Medicare Eligibility

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Medicare Eligibility is the age whereby one qualifies to access Medicare health plans in the United States. For most people, one become eligible at the age of 65. Otherwise, there are those considerations made by some states in case one is disabled and may qualify earlier, at least 24 months before the age of 65.

It’s important to note the difference between Social Security Retirement Age because Medicare is for all persons aged 65. Social security is where one can apply for income benefits once they acquire the age of 67.

Therefore the answer remains that as long as you have been a US resident for five years or more than you qualify for Medicare as soon as you turn 65.

Other exemptions that may guarantee Medicare include permanent disability whereby you can access Medicare 24 months before attaining 65 or if you have an end-stage renal disease where you will be expected to go for dialysis or kidney transplant.

You may also qualify earlier if you have a disease called Amyotrophic Lateral Sclerosis which is also known as Lou Gehrig’s.
Medicare is divided into different parts, and we are going to explain the eligibility of each part so that you know how to access the plan.


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Eligibility for Medicare Part A

As mentioned before, Medicare qualification starts at the age of 65 unless for the exemptions stated above. However, there are conditions that you must meet for you to qualify for Medicare Part A.

To start with, you need to be 65 years old, and you or your spouse should have worked for at least 10 years in the U.S, and must be paying taxes to cater for Part A.

In such a case, one does not pay for premiums once you sign up for the program since you paid taxes while working. However, you can buy Part A from Social Security if you had not worked for 10 years, which will cost an average figure of $400 per month.

However, if you had enrolled for Social security income benefits before you turn 65, then you can be enrolled automatically for Part A and Part B and get your card one month before turning 65.


humana medicare advantage plans 2021Eligibility for Medicare Part B


To be eligible for Part B, one will be required to pay monthly premiums, to cater for doctor visits, surgery fees, laboratory costs, among others, so long as you have turned 65. However, if you are still under your employer’s cover, then you may delay and enrol later.

At the time of enrollment, it’s essential to seek advice from the insurance agent Medicare in case you had delayed. He will advise on the special election periods available to avoid you getting charged for penalties.

Aetna medicare advantage plans 2021Eligibility for Medicare Part C

Medicare Part C is also well known as the Medicare Advantage Plan and offers benefits that are not available in the original Medicare, including the Medicare part D drug prescription coverage. However, this plan demands that you must sign up for Medicare Part A and B to become eligible. The only limitation is the lesser network availability, though not much of a challenge.

You must nonetheless remain enrolled for Part A and B even as you continue to enjoy the Medicare Part C benefits.

Eligibility for Medicare Part D

First and foremost, one must be enrolled in Medicare part A and B to be able to enroll for Medicare part D. This is a drug prescription service that is voluntary. Still, considering the benefits that go along with it, one should not ignore enrolling in the plan.

It’s also advisable to enroll early for the plan to avoid late penalties in the event of late enrolment.


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AARP medicare advantage plans 2021Frequently Asked Questions

Can anyone qualify for Medicare?

For you to be eligible for Medicare, you must be a US citizen or a resident who has stayed in the US for 5 years continuously.
When Do I qualify for Medicare?

You become eligible as soon as you turn 65 years.

Who is eligible for Medicare under age 65?

Anyone who is 65 years old with an exemption for the following conditions;

  • If you receive Social Security disability income, you qualify for Medicare 24 months prior
  • If you have any kidney-related disease and if you have been diagnosed with Lou Gehrig’s disease.


Aetna Medicare Advantage PlansCan a person get Medicare at age 62?

Yes, you can if you lie in the class of the exemptions mentioned above.

At what age can you apply for Medicare?

One can apply for Medicare 3 months before the 65th birthday or 3 months up to 3 months after their birthday. Otherwise, you will have to wait for the official enrollment window to open.

How long do you have to work to be eligible for Medicare?

You can either qualify if you have worked for 10 years and paying penalties or purchase the plan from the Social Security Office.

Is Medicare age changing to 67?

Medicare Supplemental InsuranceNo. This is the official retirement age for those people accessing the Social Security benefits, but eligibility starts at 65.
Is it mandatory to sign up for Medicare at age 65?

No, if you have employer coverage, you can wait until you are out of employment. However, there are penalties for late enrollment, though there is an automatic enrolment if you are registered for Social Security retirement benefits.
Who is eligible for Medicare and Medicaid?

Any person who is 65 can qualify for Medicare. Medicaid is an additional cover for people with low income, and it’s still possible to be eligible for both, Medicare being the primary option.

Who is eligible for Medicare part D?

So long as you have enrolled for Medicare Part A and Part B, then you qualify for Medicare Part D.


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How to find out your Medicare Eligibility

This happens to be a complicated process, but it does not have to stress you at all. Since each of the plans has its portion of eligibility, we can help you know your eligibility.

Feel free to call us today at 1-888-891-0229!