare to kick in. However certain diseases waive this requirment. There is a list about three pages long of qualifiers.