Medicare Eligibility: What To Know

Medicare eligibility becomes a hot topic for anyone approaching 65 years old. As you approach 65, you may begin to talk to family and friends about Medicare as you begin noticing commercials about Medicare and start receiving ads and marketing materials. So, what is Medicare? When do you start receiving Medicare? Does your Medicare coverage begin the day you turn 65? What if you’re still working or not receiving Social Security?

Medicare is a federal insurance program that helps seniors and younger people with disabilities throughout the United States cover some of their healthcare costs, including providing access to the quality and affordable healthcare they need. There are several ways to become eligible for Medicare. The most common way to become eligible for Medicare is your age. Once you’re at least 65 years old and are a United States citizen or permanent legal resident for the past five years, you are entitled to Medicare. Along with people who are 65 years old, Medicare also covers some disabled people under age 65.

To be eligible for Medicare, you must:

• Be a U.S. citizen or a permanent legal resident for at least five continuous years
• Be 65 years old or older and eligible for Social Security
• Be permanently disabled and receive disability benefits for at least two years
• Have ALS or end-stage renal disease

People who receive Social Security disability insurance usually become eligible for Medicare after a two-year waiting period, although those with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD) and amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease) can be eligible immediately.

You can get Medicare Part A at age 65 without having to pay premiums if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits, but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.

If you or your spouse didn’t pay Medicare taxes while you worked, and you’re 65 years old or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you’re are under age 65, you can get Part A without having to pay premiums if:

• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig’s disease, your Medicare benefits begin the first month you get disability benefits.)
• You are a kidney dialysis or kidney transplant patient.

Once you’ve officially qualified for Medicare, you can sign up for coverage during your seven-month Initial Enrollment Period (IEP). If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

• Begins three months before the month you turn 65
• Includes the month you turn 65
• Ends 3 months after the month you turn 65

If you’re receiving Social Security or Railroad Retirement Board benefits, you’ll automatically be enrolled in Medicare when you turn 65 years old. You’ll get your Medicare card in the mail. If you aren’t automatically enrolled in Medicare at 65 years old, you’ll need to sign up for Medicare yourself once you’re ready.

If you’re interested in more information about qualifying for Medicare, feel free to fill out the form or give us a call anytime to ask any questions that may be lingering. We guarantee you that your licensed agent is focused first and foremost on providing you with information with zero pressure to enroll in a plan.