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Who can get Medicare?

Hospital insurance (Part A)

Most people age 65 or older who are citizens or permanent residents of the United States are eligible for free Medicare hospital insurance (Part A). You are eligible at age 65 if:

  • You receive or are eligible to receive Social Security benefits; or

  • You receive or are eligible to receive railroad retirement benefits; or

  • You or your spouse (living or deceased, including divorced spouses) worked long enough in a government job where Medicare taxes were paid; or

  • You are the dependent parent of someone who worked long enough in a government job where Medicare taxes were paid.

If you do not meet these requirements, you may be able to get Medicare hospital insurance by paying a monthly premium. Usually, you can sign up for this hospital insurance only during designated enrollment periods.

NOTE:Even though the full retirement age is no longer 65, you should sign up for Medicare three months before your 65th birthday.

Before age 65, you are eligible for free Medicare hospital insurance if:

  • You have been entitled to Social Security disability benefits for 24 months; or

  • You receive a disability pension from the railroad retirement board and meet certain conditions; or

  • You have Lou Gehrig's disease (amyotrophic lateral sclerosis); or

  • You worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program; or

  • You are the child or widow(er) age 50 or older, including a divorced widow(er), of someone who has worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program.

  • You have permanent kidney failure and you receive maintenance dialysis or a kidney transplant and:

    • You are eligible for or receive monthly benefits under Social Security or the railroad retirement system; or

    • You have worked long enough in a Medicare-covered government job; or

    • You are the child or spouse (including a divorced spouse)of a worker (living or deceased) who has worked long enough under Social Security or in a Medicare-covered government job.

Medical insurance (Part B)

Anyone who is eligible for free Medicare hospital insurance (Part A) can enroll in Medicare medical insurance (Part B) by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. For more information, ask for Medicare Part B Premiums: New Rules For Beneficiaries With Higher Incomes(Publication No. 05-10161)or visit www.socialsecurity.gov/mediinfo.htm.

If you are not eligible for free hospital insurance, you can buy medical insurance, without having to buy hospital insurance, if you are age 65 or older and you are -

  • A U.S. citizen; or
  • A lawfully admitted noncitizen who has lived in the United States for at least five years.

Medicare Advantage plans (Part C)

If you have Medicare Parts A and B, you can join a Medicare Advantage plan. With one of these plans, you do not need a Medigap policy, because Medicare Advantage plans generally cover many of the same benefits that a Medigap policy would cover, such as extra days in the hospital after you have used the number of days that Medicare covers.

Medicare Advantage plans include:

  • Medicare managed care plans;
  • Medicare preferred provider organization (PPO) plans;
  • Medicare private fee-for-service plans; and
  • Medicare specialty plans.

If you decide to join a Medicare Advantage plan, you use the health card that you get from your Medicare Advantage plan provider for your health care. Also, you might have to pay a monthly premium for your Medicare Advantage plan because of the extra benefits it offers.

People who become newly entitled to Medicare should enroll during their initial enrollment period (as explained under Signing up for Medicare) or during the annual coordinated election period from November 15 – December 31 each year. There also will be special enrollment periods for some situations.

Medicare prescription drug plans (Part D)

Anyone who has Medicare hospital insurance (Part A), medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Joining a Medicare prescription drug plan is voluntary, and you pay an additional monthly premium for the coverage.
You can wait to enroll in a Medicare Part D plan if you have other prescription drug coverage but, if you don't have prescription coverage that is, on average, at least as good as Medicare prescription drug coverage,
you will pay a penalty if you wait to join later. You will have to pay this penalty for as long as you have Medicare prescription drug coverage.

People who become newly entitled to Medicare should enroll during their initial enrollment period (as explained under Signing up for Medicare). After the initial enrollment periods, the annual coordinated election period to enroll or make provider changes will be November 15 - December 31 each year. There also will be special enrollment periods for some situations.


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There are 11 Comments

CAN I QUALIFY FOR MEDICARE BENEFITS EVEN THOUGH I'M NOT DISABLE AND AM ONLY 64 YRS? EVEN IF I'M WILL TO PAY A MONTHLY PREMIUM.

Can I applied for Medicare if I'm self employed and be at the ages 66.

what site do I go to for an application that actually works?
The SSI site has a form that is not active and I am unable to put in an application at all! It is very frustrating attempting to get decent help online

Please see this page :
http://ssa-custhelp.ssa.gov/cgi-bin/ssa.cfg/php/enduser/std_adp.php?p_fa...

Here are a couple excerpts from that page :

  • If you are already getting Social Security benefits, you'll automatically be enrolled in Medicare Parts A and B.
  • If you are not already getting benefits when you turn 65, you should call 1-800-772-1213 three months prior to your birthday so we can help you decide if you should sign up for Medicare.

i AM 69YEARS OLD AND STILL WORKING. I am enrolled to medicare a automatically but not medicre b. I like to enroll medicare b now and still working. What is the proper procedure?

Excerpt from http://www.ssa.gov/pubs/10043.html

If you do not enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a "general enrollment period" from January 1 through March 31. Your coverage begins the following July. However, your monthly premium increases 10 percent for each 12-month period you were eligible for, but did not enroll in, Medicare Part B.

I am disable with a heart attack 6by pass and now cancer I just found out that when I went to get my cancer pills I have no Ins. They never contacted me to let me know that they made a mistake and I should of never had coveage for the last year. So now what do I do am I able to get Medicare A B C and D how does this all work or do I have to go with out Ins. Can someone please help me.

Need to know if I can get medicare at age 64 if I was just diagnosed
with Stage 4 cancer and unable to work. I had retired one year ago
and have cobra through my old job but this ends 5 months before
turning 65 years old. Can someone please help me?

This may be possible, but please contact the SSA directly.

If you aren't yet 65, you might also qualify for Medicare coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

Your cancer may be deemed to be a disability. Moreover, if you are judged to qualify for disability under the "Compassionate Allowances Conditions", you may be judged to be disabled in an accelerated manner.

http://www.medicare.gov/MedicareEligibility/home.asp

http://www.ssa.gov/compassionateallowances/conditions.htm

Bless you.

I am 69 years old and work full time for a large company. I plan to continue working for another 4-5yrs. I have excellent full coverage health benefits through my employer. I was recently advised that even though I am working full time and have benefits, I am still required to sign up for Medicare. Is there any truth to this and if so, what parts (A,B,C,D) am I Required to enroll in while still employed? Do I apply now (September) or wait until Jan?

You should sign up for just Medicare three months before reaching age 65, even if you plan to delay receiving retirement benefits because you are working. Otherwise, your Medicare medical insurance, as well as prescription drug coverage, could be delayed, and you could be charged higher premiums.

Medicare Parts B, C and D are voluntary and generally require payment on your part, so you may want to NOT sign up for them.

http://www.socialsecurity.gov/medicareonly


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