Medicare Eligibility

The majority of people become eligible for Medicare when they reach the age of 65. Individuals who have been receiving Social Security disability benefits for at least 24 months are also eligible.

Many people make the mistake of confusing their Medicare Eligibility Date with their Social Security retirement age. They’re not the same. Around the age of 67, a person can apply for full retirement income benefits. This is the age at which they are considered to be retired. This, however, has no bearing on the age at which they are eligible for Medicare.

Medicare has no such thing as a retirement age. Whether you have retired or not, you must be 65 years old to be eligible for Medicare. If you are a U.S. citizen or permanent resident who has lived in the United States for 5 years or more, you may be eligible for Medicare coverage at the age of 65 (or older) If you’re under 65, you may be eligible if you meet the following criteria:

  • If you have been receiving Social Security disability income benefits for the past 24 months and are permanently disabled.
  • If you have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, you have end-stage renal disease, which is kidney failure that requires dialysis or you are waiting for a kidney transplant.
Medicare Part A Eligibility

At age 65, you are eligible for Medicare Part A if you or your spouse have legally worked in the U.S. for at least 10 years.

You paid taxes toward your Part A hospital benefits during those years. As a result, when most Americans become eligible for Medicare, they do not have to pay any Part A premiums. Part A is primarily concerned with your hospital stays. You can purchase Medicare Part A if you have not worked for the required 10 years to be eligible for free Medicare Part A. To find out how much it will cost, contact Social Security.

If you have to buy Part A, the monthly cost will be over $400. Partially paid premiums are available in some cases for people who have worked more than 30 but less than 40 quarters. If you have already enrolled in Social Security income benefits, you may be automatically enrolled in Part A (and Part B) when you turn 65. About 4–6 weeks before you turn 65, your Medicare card should arrive in the mail.

Medicare Part B Eligibility

At the age of 65, you are also eligible for Medicare Part B. Part B, on the other hand, comes with a monthly fee. This covers doctor visits, lab work, surgery fees, and other outpatient services. For more information about Part B and what it covers, visit our Parts of Medicare page.

Some people over 65 may still be covered by their employer’s health insurance. They are not subject to a late enrollment penalty if they choose to delay Part B enrollment in favor of their group health insurance. If you’d like to put off enrolling in Part B, feel free to contact us for guidance on the special election periods you’ll need to use later to avoid a late enrollment penalty.

Medicare Part C Eligibility

The Medicare Advantage program is also known as Medicare Part C. If you prefer to receive your benefits through a private insurance company rather than through Original Medicare, you can enroll in Part C. These plans usually have smaller networks than Medicare, but some of them include Part D coverage as well. You must first be enrolled in both Medicare Parts A and B to be eligible for Part C and reside within the plan’s service area.

Many people believe that by enrolling in a Medicare Advantage plan, they will be able to avoid paying Part B premiums, which isn’t the case at all. To be eligible for either a Medicare Advantage or a Medicare Supplement (Medigap) plan, you must have both A and B. You must remain enrolled in Medicare Parts A and B throughout your enrollment in a Medicare Advantage plan.

Medicare Part D Eligibility

As long as you are enrolled in either Part A or B, you are eligible for Medicare Part D. You must also live within the service area of the Part D plans. Even though Medicare Part D is optional, we strongly advise it if you do not have other drug coverage. Part D protects you from unexpected medical expenses in the future. It will also help you save money on your current medications by lowering your copays. If you do not enroll in Part D and do not have other creditable coverage, you may face late enrollment penalties if you do so later.

Learn more about your Medicare Eligibility

Determining Medicare eligibility can be difficult. A lot of people ask us when they can collect Medicare, how to qualify for Medicare, what Medicare requirements are, and how to enroll in Medicare. Though the process may seem daunting to you, our agents deal with it daily and are happy to provide guidance. Feel free to contact us and we’ll be happy to help guide you through the process.

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