Who is eligible for Medicare?
Most people are eligible for Medicare at age 65. Individuals who have been receiving Social Security disability benefits for at least 24 months also qualify.
What is the difference between Medicare eligibility and Social Security retirement age?
The normal Medicare eligibility age is 65, whether you have retired or not. You can qualify for Medicare coverage at age 65 (or older) if you are a U.S citizen or a permanent resident and you’ve lived here continuously for 5 years or more.
You can also qualify for Medicare under these circumstances when you are under age 65:
- If you are permanently disabled and you have been receiving Social Security disability income benefits for 24 months.
- When you have end-stage renal disease, which is kidney failure that requires you to get dialysis or you are waiting for a kidney transplant.
- If you have Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s disease.
- What are the next steps?
If you think you might be eligible for Medicare, the next step is to contact your local Social Security office to find out more and to apply for benefits.
Eligibility for Part A
Medicare Part A is available to those who are age 65 and above, as well as to those under 65 who have a disability or end-stage renal disease. To be eligible for free Part A coverage, you or your spouse must have worked for at least 10 years in the United States and paid taxes towards your Part A hospital benefits during that time. Most Americans, therefore, do not pay any monthly premiums for Part A coverage.
Part A mainly covers your hospital stays. If you have not worked the required 10 years to qualify for free Part A coverage, you can still purchase Part A. The cost of this coverage is over $400 per month. However, in some cases, there is a partial premium available for those who have worked between 30 and 40 quarters.
You may be automatically enrolled in Part A (and Part B) coverage when you turn 65 if you are already receiving Social Security benefits. Your Medicare card will usually arrive in the mail 4-6 weeks before your 65th birthday.
Eligibility for Medicare Part B
We are excited to offer our Part B coverage to those aged 65 and over. This provides for your outpatient benefits such as doctor visits, lab work, surgery fees, and more. Check out our Part B page for more on what Part B covers.
If you are still employed and have health insurance through your employer, you may delay your enrollment into Part B in favor of your group health insurance without fearing a late penalty. However, if you do delay enrollment into Part B, be sure to consult with an insurance agent who specializes in Medicare so that you can take advantage of special election periods and avoid a late enrollment penalty.
Eligibility for Medicare Part C
Medicare Part C is another name for the Medicare Advantage program. The Medicare Advantage program is a way for you to get your benefits through a private insurance company instead of through Original Medicare. Usually, these plans have smaller networks than Medicare, but some of them include built-in Part D coverage.
To be eligible for Part C, you must first be enrolled in both Medicare Parts A and B. You must also live in the plan’s service area.
Many people think that if they enroll in a Medicare Advantage plan, they can drop their Part B and escape paying Part B premiums. However, this is not the case—you must have both A and B to even be eligible to enroll in either a Medicare Advantage plan or Medigap plan. You must also continue to be enrolled in Parts A and B during the entire time that you are enrolled in a Medicare Advantage plan.
Eligibility for Medicare Part D
Medicare Part C is another name for the Medicare Advantage program. The Medicare Advantage program is a way for you to get your benefits through a private insurance company instead of through Original Medicare. Usually, these plans have smaller networks than Medicare, but some of them include built-in Part D coverage.
To be eligible for Part C, you must first be enrolled in both Medicare Parts A and B. You must also live in the plan’s service area.
Many people think that if they enroll in a Medicare Advantage plan, they can drop their Part B and escape paying Part B premiums. However, this is not the case—you must have both A and B to even be eligible to enroll in either a Medicare Advantage plan or Medigap plan. You must also continue to be enrolled in Parts A and B during the entire time that you are enrolled in a Medicare Advantage plan.
Frequently Asked Questions
Who is eligible for Medicare?
If you are aged 65 or over, you are automatically eligible for Medicare. You can also qualify if you are under 65 and have a disability, or if you have End-Stage Renal Disease.
When do I qualify for Medicare?
You will qualify at age 65 regardless of when you apply for Social Security income benefits. If you have a disability, you may qualify earlier.
Can a person get Medicare at age 62?
No, unless they qualify under one of the circumstances discussed in the previous question. Your Medicare eligibility date is not the same as your Social Security eligibility date.
At what age can you apply for Medicare?
You can apply when you are age 64, as early as 3 months before your 65th birthday month.
How long do you have to work to be eligible for Medicare?
Your eligibility for Medicare is not based on your work history. However, people with at least 10 years (40 quarters) of paying Medicare payroll taxes will get Part A services without paying premiums once they are eligible.
Is it mandatory to sign up for Medicare at age 65?
No, but if you do not have other creditable health coverage, you will face penalties for delaying your Medicare enrollment. You should also know that when you enroll into Social Security income benefits, you will be automatically enrolled into Medicare Part A. You cannot have one without the other.
Who is eligible for Medicare and Medicaid?
Medicare is our national health insurance system for people aged 65 and older and people with certain disabilities. Medicaid is a joint federal and state program to provide benefits for people with low incomes. It is possible to have qualify for both Medicare and Medicaid. In this scenario, Medicare is primary and Medicaid is secondary.
Who is eligible for Medicare part D?
Anyone who is enrolled in either Medicare Part A or Part B (or both) is eligible to enroll in Part D. You must enroll when you are first eligible unless you have other creditable drug coverage. Otherwise, you will be subject to an expensive late penalty for Part D later one.
Find out about your Medicare Eligibility
Determining your Medicare eligibility is sometimes tricky. We get many questions about when you can collect Medicare, how to qualify for Medicare, what the Medicare requirements are, when to enroll in Medicare, and how to set up Medicare supplement insurance. Though the process may seem overwhelming to you, our experts deal with these processes every day. We can guide you easily through the process before you reach Medicare age.
You are not alone – let a UrMedicare licensed agent assist you in making this entire process easier.
We understand that dealing with paperwork and appointments can be daunting. Let us help make this process as smooth as possible for you so that you can focus on enjoying your retirement.