What Age Do You Get Medicare

At What Age Can You Get On Medicare

While most people assume that Medicare is reserved for those who have reached retirement age, that isnt necessarily true. Medicare coverage can also benefit others in certain circumstances. However, those who qualify before age 65 should be aware that they will need to reapply when they do reach age 65.

You Want More Benefits

Nearly half of Medicare beneficiaries enrolled in Medicare Advantage plans in 2022, according to a survey conducted on behalf of The Commonwealth Fund, a foundation devoted to improving health care systems. Nearly a quarter of those with Medicare Advantage selected such a plan because it provided additional benefits, the survey found.Seven in Ten Medicare Beneficiaries Did Not Compare Plans During Past Open Enrollment Period. Kaiser Family Foundation. Accessed 10/25/2022.

Many Medicare Advantage plans provide coverage not found in Original Medicare, such as vision or dental benefits. They may also offer ancillary benefits, such as gym memberships or transportation coverage, says Rees.

Even if youre happy with your current Medicare Advantage plan, it may be worthwhile to compare your options to see if more or better benefits are available elsewhere.

Receiving Social Security For A Disability

If youve received Social Security Disability Insurance for 24 months, youll automatically be enrolled in Medicare on the 25th month after your first SSDI check was received.

According to the Centers for Medicare & Medicaid Services , in 2019 there were 8.5 million people with disabilities on Medicare.

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Preparing As The Eligibility Age Nears

If a person already receives benefits from the Social Security Administration, the Administration will automatically enroll them in Medicare parts A and B.

The person will receive a âWelcome to Medicareâ packet 3 months before their 65th birthday, with instructions on how to sign up.

A person does not have to be retired to receive Medicare. If a person is not currently receiving Social Security benefits, they can apply for Medicare benefits as early as 3 months before their 65th birthday.

For example, if a person turns 65 years of age in April, they can apply for Medicare benefits in January of the same year.

Applying for Medicare benefits as early as possible may help the Social Security office process the paperwork in time for the personâs 65th birthday.

People who apply too late may face a premium 10% higher than that of those who apply on time. This premium would apply for double the time a person has been eligible but did not apply.

A person can apply for Medicare during their birth month or up to 3 months after their birth month without having to pay penalties for Medicare coverage.

However, their benefits will not begin until the Centers for Medicare and Medicaid Services process their request.

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Review Your Medicare Choices Each Year

Whether you enroll in original Medicare or a Medicare Advantage plan, you generally do not need to renew coverage every year. That being said, plans are sometimes discontinued or their benefits and costs may change to the point that the plan no longer meets your needs. Its not unusual for pharmacy and provider networks to change, for costs to increase, or the list of covered prescription drugs to vary. Thats why its a good idea to review your plan each year and compare it against your current health care needs.

Your health insurer is required to send you an Annual Notice of Change by September 30 each year. The notice outlines any changes in coverage and costs expected to begin the following January. If you decide to change your health care plan after reviewing those updates, you can do so during Medicares open enrollment period. The period runs from October 15 to December 7. During this time, you can switch from original Medicare to Medicare Advantage or vice versa. You can switch from one Medicare Advantage plan to another or from one Medicare Part D plan to another. You can also enroll in Medicare Part D if you have not done so already, although late enrollment penalties may apply.

If you find that the new health care plan is not meeting your needs, you can reverse some plan decisions January 1 to March 31 of the following year. Guidance for the renewal process is offered through the U.S. governments phone line at 1-800-MEDICARE or through your local SHIP.

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Your First Chance To Sign Up

Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

Avoid the penaltyIf you miss your 7-month Initial Enrollment Period, you may have to wait to sign up and pay a monthly late enrollment penalty for as long as you have Part B coverage. The penalty goes up the longer you wait. You may also have to pay a penalty if you have to pay a Part A premium, also called Premium-Part A.

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 sign up for 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 their behalf 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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If Your Income Has Gone Down

If your income has gone down and the change makes a difference in the income level we consider, contact us to explain that you have new information. We may make a new decision about your income-related monthly adjustment amount for the following reasons:

• You married, divorced, or became widowed.
• You or your spouse stopped working or reduced your work hours.
• You or your spouse lost income-producing property because of a disaster or other event beyond your control.
• You or your spouse experienced a scheduled cessation, termination, or reorganization of an employers pension plan.
• You or your spouse received a settlement from an employer or former employer because of the employers closure, bankruptcy, or reorganization.

If any of the above applies to you, we need to see documentation verifying the event and the reduction in your income. The documentation you provide should relate to the event and may include a death certificate, a letter from your employer about your retirement, or something similar. If you filed a federal income tax return for the year in question, you need to show us your signed copy of the return. Use Form Medicare Income-Related Monthly Adjustment Amount Life-Changing Event to report a major life-changing event. If your income has gone down, you may also use Form SSA-44 to request a reduction in your income-related monthly adjustment amount.

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Who Is Eligible For Medicare

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.

To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.

If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:

• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
• You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

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The Parts Of Medicare

Social Security enrolls you in Original Medicare .

• Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
• Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.

Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.

• Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
• Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
• Medicare Part D helps cover the cost of prescription drugs.

Most people age 65 or older are eligible for free Medicare hospital insurance if they have worked and paid Medicare taxes long enough. You can sign up for Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .

How Do I Know If I Am Automatically Enrolled In Medicare

Medicare will enroll you in Part B automatically. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you’re not getting disability benefits and Medicare when you turn 65, you’ll need to call or visit your local Social Security office, or call Social Security at 1-800-772-1213.

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What If Im Not Automatically Enrolled At 65

If your Medicare enrollment at 65 is not automatic, but you want to enroll, here are some more magic numbers.

3 and 7.

To start taking advantage of Medicare at 65, you need to sign up during the three months before the birthday month you turn 65. Those are the first three months of your seven-month Initial Enrollment Period.

Unless your birthday is on the first day of the month, your Initial Enrollment Period includes the three full months before turning 65, the month you turn 65, and the three months after you turn 65. If you were born on the first day of the month, IEP is the four months before your birth month, along with your birthday month and the two months after.

If you sign up during one of the months before your 65th birthday, your coverage will begin on the first day of the month you turn 65 .

Are you eligible for cost-saving Medicare subsidies?

Get Started With Medicare

Medicare is health insurance for people 65 or older. Youre first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease , or ALS .

Follow these steps to learn about Medicare, how to sign up, and your coverage options. Learn about it at your own pace.

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It Pays To Look At Plan Ratings

Medicare has a plan-finder tool on its site that allows you to explore your options for Part D and Advantage plans based on factors like your geographic location and prescription needs. You should also know that Medicare employs a star ratings system that can help you assess the quality of the different plan choices youre presented with. All plans are rated from one to five stars, with five being the best.

How Old Do You Have To Be To Get Medicare Part C Or Medicare Supplement

To get Medicare Part C or Medicare Supplement plans, you must be enrolled in Original Medicare. This means, you must be at least 65 years old or meet the Medicare criteria for enrolling under age 65. If you do not meet these criteria, you can get Medicare at age 65.

Medicare Part C and Medicare Supplement plans both act as a supplemental coverage to Original Medicare. However, you cannot have both plans. You are only able to enroll in Medigap OR Part C. If you enroll in Medicare Part C, the plan becomes your primary coverage over Original Medicare. If you enroll in a Medicare Supplement plan, it will pay secondary to Original Medicare. Because they require you to have Original Medicare, you cannot enroll in a plan without Medicare Part A and Part B.

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Automatic Enrollment And Applying

Those who are already qualified for Social Security benefits or Railroad Retirement Board benefits will typically be automatically enrolled for Medicare.

Those who have not qualified for those benefits will have to fill out paperwork to be enrolled. Dont let the process of applying for a government-funded program scare you. The process for enrolling is pretty simple, and you can start it seven months before you become eligible. This seven month period is called your Initial Enrollment Period .

As mentioned above, the Initial Enrollment Period can change based on circumstances. For those qualifying due to a disability, the IEP begins in the 22nd month of receiving social security benefits. For those who qualified before age 65 and are requalifying at age 65, there is a second IEP that begins seven months before that birthday.

Will The Medicare Age Be Raised To 67

In recent years, the proposal to raise the Medicare eligibility age to 67 began to gain traction. However, many are actually in favor of lowering the Medicare age below 65 rather than pushing it back to 67.

As of now, there has not been any indication that either of these proposals will become law. The standard Medicare enrollment age is currently 65 and there are no plans of changing that in the near future.

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Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

Stacy Crayder

Stacy Crayder is the corporate trainer and licensed Medicare agent at MedicareFAQ. As an educator, Stacy is dedicated to teaching new Medicare agents all the necessary information regarding Original Medicare, Medicare Advantage, and Medicare Supplement plans. In her Medicare101 training classes, Stacy provides an intensive education on all things Medicare. Additionally, as a Medicare Expert, Stacy provides high-quality Medicare information to beneficiaries eager to learn more about their healthcare coverage.

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You Automatically Get Medicare

• You should already have Part A and Part B , because you have ALS and youre already getting disability benefits.
• We mailed you a welcome package with your Medicare card.

Sign up for Part B if you live in Puerto Rico or outside the U.S.

• Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.

Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up and pay a monthly late enrollment penalty.

• Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.

Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.

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