Medicare Eligibility

Medicare eligibility rules allow most U.S. adults 65 and older to sign up for any of the program’s various components. You simply have to have been a U.S. citizen or permanent resident for at least 5 years.

The Medicare eligibility age can also extend below 65 under certain circumstances. These include individuals who:

  • Receive Social Security disability benefits for at least 24 months
  • Have end-stage renal disease (ESRD), also known as kidney failure
  • Have amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease

Enrollment in Medicare Part A is automatic if you have registered for Social Security benefits by age 65, and you will also likely be enrolled in Part B. You are not likely to pay a premium for Part A if you have worked at least 10 years (40 quarters) at a job that withheld Medicare taxes.

When Am I Eligible for Medicare?

At what age are you eligible for Medicare? The vast majority of beneficiaries will meet the Medicare eligibility requirements when they turn 65.

Your initial enrollment period begins three months before the month you turn 65 as well as the three months after — equalling 7 months total. You can sign up for Medicare Part A during this time, and you can optionally sign up for Part B or Part D

If you do not have employer-based group health insurance, you should strongly consider whether you want to sign up for Part B and/or Part D during this enrollment period. Signing up later without an extenuating circumstance could lead to paying a penalty the entire time you are enrolled.

You can also optionally sign up for Medicare Part C, also known as a Medicare Advantage plan. To do so, you must be enrolled in both Part A and Part B. You must also not be enrolled in Part D if you plan on signing up for a Medicare Advantage plan that includes prescription drug coverage.

When Are You Eligible for Medicare if You Have a Qualifying Disability or Condition?

Anyone can satisfy the requirements for Medicare eligibility at any age if they have a qualifying disability or condition.

As listed above, these include amyotrophic lateral sclerosis (ALS/Lou Gehrig’s disease) or end-stage renal disease (ESRD). The latter condition refers to a patient who is experiencing kidney failure; they will likely be on dialysis and/or awaiting a kidney transplant.

Individuals who qualify for Social Security disability benefits can also meet the Medicare eligibility requirements once they have received a disability check for at least 24 months.

Medicare Eligibility in Georgia

Eligibility for Medicare in Georgia follows the exact same rules above. The only potential caveat is that if you choose to have Part C or Part D coverage, then you must sign up for a plan that has a service area overlapping where you currently live.

Delaying Enrollment in Medicare While You Continue to Work

You can elect to delay your enrollment in Medicare for as long as you are still working and receiving creditable health coverage with no penalty. You then have a three-month window from the time you drop your existing health coverage to sign up for Medicare without any penalty.

Eligibility for Individual Medicare Parts

The above general rules for Medicare eligibility apply almost universally to all forms of coverage. However, individual components to Medicare can have their own eligibility requirements.

Review the following Medicare eligibility age chart to perform a quick Medicare eligibility check and see if you meet the requirements:


Questions About the Medicare Eligibility Requirements?

If you are unsure of whether you meet the above requirements, you can contact the Social Security department through one of the following methods:

You can also consult with an experienced health insurance professional here at MMIG who can help you determine if you meet the requirements and also select a plan that’s perfect for your health needs and personal preferences.

Contact us today if you have any questions, want guidance, or need any other form of assistance to help you Protect What’s Ahead.

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