What Is The Medicare Eligibility Age
For just about everyone, the Medicare eligibility age is 65. At that point, youll have access to Medicare Part A and are able to purchase Medicare Part B. For some with disabilities or End Stage renal disease, though, eligibility may come at a younger age. Most people are eligible to receive part A without having to pay for it, but there are a few exceptions, which well note in further detail below. For help with healthcare planning and other questions about finances and retirement, consider working with a financial advisor.
Medicare Penalty: Sign Up Before You Turn 65 To Avoid Late Enrollment Charges
If youre closing in on age 65, nows a good time to sign up for Medicare benefits to avoid late enrollment penalties especially since the open enrollment period is currently underway through Dec. 7.
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The U.S. Department of Health & Human Services recommends filing for Medicare benefits three months before your 65th birthday when those benefits kick in. If you already receive Social Security, youll automatically be enrolled in original Medicare Part A for hospital coverage and Part B for medically necessary and preventive services without having to fill out an additional application. However, you can opt-out of Part B if you dont want to pay the premium.
If you enroll three months ahead of time, youll receive a Medicare card about two months before age 65. Or, you can wait until you turn 65 to sign up for original Medicare and add on any additional coverage from there, such as Part D for drug coverage. But if you wait too long, youll face late enrollment charges.
Heres how the various rate enrollment penalties work:
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Already Enrolled In Medicare
If you have Medicare, you can get information and services online. Find out how to .
If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You can use one of the following options to submit your enrollment request under the Special Enrollment Period:
Note: When completing the forms CMS-40B and CMS-L564
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Some people with limited resources and income may also be able to get .
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Turning 65 What You Need To Know About Signing Up For Medicare
The first of the 78 million baby boomers turned 65 on January 1, 2011, and some 10,000 boomers a day will reportedly reach that milestone between now and 2030. If you are about to turn 65, then it is time to think about Medicare. You become eligible for Medicare at age 65, and delaying your enrollment can result in penalties, so it is important to act right away.
There are a number of different options to consider when signing up for Medicare. Medicare consists of four major programs: Part A covers hospital stays, Part B covers physician fees, Part C permits Medicare beneficiaries to receive their medical care from among a number of delivery options, and Part D covers prescription medications. In addition, Medigap policies offer additional coverage to individuals enrolled in Parts A and B.
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Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don’t need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65. If you do not receive Social Security benefits, then you will need to sign up for Medicare by calling the Social Security Administration at 800-772-1213 or online at . It is best to do it as early as possible so your coverage begins as soon as you turn 65.
Does The Eligibility Age Change For Types Of Medicare Coverage
No. You need to have Medicare Part A and Part B if you want to sign up for a Medicare Advantage plan or a Medicare Supplement insurance plan. If you sign up for a stand-alone Medicare prescription drug plan, you need Part A and/or Part B.
So, itâs not like you can get a Medicare Advantage plan, for example, when youâre younger than 65 unless you qualify by disability.
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How Old Do You Have To Be To Get Medicare
Are you wondering at what age you can get Medicare coverage? You could say that Medicare age ranges from 65 up, for the rest of your life, for most people in the U.S. If you qualify for Medicare by disability, you can get Medicare before age 65. Youâre generally eligible for Medicare if youâre younger than 65, and:
- Youâve been getting Social Security disability benefits for at least 24 months. Youâre typically signed up for Medicare automatically when you start the 25th
- You have end-stage renal disease . You might qualify for Medicare, but youâre not automatically signed up. You need to contact Social Security or visit their website, gov.
- You have amyotrophic lateral sclerosis , also known as Lou Gehrigâs disease. Youâre automatically signed up for Medicare the same month your Social Security disability benefits start.
Reaching Age 62 Can Affect Your Spouse’s Medicare Premiums
Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.
When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they havent yet qualified based on their own work history.
- For example, Gerald is 65 years old, but he doesnt qualify for premium-free Part A because he did not work the minimum number of years required for eligibility. He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.
- Lets say Geralds wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.
In the above example, Jessica has not become eligible for Medicare by turning 62. Her husband Gerald, however, is now eligible to receive his Medicare Part A benefits without paying a monthly premium any longer.
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Delaying Medicare Due To Work: Special Enrollment Period
If you didn’t enroll in Medicare because you were still working, and you were covered under a group health plan based on employment, you have a Special Enrollment Period during which you can sign up for Part A and/or Part B. While you or your spouse are still working and you’re still covered under a group health plan, you can sign up anytime.
After your or your spouse’s employment ends, your Special Enrollment Period lasts eight months, starting the month after the employment or group health plan ends . However, you have only two months after the employment or group health plan ends to sign up for a Medicare Advantage plan or Part D prescription drug plan . You can enroll in a Medicare Advantage plan starting three months before your Medicare Part B enrollment is due to take effect up to the day before your Part B coverage startsbut again, enrollment must take place within two months of your employment or group health plan ending.
Example:
Judy’s last day of work is July 1 and her group health plan ends July 31. She has eight months, until April 30, to sign up for Part B without a penalty. But if she wants to join a Medicare Advantage plan, she needs to do so by September 30 . Instead, on June 15, Judy signs up for Part B coverage to begin on August 1, so that she won’t have a gap in coverage. She has only until July 31 to add a Medicare Advantage plan . Her Medicare Advantage plan will start August 1.
Can You Sign Up For Medicare At Any Time
No, you can only enroll in Medicare during one of the enrollment periods. The first opportunity you have to enroll is during your Initial Enrollment Period. If you miss your Initial Enrollment Period, your second opportunity to sign up is during the General Enrollment Period. Outside both of these enrollment windows, you can sign up during a Special Enrollment Period if you qualify.
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During A Special Enrollment Period
This SEP is available only if you have health insurance from an employer for which you or your spouse actively works. It allows you to delay enrolling in Part B until the employment or the coverage ends whichever occurs first.
The SEP actually lasts throughout the time you have coverage from current employment and for up to eight months after it ends. If you enroll at any point during this time frame, your Medicare coverage will begin on the first day of the following month, and you will not be liable for late penalties regardless of how old you are when you finally sign up.
Be aware that an IEP always trumps an SEP if the two should happen to overlap. For example, if your IEP ends on Aug. 31, and you retire on the same date, you will not be entitled to an SEP. Therefore, if you delayed enrollment until after Aug. 31, you would not be able to sign up until the following general enrollment period and your coverage would not begin until July 1 so you would be left for almost a year without coverage. Even if you signed up during the final months of your IEP, your coverage would still be delayed by two or three months. But, to continue this example, if you retired on Sept. 1, under the rules of the SEP, you could enroll in August and receive Medicare starting Sept. 1 with no loss of coverage.
Two other Medicare enrollment scenarios have different rules.
What Are My Insurance Options If I Cannot Get Medicare At Age 62
If you dont qualify for Medicare, you may be able to get health insurance coverage through other options:
- Employer-provided insurance
LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.
Moore holds a bachelors degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.
Hes passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.
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Medicare Eligibility At Age 65
- You are at least 65 years old
- You are a U.S. citizen or a legal resident for at least five years
In order to receive premium-free Part A of Medicare, you must meet both of the above requirements and qualify for full Social Security or Railroad Retirement Board benefits, which requires working and paying Social Security taxes for at least 10 full years .
Learn more about Medicare eligibility at and before age 65 by referring to this helpful chart and reading more information below.
When Medicare Starts: Special Enrollment Periods
You can qualify for a special enrollment period and avoid penalties in a few circumstances, such as when youre covered by a group health insurance plan from a current employer with 20 or more employees either your own or your spouses. In this case, the clock starts ticking when the employment or the coverage ends, whichever comes first.
Then, you have two months to enroll in Medicare Advantage or Part D and eight months to enroll in Medicare Part B. If you apply using a special enrollment period and your application is approved, your coverage starts either the first day of the month that you applied or the first day of the following month, depending on the situation.
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Full Retirement Age By Year
Full retirement age is the age you begin to receive full Social Security benefits. If you start to draw your Social Security benefits before reaching your full retirement age, the payment you receive will be less.
An easy way to think about full benefits and retirement age is this,
- Social Security will reduce your payments if you choose to receive your benefit before full retirement age. The percentage of reduced amount is highest at age 62 and decreases until you reach full retirement age.
- If you choose to receive Social Security payments when you reach full retirement, you will get the total amount.
- Suppose you choose not to receive Social Security payments when you reach full retirement and delay your benefit. In that case, you can increase the amount of your payment by earning delayed retirement credits.
If youre not sure when you reach full retirement age, our table provides the years and months you need to know for full retirement.
Individual And Family Health Insurance
In some cases, buying your own health insurance may be your only or best option for finding coverage before you age into Medicare.
Navigatingthe health insurance marketplace can be difficult, especially if youve onlyreceived health insurance through your employer in the past. But eHealth ishere to guide you through it!
Youwhich runs from November 15th through December 15th, inmost states, for coverage starting on January 1st of the followingyear. However, you will likely qualify for a special enrollment period when youretire this 60 day enrollment period allows you to enroll in health insuranceanytime of the year.
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Medicare Eligibility Age Chart
Most older adults are familiar with Medicare and its eligibility age of 65. You can qualify for Medicare Part A and Medicare Part B by:
- Being age 65 or older
- Living with a qualifying disability
- Living with certain health conditions, like end-stage renal disease or amyotrophic lateral sclerosis
Individuals under 65 and already receiving Social Security or Railroad Retirement Board benefits for 24 months are eligible for Medicare. Still, most beneficiaries enroll at 65 when they become eligible for Medicare.
When To Start A Medicare Supplement Plan
Medicare Supplement plans are additional insurance plans that fills the gaps in coverage that Original Medicare leaves behind. Medigap plans can pay for more extended hospital stays, deductibles, and foreign emergencies. Your one-time Medigap Open Enrollment Period starts on the first day of the month you turn 65 and have Medicare Part B.
Signing up for Medigap during Open Enrollment means the insurance company cannot deny you coverage based on your health. If you wait until after this window closes, you may need to answer underwriting health questions. This means you can be turned down or charged more because of your health.
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Signing Up Late: General Enrollment Period
Part A. If you didn’t sign up for Medicare Part A when you were first eligible, you can sign up for Part A anytime, without penalty.
When coverage begins. Your Part A coverage will go back to six months before the date you signed up .
Part B, C and D. If you didn’t sign up for Medicare Part B when you were first eligible, you can sign up for Part B during a General Enrollment Period, which happens between January 1 through March 31 each year. You will also have from April 1 through June 30 of that year to add a Medicare Advantage plan or Medicare Part D plan.
When coverage begins. When you sign up for Part B, C, or D during a General Enrollment Period, your coverage will start July 1.
Late sign-up penalty. Individuals who did not sign up for Medicare Part B when they turned 65 might face a penalty of higher lifetime premiums when they do sign up. However, most individuals who were covered by a group health plan through an employer are not subject to the penalty. If you didn’t sign up for Part B because you had group health benefits through work, you should be able to sign up during your Special Enrollment Period.
