Who Is Eligible For Medicare?

Eligibility is a word you’ve probably heard many times. Perhaps your child was eligible for financial aid, which helped them attend college. Or maybe you’re eligible for discount as your local store thanks to a great rewards program. Or it could just be that you’re eligible to give blood and help save a life. Whatever it means to you, eligibility typically indicates that something good is coming.

When it comes to understanding if you’re eligible for Medicare, you might be a little intimidated. After all, health care can be a complicated topic. But it’s actually simple to know who is eligible for Medicare – and when!

Qualifications for Original Medicare

It is important to note that when discussing Medicare eligibility, we’re talking about who is eligible for Original Medicare. Original Medicare is made up of Medicare Part A and B, which includes hospital and medical care provided by the government. Understanding the parts of Medicare will help inform what being eligible for Medicare means for you.

The most basic qualification of Medicare is that you must be at least 65 years old, and a citizen or legal resident of the United States for at least five continuous years.

Outside of the basic qualifications, there are special cases where even if you are under 65, you may still be eligible to receive the benefits of Medicare. For example, you may be eligible for Medicare in certain cases if you are disabled and receiving disability benefits, or if you have a life-threatening disease.

What if you’re still working when you turn 65? How does Medicare work with your employer’s plan? In this case, you need to find out if your employer requires you to sign up for Medicare. If not, you can enroll in Medicare later during a Special Enrollment Period. That means, if you’re over 65 and have employee coverage, you don’t need to take any action until you are ready retire. Doing this prevents the risk of losing your coverage.

What if you don’t want Medicare, or all parts of Medicare?

Joining Medicare is voluntary, but there may be consequences for not enrolling when you are first eligible for Medicare. While you can delay enrolling in Part A, there is no reason to not sign up as soon as you’re eligible. Because you’ve already paid to participate in Part A through taxes at work, enrolling is free and doesn’t require monthly premiums.

If you delay enrolling in Part B, you could incur a late penalty – which adds to the cost of your premiums permanently. However, if you’re still working and have primary health insurance from your employer, you are exempt from the penalty.

So you’re eligible for Medicare. What’s next?

Once you’ve confirmed your eligibility, the first step is to sign up! To enroll in Original Medicare, you can either apply online through the Social Security website, or visit your local Social Security office. When you’re eligible, you can sign up for Medicare during what is known as your Initial Enrollment Period. This is the 7-month period that includes 3 months before your 65th birthday, your birthday month, and 3 months post your birthday month.

After you’ve signed up, you will then choose your coverage. You may choose to stick with Original Medicare, add a Medicare Supplement plan with additional benefits, or consider a Medicare Advantage plan. No matter your decision, understanding the costs of Medicare can help.

Medicare provides the convenience and freedom to enjoy your retirement years knowing you have great health coverage. Now that you know more about Medicare eligibility, you will be prepared to make the choice that is right for you. If you still need help confirming whether or not you’re eligible for Medicare, use this Medicare eligibility calculator.

Sources:
Medicare.gov

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