Medicare is available to United States citizens and legal residents who have lived in the United States for at least 5 years in a row. Medicare is individual insurance. It doesn't cover spouses or dependents. You may become eligible to receive Medicare benefits based on any one of the following.
Medicare Eligibility
I am Turning Age 65 or am Older than Age 65
Did you know that on average 10,000 Baby Boomers are turning Age 65 every day for the next decade? Below are some important facts you need to know to prepare for your Medicare.
- You must be 65 to enroll in Medicare—your spouse’s age doesn’t count.
- You may enroll in Medicare even if you’re not collecting Social Security income yet.
- You may enroll in Medicare even if you work past age 65 and have employer coverage, or you are 65 and have coverage through your spouse’s employer.
When to Enroll in Medicare
The Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. The IEP begins three months before, the month, and three months after your 65th birthday. This equates to a total 7 month period of time that you have to enroll into Medicare. You have the right to enroll during your IEP or at a later date, however you should be aware of how deferring your Medicare enrollment can affect you.
Enrollment in Medicare may be automatic if you are currently receiving Social Security or Railroad Retirement Board benefits. If this occurs then you can expect to receive your Medicare card in the mail a few months prior to your 65th birthday. It's important to remember though that if this occurs, you still qualify for IEP to make your personal Medicare decisions, just like everyone else.
Medicare Enrollment:
Time to Enroll into Medicare!
You can enroll in person at your nearest Social Security office or you can enroll easily online!
Direct link to online Medicare Enrollment : https://secure.ssa.gov/iClaim/rib Within about a months time, you will receive your enrollment letter with your Medicare Beneficiary number and your Part A and Part B effective dates.
Deferring Medicare :
Some people do not choose to begin Medicare at the age of 65 and instead elect to defer to a later date. You can easily do this by simply not enrolling into Medicare Part B. Remaining with your current health provider, either through work or your spouse's work qualifies you to defer taking Medicare on yourself.
Deferred Medicare and Ready to Retire?
Once you are ready to enroll into Medicare you will need to apply for Part B. You can do this online or at your local Social Security office. The date your Part B (medical insurance) begins always falls on the first of the month. You will need to make sure you receive, from the current health insurance provider, a Letter of Voluntary Disenrollment. Provide this letter to your designated Medicare Advisor so that when applying for Medicare Advantage or a Supplement plan, the insurance carrier understands that you are within a Special Election Period (SEP) and not subject to medical underwriting. This will also ensure that Centers for Medicare Services (CMS) and the Social Security Administration (SSA) do not hit you with a Late Enrollment penalty.
Beware of enrolling into Medicare Part B and electing to stay with your employer at the same time. It is not the same as deferring your Medicare, and if you desire at some point into the future to enroll in a Supplement plan, you could be subjected to medical underwriting. If your health at that point in the future is not a risk that the insurance carrier is willing to assume your plan could be denied, preventing you from ever obtaining a medical Supplement.
I am Receiving Social Security Disability (SSDI) Benefits
Recipients of Social Security disability benefits will be automatically enrolled into Medicare after 24 months.
Here’s what you need to know:
- You’ll be automatically enrolled in Original Medicare (Parts A and B). Your Medicare card will arrive in the mail a few weeks before your eligibility date.
- Your coverage starts the first day of the month you receive your 25th disability check.
- You still have an Initial Enrollment Period (IEP) when you may make decisions about your Medicare coverage.
Your IEP is 7 months long. It includes your 25th month of disability, the 3 months before and 3 months after.
I Have End Stage Renal Disease (ESRD) / Amyotrophic Lateral Sclerosis (ALS)
Medicare Coverage and ALS
If you have been diagnosed as having Amyotrophic Lateral Sclerosis (ALS) you will be automatically enrolled in Original Medicare, the month your Social Security disability benefits begin. Its best to apply for Medicare benefits as soon as you have been diagnosed, since a waiting period may need to be satisfied first.
You still have the right to make Medicare coverage choices, such as adding Medicare Part D prescription drug coverage or choosing a Medicare Advantage plan.
Medicare Coverage and ESRD
You may get Medicare benefits at any age if you have ESRD and one of the following applies :
- You are eligible for Medicare based on your work record.
- You are already getting Social Security or Railroad Retirement Board benefits, or you are eligible for benefits.
- Your spouse or parent meets one of the above requirements.
Medicare coverage starts the fourth month you receive dialysis treatments.
Medicare coverage could start the first month you receive treatments if all of these apply:
- You attend a home dialysis training program provided by a Medicare-certified training facility.
- Your doctor expects you to complete the training and be able to do your own dialysis treatments.
- You maintain regular dialysis treatments throughout the usual required waiting period.
You must enroll in Original Medicare Parts A and B yourself. Once you have both Part A and Part B, you may make other Medicare coverage choices, such as adding Medicare Part D prescription drug coverage or choosing a Medicare Advantage plan.
If you are 65 or older, or disabled, and are already enrolled in Part A, you may enroll in Part B without penalty if you are approved for Medicare based on ESRD. You may also have an existing Part B late enrollment penalty removed.
We do not offer every plan available in your area. Currently, we represent 10 organizations that offer 115 products in your area.
Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program to get information on all of your options.