Who is eligible for Medicare anyway? Medicare eligibility begins for most people at age 65. Individuals who have been entitled to Social Security disability for at least 24 months also qualify.
Many people confuse their Medicare Eligibility date with their Social Security date. They are different. A person can apply for full retirement income benefits at age 66. However, this does not affect the age at which they qualify for Medicare.
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 for 5 years or more.
Read on for further Medicare eligibility details:
Eligibility for Medicare Part A
You are eligible for Medicare Part A at age 65 if you or your spouse has legally worked for at least 10 years in the U.S. During those years, you paid taxes toward your Part A hospital benefits. This is why most Americans pay no Part A premiums when they become eligible for Medicare. Part A mainly covers your hospital stays.
If you have not worked the required 10 years to qualify for Medicare Part A at no cost, you can purchase Part A. Contact Social Security to find out the cost. If you must purchase Part A, the coverage will cost over $400/monthly. In some cases, however, there are partial premiums for people who have worked over 30 but less than 40 quarters.
Eligibility for Medicare Part B
You are eligible for Medicare Part B at age 65 as well. However, you must pay a monthly premium for Part B. This provides for your outpatient benefits such as doctor visits, labwork, surgery fees, and more. Check out our Part B page for more on what Part B covers.
Some people turning 65 still health insurance through an employer. They can delay their enrollment into Part B in favor of their group health insurance without fearing a late penalty.
If you delay enrollment into Part B, consult with an insurance agent who specializes in Medicare. He or she can explain the special election periods which you must use later on so that you won’t be subject to a late enrollment penalty.
Eligibility for Medicare Part C
Medicare Part C is another name for the Medicare Advantage program. You can enroll in Part C if you wish to get your benefits through a private insurance company instead of 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. 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 continue to be enrolled in Parts A and B during the entire time that you are enrolled in a Medicare Advantage plan.
Learn more about Part C Advantage plans here.
Eligibility for Medicare Part D
You are eligible for Medicare Part D as long as you are actively enrolled in either Part A and/or B. You must also live in the Part D plans’s service area. Though Medicare Part D is voluntary, we strongly recommend it if you have no other drug coverage. Part D provides your insurance against future catastrophic medication costs. It will also help give you lower copays on medications you take now.
Be aware that if you do not enroll in Part D and you have no other creditable coverage, you may incur late penalties when you enroll later on.
Frequently Asked Questions
When do I qualify for Medicare?
If you aging into Medicare, you will qualify at age 65. This is regardless of when you apply for Social Security income benefits.
Who is eligible for Medicare under age 65?
Although Medicare was originally for only people aged 65 and over, that has changed over the years. The following people can now also qualify:
- Individuals who receive Social Security disability income benefits for 24 months are automatically enrolled in Medicare on the 25th month
- People who receive Social Security disability income benefits and are diagnosed with Lou Gehrig’s disease are enrolled in Medicare on the first month
- People on kidney dialysis or who are a kidney transplant patient are eligible for Medicare. When those benefits will begin depends on your specific circumstances
Can a person get Medicare at age 62?
Not 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.
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 Medicare age changing to 67?
Under the current federal laws, the age of eligibility for Medicare is still 65, although some younger people can enroll as discussed above. Congress has discussed changing the age of Medicare eligibility, but as of yet that change has not been voted into law.
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.
Find out about your Medicare Eligibility
Determining your Medicare eligibility is sometimes tricky. We get many questions about how to qualify for Medicare, what the Medicare requirement 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.
You are not alone – let a Boomer Benefits licensed agent assist you in making this entire process easier.
Call (855) 732-9055 or click below to request a free consultation!
To continue learning Medicare, go next to: Medicare Costs