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Medicare Eligibility

Most folks are eligible for Medicare at age 65, whether you’ve retired or not. 

You may qualify for Medicare coverage at 65 (or older) if you’re a U.S. citizen or a permanent resident and you’ve lived here continually for 5 or more years. There’s a 7-month term, known as the Initial Enrollment Period, where you can enroll into Medicare.

When You’re Under Age 65

Also, you can qualify for Medicare under these conditions when you’re under age 65:

  • If you’re permanently disabled and you’ve been getting Social Security disability income benefits for 24 months.
  • When you have end-stage renal disease (kidney failure) that requires dialysis or a kidney transplant. 
  • If you have Amyotrophic Lateral Sclerosis (ALS) or “Lou Gehrig’s disease”.

Below, we explain the eligibility requirements for each of the four parts of Medicare.

Eligibility for Medicare Part A

If you or your spouse has worked for a minimum of 10 years in the U.S., you’re eligible for Part A at age 65. 

You can still purchase Part A if you haven’t worked the mandatory 10 years. Just contact Social Security to see what the cost is. In some cases, there are partial premiums for those who have worked more than 30 but less than 40 quarters.

You could be automatically enrolled in Medicare Part A when you turn 65 if you’ve already enrolled in Social Security income benefits. Your Medicare card will typically come in the mail about 4 to 6 weeks before your 65th birthday.

Eligibility for Medicare Part B

You’re eligible for Medicare Part B at age 65, too. But you have to pay a monthly premium for Part B. If you’re turning 65 and you still have health insurance through your employer, you can delay your enrollment into Part B without receiving a late penalty. 

If you defer enrollment into Part B, contact an agent at Cornerstone Senior Advisors. We can go over the special election periods that you must use later so you won’t face a late enrollment penalty.

Eligibility for Medicare Part C

To be eligible for Medicare Part C (Medicare Advantage), you must be enrolled in both Medicare Parts A and B. You can’t drop Part B. Also, you must live in the plan’s service area, which is based on the address you have on file with Social Security. You have to select a plan that runs in that same county. Some plans will be limited to just one or two counties, while others may cover the entire state.   

Lastly, you must not have End-Stage Renal Disease. This is the only medical question on a Medicare Part C application.

Eligibility for Medicare Part D

You’re eligible to enroll in a Part D plan if you’re enrolled in either Part A or Part B (or both) and you live in the plan’s service area. Know that if you don’t enroll in Medicare Part D and you have no other suitable coverage, you may acquire late penalties when you enroll at a later date. 

Learn About Your Medicare Eligibility

Sometimes it’s difficult to determine your Medicare eligibility. While the process may seem overwhelming and confusing for you, our agents manage the system everyday. We’re here to guide you through the process and make it easier for you and your loved ones. Call Cornerstone Senior Advisors in Wichita, KS at (316) 260-3331.