When Are You Eligible for Medicare?

By RetireMEDiQ

For many, your 65th birthday is synonymous with becoming eligible for Medicare, but did you know that you could be eligible for Medicare before 65?

What Makes Individuals Eligible for Medicare?

Most people are eligible for Original Medicare (made up of Part A and Part B) if they:

  • Are a U.S. citizen or permanent legal resident for at least 5 consecutive years
  • Are age 65 or older and eligible for Social Security
  • Are permanently disabled and receiving disability benefits for at least two years
  • Have End Stage Renal Disease (ESRD)
  • Have Lou Gehrig’s disease

This also depends largely on your employment situation. If you are still working, there may be some other considerations. But for the most part, people who fit into one or more of the descriptions above are most likely able to get their Part A and Part B benefits at age 65.

Can You Receive Medicare Benefits if You Are Under Age 65?

If you are permanently disabled and receive disability benefits for at least two years, you most likely qualify for Medicare before 65. You automatically get Part A and Part B after you get disability benefits from Social Security for 24 months or certain disability benefits from the Railroad Retirement Board (RRB) for 24 months.

You may also be able to get Medicare benefits early if you have ESRD (permanent kidney failure that requires dialysis treatment or a kidney transplant). However, you will have to sign up for Medicare benefits manually, because enrollment under the condition of ESRD is not automatic.

You may also be eligible for early Medicare benefits if you have Lou Gehrig’s disease (or ALS). If you have ALS, you will be automatically enrolled in Parts A and B the month that your disability benefits kick in.

Do You Have to Take Medicare Benefits at 65?

The short answer is no. If you are working or have coverage through a spouse, you may want to consider deferring Medicare.

However, we strongly encourage you to seek expert advice on what to do if you aren’t sure. Many individuals are given misinformation about how and when to defer Medicare, and not enrolling at the right time can lead to lifelong penalties and even periods without health insurance.

We can help you understand whether enrolling in Medicare is right for you at age 65 or not. Give us a call at 1-866-600-5638 to talk to one of our advisors about your unique situation.

What Makes You Eligible for a Medicare Advantage Plan or a Prescription Drug Plan?

Insurance companies also sell Medicare Advantage plans (MA). These plans are simply another way to get Part A and Part B benefits. In order to purchase a Medicare Advantage plan, you have to already be enrolled in Part A and Part B. It’s also important to note that you still have to pay your Part B premiums with a Medicare Advantage plan.

Part D plans (PDPs) provide coverage for your prescriptions and are also available through private insurers. You can only purchase a PDP if you enrolled in Part A. You can also get drug coverage through Medicare Advantage plans called MAPD plans.

If you are interested in learning about your options, call us at 1-866-600-5638. We can explain your options and make the decision simple!

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