Eligibility for Medicare

If you are 65 years of age or older, you have Medicare Eligibility for benefits under the following conditions:

• You are either a U.S. citizen or have been a permanent legal resident in the U.S. for at least five years.
• You are either receiving benefits from Social Security or Railroad Retirement, or you have accumulated sufficient work credits to qualify for these benefits even if you are not claiming them.
• You or your spouse have an employment history as a government employee or retiree who has not contributed to Social Security but has paid Medicare payroll taxes during your employment period.

Younger than 65?

• You may be eligible for Original Medicare if you have a qualifying disability or medical condition, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Will I Be Enrolled In Medicare Automatically?

• If you receive benefits from Social Security or the Railroad Retirement Board (RRB), you’ll be enrolled in Medicare Part A and Part B automatically when you turn 65 and have Medicare eligibility. The plan coverage starts on the first day of the month of your 65th birthday. (If your birthday is on the first day of the month, your Medicare coverage begins on the first day of the previous month.)
• If you’re under 65 and have a disability, you’ll automatically get Part A and Part B after 24 months of receiving disability benefits from either Social Security or the RRB.

What If I’m Not Enrolled Automatically?

• If you are approaching the age of 65 and are not receiving Social Security or RRB benefits, it is important to enroll in Medicare.
• The Initial Enrollment Period is the first opportunity for most people to enroll in Medicare. This period lasts 7 months and begins 3 months before your 65th birthday, includes the month of your birthday, and ends 3 months after your birthday. It is important to note that if you delay enrolling during this period, you may face a late enrollment penalty and have to pay higher premiums.

Bottom Line

Medicare eligibility can vary based on individual circumstances, and it’s important to understand the specific requirements for enrollment. It’s also essential to enroll to avoid penalties and gaps in coverage.

If you have any questions about your eligibility or how to enroll in Medicare, you can contact the Social Security Administration or visit their website for more information. Remember, having access to quality healthcare is crucial to maintaining your health and well-being as you age.

Sources: HHS.gov – Medicare.gov