In most cases, Medicare eligibility is straightforward. Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. If you are not 65, you might also qualify for coverage if you have a disability or with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).
Am I eligible for Medicare Part A?
You can start receiving Medicare Part A (hospital insurance) benefits with no premium once you are 65 or older if you or your spouse worked and paid Medicare taxes for a certain period of time. You can know you are eligible for premium-free Medicare A if one of the following applies to you:
You currently receive or are eligible for Social Security.
You currently receive or are eligible for Railroad Retirement Board (RRB) benefits.
You or your spouse served in a Medicare-covered government job.
If you received Social Security or RRB benefits at least four months prior to turning 65, you will receive Medicare Part A automatically. If not, you need to file an application with the Social Security Administration.
Am I eligible for Medicare Part B?
You can choose to purchase Medicare Part B benefits if you are eligible for Medicare Part A. It is a voluntary program that requires you to pay monthly premiums. For 2022, the standard premium is $170.10 (or higher depending on income). If you do not enroll in Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Part B coverage.
If you received Social Security or RRB benefits at least four months prior to turning 65, you will receive Part B automatically (unless you live in Puerto Rico). You will have a choice if you want to keep or refuse enrollment. If you refuse, you can re-enroll during a valid enrollment period, but you will have to pay a late enrollment penalty for as long as you have the coverage.
Eligibility for Unemployed Persons or Homemakers
If you are a U.S. citizen over 65 and you or your spouse did not pay Medicare taxes for long enough, you may be eligible to purchase Medicare Part A health insurance. In 2022, seniors who did not receive premium-free Part A coverage paid $499 or $274 per month depending on how long Medicare taxes have been paid through employment. You will not be enrolled automatically, so you need to file an application with the Social Security Administration. You can then enroll in Medicare Part A and Part B for a monthly premium during a validMedicare enrollment period. You will not be able to purchase Part A alone.
If you are under 65? You could be eligible.
You are eligible for Medicare when you are under 65 years old if you:
Have received Social Security or RRB benefits on the basis of disability for 24 months.
Have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
Have end-stage renal disease (ESRD).
How to Get Medicare Part A and Part B Coverage: If you receive Social Security or RRB benefits for 24 months, you will automatically be enrolled in Medicare Parts A and B at the beginning of the 25th month. If you have ALS, you will automatically be enrolled in Medicare Parts A and B as soon as you receive the first month of disability benefits. If you have ESRD, you must apply for Medicare benefits. Medicare eligibility depends on a variety of factors, including whether or not you are receiving dialysis, have had a kidney transplant, and/or have paid Medicare taxes sufficiently. Want to learn more about this, watch our video here