Healthcare Technology Featured Article

October 31, 2022

Who is Eligible for Medicare?

Originally, Medicare was designed to be for people who were retired. As a result of this, it became the standard that people over the age of 65 would qualify. However, there are now a range of additional ways in which you can qualify for Medicare. Younger people are eligible if they have certain disabilities or health conditions, for example. If you meet certain criteria, Medicare Part A is available free of charge. However, there is a premium to pay for Medicare Part B. Understanding who is eligible for Medicare Part A and B is important to ensure that you get the benefits you are entitled to.

Eligibility Requirements

To be eligible for Medicare, there are a variety of requirements. This is especially the case if you want to be eligible for Medicare Part A without a monthly premium. To qualify for Medicare, you will usually need to be at least 65, and a U.S. citizen or permanent legal resident who has lived in the U.S. for at least five years. You can also qualify if you are under the age of 65 but have end-stage renal disease or a qualifying disability. Get more Medicare information here.

Premium Free Medicare Part A Requirements

You will be able to get Medicare Part A without a premium if you are aged 65 or above, and you or your spouse has worked and paid Medicare taxes for ten years or more. You will also be eligible if you receive benefits from Social Security or the Railroad Retirement Board, or if you or your spouse was employed by the government and Medicare-covered.

Medicare Part A and Part B Requirements

If you meet the eligibility requirements, you can apply for Medicare coverage. The initial enrolment period will begin three months after you turn 65 and will last seven months. Your Medicare coverage will come into effect on the first day of the month that you are to turn 65 if you sign up during the first three months.

If you meet the eligibility requirements for Medicare Part A without a premium and are in receipt of Social Security Benefits when you become eligible for Medicare, you will automatically get Part A coverage when you turn 65. If you are not in receipt of any benefits, you will need to contact Medicare directly or enroll online to get Part A on time.

All individuals must enroll in Part B, even if enrolment in Part A was automatic for you. You will be able to enroll in Part B during the initial enrolment period around your entitlement to Part A. Otherwise, you will usually only be able to apply between January 1 and March 31.

If you fail to apply for Medicare Part B when you are eligible to do so, then you may have to pay a late enrolment penalty.

Medicare is generally only available to people over the age of 65. However, if you have a qualifying disability, or end-stage renal disease, then you can apply to get this healthcare insurance benefit earlier in life.

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