Medicare Eligibility: Age 65 And Other Ways To Qualify
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You become eligible for Medicare at age 65, or beforehand through a disability or medical condition.
In addition, there are other eligibility restrictions based on citizenship, type of Medicare plan, where you live and your work history.
Remember that income does not affect your eligibility for Medicare. But those who have a low income can be dual-enrolled in both Medicare and Medicaid, which can further reduce your medical expenses.
| Medicare eligibility by age | Medicare eligibility by health condition | |
|---|---|---|
| Main eligibility requirement | ||
| Work history requirements | None for enrollment, but there are requirements to determine if you’re eligible for free Medicare Part A | None for those with a disability who automatically get free Medicare Part A, but those with ESRD have a work requirement |
| Location restrictions | No restriction for Parts A and B, but for other Medcare parts, you’re only eligible for the plans offered in your area | No restriction for Parts A and B, but for other Medcare parts, you’re only eligible for the plans offered in your area |
If you qualify for Medicare by age, your initial enrollment period starts three months before your birthday month and ends three months after your birthday month.
If you don’t qualify for Medicare and still need health insurance, you may be eligible for:
- A health insurance marketplace plan: Plans available to all with discounts based on income
- Medicaid/ CHIP: Health insurance for those with low incomes
Do I Automatically Get Medicare When I Turn 65
Some people automatically get Medicare at age 65, but those numbers have declined as the Medicare and Social Security ages have continued to drift apart.
Most people who automatically get Medicare at age 65 do so because they have been receiving Social Security benefits for at least four months before turning 65. Traditionally, Medicare premiums are deducted from your Social Security check. For the longest time, you could retire with full Social Security benefits at 65 and start on Medicare at the same time.
You are still automatically enrolled in Medicare Part A and Part B at 65 if youre drawing Social Security, but not as many people draw Social Security that early these days because of changes to the eligibility age for full Social Security benefits.
In 2000, the Social Security Amendments of 1983 began pushing back the standard age for full Social Security benefits. The progressive changes are nearing their conclusion: Beginning in 2022, the standard age for full benefits will be 67 for anyone born after 1960.
Besides the Medicare eligibility age of 65, what remains unchanged is that you can opt to begin drawing partial Social Security benefits as early as age 62. So, if you opt for accepting partial Social Security benefits before age 65, you are automatically enrolled in Medicare.
A smaller group of people also automatically get Medicare at age 65: people who receive Railroad Board benefits for at least four months before 65.
Medicare Eligibility At Age 65
- You are at least 65 years old
- You are a U.S. citizen or a legal resident for at least five years
In order to receive premium-free Part A of Medicare, you must meet both of the above requirements and qualify for full Social Security or Railroad Retirement Board benefits, which requires working and paying Social Security taxes for at least 10 full years .
Learn more about Medicare eligibility at and before age 65 by referring to this helpful chart and reading more information below.
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In General It’s 65 But You Might Be Eligible Sooner
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When you think of Medicare, you probably assume that its for people of retirement age. Thats true, but the program covers more than just those who have worked all their life. You might be eligible right now and not know it. While most beneficiaries are people aged 65 or older, others receive these services at a younger age due to a qualifying disability.
Can I Get Medicare If I Never Worked
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.3
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 valid Medicare enrollment period. You will not be able to purchase Part A alone.
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Monthly Medicare Premiums For 2022
The standard Part B premium for 2022 is $170.10. If youre single and filed an individual tax return, or married and filed a joint tax return, the following chart applies to you:
| Modified Adjusted Gross Income | Part B monthly premium amount | Prescription drug coverage monthly premium amount |
|---|---|---|
| Individuals with a MAGI of less than or equal to $91,000 Married couples with a MAGI of $182,000 or less | 2022 standard premium = $170.10 |
| Your plan premium + $77.90 |
Top 5 Things You Need To Know About Medicare Enrollment
1. People are eligible for Medicare for different reasons.
Some are eligible when they turn 65. People under 65 are eligible if they have received Social Security Disability Insurance or certain Railroad Retirement Board disability benefits for at least 24 months. If they have amyotrophic lateral sclerosis , theres no waiting period for Medicare. Some people with End Stage Renal Disease may be eligible for Medicare. Its important to know the different ways that people qualify for Medicare so you can help current and former employees and their dependents anticipate their eligibility for Medicare so they can make timely and appropriate decisions about their enrollment.
2. Some people get Medicare Part A and Part B automatically and some people need to sign up for them.
People living in the United States and U.S. Territories who are already collecting Social Securityeither disability or retirementare automatically enrolled into Part A and Part B when theyre first eligible. These people will get a packet of information a few months before they turn 65 or receive their 25th month of Social Security Disability or Railroad Retirement Board benefits. At that time, they can choose to keep or decline Part B, but cant decline Part A unless they withdraw their original application for Social Security and pay back all Social Security cash benefits.
3. Enrolling in Medicare can only happen at certain times.
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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.
Check Out Our Recent Facebook Live About This Very Topic
I interviewed my mom, Sharon Slovak, who two years ago retired after 30 years in the classroom. After teaching grades from kindergarten through 12th grade English, she found her niche in upper elementary and spent 24 years teaching 4th 6th grades. Read on for 10 surprising and enlightening items about teacher retirement.
1. August/September will always feel like the beginning of the year.
Even if you do not have a classroom to ready or a seating chart to prepare, Labor Day weekend will always be your time for personal resolutions and a fresh start.
2. You will love having the entire calendar year to make plans.
After years of traveling only during winter, spring and summer breaks, you will love the freedom of 52 whole weeks in which to visit new places and old friends.
3. You will still find yourself obsessed with school supply sales.
You will not be able to help yourself from pawing through the racks and bins of supplies on sale. However, you will be able to skip the worries of not locating 35 identical copies of your favorite finds.
4. You will miss creating new learning units.
My mother says that she was surprised to realize how much she misses mapping new themes for a class. She did not foresee how much nostalgia she would feel for research, choosing books and artwork, and locating artifacts.
5. You will miss introducing new authors to students.
6. You will not miss bells.
7.Looking back, the years you had to switch grades ended up being awesome.
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What If You Still Work
You can work and receive Medicare disability benefits for a transition period under Social Security’s work incentives and Ticket to Work programs.
There are three timeframes to understand. The first, the trial work period, is a nine-month period during which you can test your ability to work and still receive full benefits. The nine months don’t have to be consecutive. The trial period continues until you have worked for nine months within a 60-month period.
Once those nine months are used up, you move into the next time framethe extended period of eligibility. For the next 36 months, you can still receive benefits in any month you aren’t earning “substantial gainful activity.”
Finally, you can still receive free Medicare Part A benefits and pay the premium for Part B for at least 93 months after the nine-month trial periodif you still qualify as disabled. If you want to continue receiving Part B benefits, you have to request them in writing.
If you’re disabled, you may incur extra expenses that those without disabilities do not. Expenses such as paid transportation to work, mental health counseling, prescription drugs, and other qualified expenses might be deducted from your monthly income before the determination of benefits, which mayallow you to earn more and still qualify for benefits.
Make Your Decisions Independently
Collecting Social Security is by no means a prerequisite to getting Medicare. In fact, its often advisable to sign up for Medicare as soon as youre eligible but wait on Social Security to avoid a reduction in benefits, or boost them as much as possible.
The only downside to signing up for Medicare alone is having to make your premium payments directly, as opposed to having them deducted from your Social Security benefits, but its a small price to pay for the upside of a higher lifetime income stream.
Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.
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Who Is Eligible For Medicare Advantage Plans
Youll automatically qualify for Medicare Advantage once you qualify for Part A and Part B coverage. Advantage plans are sold by private companies and are designed to cover some of the out-of-pocket costs Original Medicare does not cover.
4 Medicare Advantage Eligibility Requirements
While regular Medicare Advantage does not cover ESRD, you may qualify for a Medicare Special Needs Plan . SNPs are special types of Advantage plans specifically designed for a particular condition or financial situation.
You can keep your Medicare Advantage plan if you purchased it before developing ESRD. You can also buy an Advantage plan after being medically determined to no longer have ESRD usually from a successful kidney transplant.
Don’t Leave Your Health to Chance
Can I Get Medicare Early If I Retire Early
If you retire earlier than age 65, you will not be eligible for Medicare. Although Medicare is often thought of as insurance for retired people, the Medicare age requirement is still 65. Some people continue to work past age 65 and have insurance coverage through their employer. Many people retire before they turn 65 and must purchase health insurance or are covered on their spouses insurance plan. Although you may be eligible for social security retirement benefits if you retire early, it does not change your age requirement for Medicare health insurance coverage.
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If I Enroll Earlier Than Age 65 Is My Medicare Coverage Reduced
You donât have to worry about this, because you canât enroll in Medicare before youâre eligible.
If you qualify for Medicare before age 65 due to disability:
- You can get full Original Medicare benefits.
- If you want to buy a Medicare Supplement insurance plan , some states will let you do this and others wonât. You can check with your stateâs State Health Insurance Assistance Program agency to find out if you can get a Medicare Supplement insurance plan if youâre disabled and not yet 65.
Reaching Age 62 Can Affect Your Spouse’s Medicare Premiums
Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.
When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they havent yet qualified based on their own work history.
- For example, Gerald is 65 years old, but he doesnt qualify for premium-free Part A because he did not work the minimum number of years required for eligibility. He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.
- Lets say Geralds wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.
In the above example, Jessica has not become eligible for Medicare by turning 62. Her husband Gerald, however, is now eligible to receive his Medicare Part A benefits without paying a monthly premium any longer.
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Can A 62 Year Old Get Medicaid
Yes. Medicaid qualification is based on income, not age. While Medicaid eligibility differs from one state to another, it is typically available to people of lower incomes and resources including pregnant women, the disabled, the elderly and children.
Learn more about the difference between Medicare and Medicaid.
Requalifying For Medicare At 65
If you become eligible for Medicare before you turn 65 due to disability or one of the above diagnoses, youll requalify again when you reach age 65. When you do, youll have another Initial Enrollment Period and all the benefits of a newly eligible Medicare recipient, such as a Medicare Supplement Enrollment Period.
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To Transfer Your Existing Direct Deposit Of Your Retirement Or Survivor Benefit
- to another bank or to another account within the same bank, complete and return a new Direct Deposit Authorization form. Please note: You should not close your old account until the first deposit has been made to your new bank or you receive a retirement check at home. The process of changing your direct deposit from one account to another takes approximately two months to complete. Occasionally, before the changeover is completed, one check may be mailed to the address shown on the Direct Deposit Authorization form.
If the new account is a checking account, please attach a voided check to your correspondence.
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How Do People Under Age 65 With Disabilities Qualify For Medicare
People under age 65 become eligible for Medicare if they have received SSDI payments for 24 months. Because people are required to wait five months before receiving disability benefits, SSDI recipients must wait a total of 29 months before their Medicare coverage begins. People under age 65 who are diagnosed with end-stage renal disease or amyotrophic lateral sclerosis automatically qualify for Medicare upon diagnosis without a waiting period.5 Of those who were receiving SSDI in 2014, 34% qualified due to mental disorders, 28% due to diseases of the musculoskeletal system and connective tissue, 4% due to injuries, 3% due to cancer, and 30% due to other diseases and conditions.6
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Medicare Eligibility Due To Specific Illnesses
In addition to the above ways to qualify for Medicare health insurance, you may also be eligible if you have one of the following diseases:
- End-stage renal disease. To qualify, you must need regular dialysis or a kidney transplant, and your coverage can begin shortly after your first dialysis treatment. If you receive a transplant and no longer require dialysis, youll lose Medicare eligibility.
- Amyotrophic lateral sclerosis. Also known as Lou Gehrigs Disease, patients diagnosed with this terminal disease gain immediate Medicare eligibility.