One of the most common questions we receive is: “Am I eligible for Medicare?” Well, there’s no black and white answer to Medicare eligibility. Your Medicare eligibility may depend on several different situations. Luckily, we make Medicare easy—this post will show you how and when to apply for Medicare based on your unique situation.
You become eligible for Medicare when you turn 65 (or younger if you have certain disabilities or diseases). If you or your spouse ha worked in the U.S for more than 10 years, you qualify for Medicare benefits.
Make Comparing Medicare Plans a Breeze
Medicare has four parts: Medicare Part A , Part B, Part C and Part D. Parts A and B include doctor and hospital insurance. Together, Parts A and B are referred to as Original Medicare.
You can apply for Original Medicare the year you turn 65, but only if you meet one of the below requirements:
- You’re eligible to receive Social Security benefits or Railroad Retirement benefits.
- You’re already receiving your retirement benefits from Social Security or Railroad Retirement.
- You or your spouse are covered for Medicare through government employment.
Medicare eligibility doesn’t mean you have to start using it. People are different—some may be ready and waiting to get their Medicare benefits and some may not need coverage yet. If you’re getting ready to turn 65, read on to see your Medicare options.
I’m Turning 65 This Year…
If you’re turning 65 soon, you may want to do one of many things depending on your situation:
- You’re retired
- You want to retire
- You have other health coverage
- You are still working and don’t want to retire yet
See the options for your situation below.
…and Want to Apply for Medicare
If you’re planning to receive retirement benefits before or at the age of 65, apply for Medicare at the same time or at least 3 months before your birthday. That way you’ll become automatically enrolled in Medicare when you turn 65.
…and Am Still Working
If you’re still working when you turn 65, you might want to keep your current health coverage provided by your employer. You can keep your current coverage and still apply for Medicare Part A (most people don’t have to pay a premium for Medicare Part A, so you won’t have to incur a cost).
However, you may consider deferring Medicare Part B to avoid the monthly premiums. We recommend checking with your employer to see how your current coverage may work with Medicare Part B before you make any decisions.
…and Am Covered by My Spouse
If you’re still getting health coverage from your spouse that’s working, refer to the paragraph above.
…and Did Not Pay Medicare Taxes While Working
There are some cases where individuals are 65 and older and a permanent resident of the United States, but they (or their spouse) did not pay Medicare taxes while working. If this is your situation, you still have options.
- Medicare Part A with premiums
- You can purchase Medicare Part A.
- Medicare Part A without premiums
- You’re receiving Railroad Retirement
- Kidney transplant patients/dialysis patients may still be able to receive benefits per special circumstance.
I’m Over 65 and Haven’t Enrolled in Medicare
If your 65th birthday has come and gone, you still have several options and opportunities to receive your healthcare.
- If you’re within 3 months of your 65th birthday, you still qualify for enrollment under your initial enrollment period.
- Otherwise, you can wait until general enrollment (January 1 – March 3).