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Who Qualifies for Medicare?

July 27, 2021

Who Qualifies for Medicare?

Medicare was originally designed for individuals who had retired from the workforce. As a result, the standard was set that you qualify for Medicare when you’re 65 years old. However, there are now additional ways to qualify for Medicare. Younger people with qualifying disabilities can also be eligible, along with individuals with end-stage renal disease. If you meet certain qualifications, you can get Medicare Part A for free, but Medicare Part B comes with a monthly premium.

It’s important to understand who is eligible for Medicare Part A and Part B and who is not eligible for Medicare so you get the benefits you understand your medical benefits and costs.

Medicare Eligibility Requirements

There are a variety of requirements to be eligible for Medicare, especially if you want Part A with no monthly premium. Below are some of the more specific details on Medicare eligibility requirements.

To qualify for Medicare you need to:

  • Be a U.S. citizen or permanent legal resident who has been in the U.S. for at least five years
  • Be 65 or older
  • You can qualify for Medicare if you’re under 65 but have a qualifying disability or end-stage renal disease

Who Qualifies for Premium-Free Medicare Part A?

You can get Medicare Part A without a premium if:

  • You are 65 or older and you or a spouse worked and paid Medicare taxes for at least 10 years
  • You receive benefits from Social Security or the Railroad Retirement Board
  • You or your spouse had government employment that was Medicare-covered

Who Can Apply For Medicare Part A and Part B?

Anyone who meets the eligibility requirements can apply for Medicare coverage. Your initial enrollment period begins three months before your 65th birthday and lasts seven months. If you sign up during the first three months of your enrollment period, your Medicare coverage will go into effect the first day of the month you turn 65.

If you qualify for premium-free Medicare Part A and you are receiving Social Security benefits when you become eligible for Medicare, your Part A coverage will begin automatically when you turn 65. . If you’re not receiving benefits, you can still get Medicare Part A on time by enrolling online or contacting Medicare directly. While Part A may be automatic for some, all individuals must apply to enroll in Part B. You can sign up for Part B during your initial enrollment period that occurs around your entitlement to Part A, and then generally only between January 1 and March 31 of each year (unless you have delayed because you continue to work). .

If you don’t apply for Medicare Part B when you’re eligible, you’ll most likely have to pay a late enrollment penalty.

If you have to pay for Medicare Part A, it follows the same rules as Medicare Part B. You can only enroll at specific times, and you have to sign up.

Who can Apply for Medicare Online?

Any qualifying individual can apply for Medicare online, however, you can only sign up during the initial enrollment period and then between January 1 and March 31 of each year.

Medicare Eligibility FAQs

Here are a few common questions we hear about Medicare eligibility:

Can I Get Medicare at 62?

Some people begin to claim retirement benefits from social security at age 62 and might wonder if they can also get Medicare benefits at that time. Generally, the answer is no. You can only get Medicare before age 65 if you have been on Social Security disability for at least two years, have ALS (Lou Gherig’s disease), or suffer from end-stage renal disease.

Can You Get Medicare If You’ve Never Worked?

If you haven’t worked, you can still qualify for Medicare, but you may have to pay a monthly premium for both Medicare Part A and Part B. You may still be able to get Medicare Part A premium-free if your spouse worked, or if you have specific disabilities or medical conditions.

Who Can Get Premium-Free Medicare Part A?

You can qualify for premium-free Medicare Part A if you qualify for Original Medicare and have the appropriate work history as described above (i.e. paid Medicare taxes for 10 years). Generally, you have to pay a premium for Medicare Part B, but there are options for those with limited income and limited assets.

The Medicare Savings Program (MSP) can help pay your Medicare Part A and B premiums if you qualify.

Learn More About Medicare Eligibility Requirements

If you’re curious about your Medicare eligibility and want to talk to a licensed insurance agent, we’re here to help. Simply give us a call at 1-866-955-0898 (TTY 711) or visit our website to review your options today!

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