What Age Does A Person Qualify For Medicare

What Is The Medicare Eligibility Age

Do I Have to Apply for Medicare?

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.

Will I Get Medicare At 62 If I Retire Then

If you retire before the age of 65, you may be able to continue to get medical insurance coverage through your employer, or you can purchase coverage from a private insurance company until you turn 65. While waiting for Medicare enrollment eligibility, you may contact your State Health Insurance Assistance Program to discuss your options.

Here are other ways you may be eligible for Medicare at age 62:

Or, you have been diagnosed with End-Stage Renal Disease
You may qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months

Are getting dialysis treatments or have had a kidney transplant

Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.

How Do I Become Eligible For Medicare Advantage

If youre eligible for Medicare benefits, you have to choose how to receive them either through the government-run Original Medicare program, or through Medicare Advantage. The majority of all Medicare beneficiaries use Original Medicare, but more than four in ten are enrolled in Medicare Advantage plans, and Advantage enrollment has been steadily climbing at a much faster pace than overall Medicare enrollment.

You need to have both Medicare Part A and Part B in order to enroll in Medicare Advantage, and you can select a plan during your Medicare initial enrollment period the seven months surrounding the month you qualify for Medicare .

Most Medicare Advantage plans also include Part D prescription drug coverage if you have a Medicare Advantage plan, you typically receive your Part D coverage together with the health and hospital benefits, in one single package, although the maximum out-of-pocket limits for Medicare Advantage do not include the cost of prescription drugs.

People with end-stage renal disease are eligible for Medicare, but used to be ineligible for most Medicare Advantage plans. This changed as of 2021, however, under the terms of the 21st Century Cures Act. As of 2021, people with ESRD have the same access to Medicare Advantage plans as other Medicare beneficiaries.

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Find Out About Your Medicare Eligibility

Determining your Medicare eligibility is sometimes tricky. We get many questions about how to qualify when to enroll in Medicare, and how to set up Medicare supplement insurance. Though the process may seem overwhelming to you, our experts deal with these processes every day. We can guide you easily through the process.

You are not alone let a Florida Medicare Agency licensed agent to assist you in making this entire process easier.

Get Your Free Copy of the Ultimate Medicare Quick Reference Guide from Florida Medicare Agency!

This guide helps you learn about the different parts of the Medicare program, including Medicare Part A and Part B , Part C and Part D .

Get Answers To Your Medicare Questions And Enroll In A Plan

If you have further questions about Medicare eligibility, contact a licensed insurance agent today. A licensed agent can help answer your questions and help you compare Medicare Advantage plans that are available where you live.

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About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.

Where you’ve seen coverage of Christian’s research and reports:

Medicare Enrollment Guide

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.

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.

Medicare Eligibility Requirements For 2020

Not sure if youre eligible for Medicare health insurance? The Social Security Administration enrolls some people automatically. But dont expect that or wait for your Medicare card to show up. Find out if youre eligible now so you can enroll at the right time and avoid any Late Enrollment Penalties .

Theres more than one way to qualify for Medicare, and enrolling in the different parts of Medicare differ as well. Plus, how you qualify may determine how you can receive coverage and what your premiums might be.

If youre looking for more of a crash course in the different parts of Medicare and how the program works as a whole, check out our Ultimate Medicare Guide. Otherwise, read on.

Call a Licensed Agent:

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Can You Get Private Insurance Instead Of Medicare

If you have Medicare Part A or Part B, insurers generally arent allowed to sell you a traditional individual health insurance plan .

You can purchase individual health insurance if youve never enrolled in Medicare because you think the overall costs are too high. If youre in the unusual situation of paying for Part A premiums, you can also switch to individual health insurance.

If you develop a medical condition before turning 65 that would qualify you for Medicare, such as ESRD, you can decline to purchase Medicare.

If you decide to purchase private insurance once youre eligible for Medicare unless youre continuing the employer-sponsored insurance that qualifies you for a Special Enrollment Period then youll have to pay the costly late enrollment penalty once you do apply.

If youre nearing the age of 65, then its important you start considering your Medicare coverage.

A Disability And A Long Wait Are Required For Early Medicare Enrollment

Who Qualifies for Medicare?

Lisa Sullivan, MS, is a nutritionist and a corporate health and wellness educator with nearly 20 years of experience in the healthcare industry.

ESRD Coverage

Medicare isn’t available to most people until age 65, but if you have a long-term disability or have been diagnosed with certain diseases, Medicare is available at any age.

According to Kaiser Family Foundation data, 14% of all Medicare beneficiaries are under age 65. As of April 2021, 63.3 million Americans were enrolled in Medicare. So roughly 9 million of those beneficiaries are under age 65 and eligible for Medicare because of a disability as opposed to age.

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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.

End Stage Renal Disease

You can qualify for early Medicare coverage if you:

have received a diagnosis of ESRD from a medical professional
are on dialysis or have had a kidney transplant

are able to receive SSDI, Railroad Retirement benefits, or qualify for Medicare

You must wait 3 months after starting regular dialysis or receiving a kidney transplant to qualify for Medicare coverage.

Your Medicare coverage will begin the first day of the fourth month of your dialysis treatment. You can get coverage as soon as your first month of treatment if you complete a Medicare-approved training program to do your own at-home dialysis treatment.

Providing coverage to those with medical disabilities and some chronic health conditions has even increased access to healthcare and reduced the number of deaths. An estimated 500,000 people with Medicare have ESRD, according to a 2017 article. The researcher determined that the ESRD Medicare program prevents up to 540 deaths from ESRD each year.

When Should I Sign Up For Medicare

Generally, we advise people to file for Medicare benefits 3 months before age 65. Remember, Medicare benefits can begin no earlier than age 65. If you are already receiving Social Security, you will automatically be enrolled in Medicare Parts A and B without an additional application. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will receive a Medicare card about two months before age 65. If you would like to file for Medicare only, you can apply by calling 1-800-772-1213. Our representatives there can make an appointment for you at any convenient Social Security office and advise you what to bring with you. When you apply for Medicare, we often also take an application for monthly benefits. You can apply for retirement benefits online.

If you didnt sign up when you were first eligible for Medicare, you can sign up during the General Enrollment Period between January 1 and March 31 each year, unless you are eligible for a Special Enrollment Period.

Medicare For Immigrants: Is It Possible

Can You Get Medicare At Age 62? Medicare Under 65

Medicare is a federal health insurance program. Its primarily for people age 65 and older. Some younger people may qualify for Medicare if they have certain health conditions or disabilities. Your parents, like others, have to meet the eligibility requirements for Medicare. To qualify for full Medicare benefits:

Your parents must be U.S. citizens or permanent legal residents who have lived in the United States for at least five continuous years.

They must be age 65 or older, or qualify due to a disability.

Your parents get Medicare separately. Both your Mom and your Dad need to apply one application wont cover both of them. Each parent will also have to qualify for Medicare separately in most cases.

For example, suppose Mom is 61 and Dad is 65. Generally, Dad might be eligible for Medicare if he meets eligibility requirements. But Mom wont qualify at age 61 in most cases. If she has a disability that qualifies her for Medicare before age 65, and she meets residency and legal status requirement, she might be eligible.

NEW TO MEDICARE?

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Requalifying For Medicare At 65

If you become eligible for Medicare before you turn 65 due to disability or one of the above diagnoses, youll requalify again when you reach age 65. When you do, youll have another Initial Enrollment Period and all the benefits of a newly eligible Medicare recipient, such as a Medicare Supplement Enrollment Period.

Eligibility For Medicare Part A

Medicare Eligibility begins at age 65 for most people.

You are eligible for Medicare Part A at age 65 if you or your spouse has legally worked for at least 10 years in the U.S. During those years, you paid taxes toward your Part A hospital benefits. This is why most Americans pay no Part A premiums when they become eligible for Medicare. Part A mainly covers your hospital stays. If you have worked and paid taxes in the US then you will be issued Medicare Part A automatically. Even if you are employed with a company with over 20 employees it makes perfect sense to have this benefit.

If you have not worked and paid taxes the required 10 years, Part A may be available for you to purchase. You can call Social Security at 1-800-772-1213, or visit your local Social Security office for more information about buying Part A.

Find out about your Medicare Eligibility

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How Social Security Helps Pay For Medicare

In addition to automatically enrolling you in Medicare, if you are receiving Social Security or Railroad Retirement Board benefits, your Medicare Part B premium will be automatically deducted from your monthly benefit payment.

If you are not receiving Social Security or Railroad Retirement Board benefits yet, you will get a bill called a Notice of Medicare Premium Payment Due . Bills can be paid for by check or money order, a credit or debit card, or through online bill pay services.

In conclusion, as youre starting to think about Medicare and retirement, do some research and make sure you understand how your Social Security benefits can or will play a role.

Medicaid The Underinsured The Uninsured

How Do You Qualify for Medicare?

Having health insurance does not always mean you can afford to use it. There may be expensive deductibles to pay out of pocket before your insurance coverage kicks in. When insurance does pay for services, you could still be left to pay copays or coinsurance .

Not everyone is fortunate enough to afford health insurance. As many as 17% of adults between 60 and 64 are on Medicaid, and 8% are uninsured. States where Medicaid expansion did not occur tend to have higher rates of uninsured people.

Unfortunately, many people delay care due to concerns over cost. In 2019, 9.1% of people delayed getting the care they needed, and 8.3% chose not to get care at all. When it came to people who did not have insurance, those rates increased to 32.2% and 30.4%, respectively.

A study in the journal Cancerlooked at a national database of cancer diagnoses from 2014 to 2016. The researchers focused on uninsured adults between 61 and 64 years old and compared them to insured adults on Medicare from 65 to 69 years old.

Interestingly, there was a significant rise in cancer diagnoses at 65 years old, especially for colon cancer and lung cancer. The implication is that people delayed care until they qualified for Medicare.

Medicare at 60 could be an option for Americans who do not qualify for Medicaid or who cannot otherwise access affordable health care.

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Medicare Enrollment Can Be Impacted By Social Security Benefits

Depending on your situation, you with either need to enroll in Medicare at age 65 or you may be able to delay. If you continue to work past age 65 and have creditable employer coverage , you can likely delay enrolling in Medicare until you lose that employer coverage. In most cases, people turning 65 will need to get Medicare during their 7-month Initial Enrollment Period to avoid financial penalties for enrolling late. Your IEP begins 3 months before the month of your 65th birthday and ends 3 months after.

Social Security benefits fit in the Medicare enrollment journey in one special way. If you are receiving either Social Security benefits for retirement or for disability, or Railroad Retirement Board benefits, you will be automatically enrolled in Medicare Part A and Part B when you first become eligible.