Medicare Eligibility

If one or more of the following apply to you, you are eligible for Medicare:

  • Over 65
  • Are under 65 and have received disability benefits for at least 24 months
  • Are under 65 and have end-stage renal disease (ESRD)

Furthermore, anyone who has worked at least 40 quarters (10 years) in the U.S can qualify for Part A Medicare at age 65 without having to pay a premium.

Eligibility for Medicare Part A

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.

If you have not worked the required 10 years, Part A may be available for you to purchase. Contact Social Security to find out the cost. If you must purchase Part A, the coverage will cost $422/monthly. In some cases, however, there are partial premiums for people who have worked over 30 but less than 40 quarters.

Find out more about Part A here.

Eligibility for Medicare Part B

You are eligible for Medicare Part B at age 65 as well. However, you must pay a monthly premium for Part B.  For information on what Part B covers, see our page on Medicare Part B

What if you are 65 and still get health insurance through an employer group plan? You can delay enrollment into Part B and keep your group plan without incurring a late penalty when you choose to enroll later.

If you delay enrollment into Part B, consult with an insurance agent who specializes in Medicare. He or she can explain the special election periods which you must use later on so that you won’t be subject to a late enrollment penalty.

To learn more about Part B click here.

Eligibility for Medicare Part C

Medicare Part C is another name for the Medicare Advantage program. You can enroll in Part C if you wish to get your benefits through a private insurance company instead of Original Medicare. Many of these plans also include prescription drug coverage.

To be eligible for Part C, you must first be enrolled in both Medicare Parts A and B. You must also live in the plan’s service area.

Many people think that if they enroll in a Medicare Advantage plan, they can drop their Part B and escape paying Part B premiums. However, this is not true. You must be enrolled in both Part A and Part B the entire time you have a Medicare Advantage Plan because you are receiving Original Medicare benefits.

Click here to learn more about Part C Advantage.

Eligibility for Medicare Part D

You are eligible for Medicare Part D as long as you are entitled to Part A and/or enrolled in Part B. You must also live in the Part D plans’ service area. Medicare Part D is optional coverage, which is why you must select to enroll if you want drug coverage. We recommend that if you have no other prescription drug coverage that you consider this option.

To learn more about Part D click here.

Find out about your Medicare Eligibility

If you are facing some difficulty determining if you are eligible for any Medicare plans, don’t worry. We are experts in Medicare and can guide you through the entire process. Don’t hesitate to contact us!