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Medicare Eligibility

Regardless if you are under 65 or over, there are several ways in which you can be eligible for Medicare.

Under 65

To be eligible for Medicare while under 65, you must:

  • Be permanently disabled
  • Receive Social Security disability income for at least 24 months
  • Have End-Stage Renal Disease (ESRD)

65 and Over

If you are 65 and over, it is possible to be eligible for premium-free Part A. To be eligible for this, you or your spouse must have worked for at least ten years while also paying Medicare taxes. Other requirements that would qualify you for this include:

  • Getting retirement benefits or being eligible for benefits from either Social Security or the Railroad Retirement Board
  • You or your spouse having Medicare-covered government employment

If you are 65 or older and do not meet these requirements, you can still enroll in Medicare, but you probably won’t be eligible for premium-free Part A. As long as you are 65 or older and are a U.S. citizen or permanent resident, you can enroll during your Initial Enrollment Period.

Your Initial Enrollment Period will begin three months before your 65th birthday month, and will then end three months after your 65th birthday month. This gives you a total of seven months to enroll in Medicare. However, delaying your enrollment could cost you, especially if you do not qualify for a Special Enrollment Period. This means you will be subjected to late enrollment penalties that can be permanent.

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Original Medicare

As mentioned previously, being eligible for Original Medicare (Part A and B) means you or your spouse worked for 40 quarters (10 years) while also paying Medicare taxes. Part A will then be premium-free, but Part B will still have a premium.

If you are enrolled in Social Security, you will also be enrolled automatically in Original Medicare.

Medicare Part C and D

Eligibility for Part C, or Medicare Advantage, comes from being enrolled in Original Medicare. You cannot have a Medicare Advantage Plan without being enrolled in Part A and B.

For Part D, you must be enrolled in either Part A or B to be eligible.

For more information about Medicare eligibility, contact Rothrock Insurance Solutions today!