What Age Do You Get Medicare Benefits

Medicare Eligibility For People Under 62

There are a few exceptions for Medicare age limits that can allow people younger than 65 and under age 62 to enroll in Medicare.

• If you have ALS , you are immediately eligible for Medicare regardless of your age as soon as your Social Security or Railroad Retirement Board disability benefits begin.
• You may also qualify for Medicare if you have kidney failure that requires dialysis or a kidney transplant, which is known as end-stage renal disease .
• You may also qualify for Medicare at age 62 or any age before 65 if you receive disability benefits from either Social Security or the Railroad Retirement Board for at least 24 months.

If you qualify for Medicare under the age of 65 because of a disability, you might also qualify for a Medicare Advantage Special Needs Plan.

Enrolling Your Newborn Baby

You can enrol your newborn baby by using the Newborn Child Declaration. Youll get the declaration from the hospital. Find out how to enrol your baby.

If youve adopted a child or your child was born overseas, youll need to give us extra documents. Read more about what to do:

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Can I Get Medicare At Age 62

Retirement and Medicare typically go hand in hand. So, if you retire at age 62 are you eligible to enroll in Medicare? Unfortunately, you would not be eligible for Medicare if you retire at age 62. You can typically get Medicare at age 65.

If you retire before age 65, you may be eligible for Social Security benefits at age 62, but that will not allow you to enroll in Medicare coverage. You will need to wait until your Initial Enrollment Period begins three months before your 65th birthday to begin the Medicare enrollment process.

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What Is A Quarter Of Coverage

To calculate a persons eligibility for premium-free Medicare Part A insurance, Medicare counts the number of employment quarters the individual worked.

A quarter of coverage is a 3-month calendar quarter in which a person worked in a job and paid Medicare taxes. Every quarter of coverage earned counts as one credit toward qualifying for free Medicare Part A.

During a quarter of coverage, an employee pays Federal Insurance Contributions Act taxes, which combine withheld taxes for Medicare and Social Security.

On a paycheck, Medicare withholding tax appears as Fed Med/EE. Each year has four quarters. Roughly, 40 quarters equals 10 years of work.

The 40-quarters rule only applies to premium-free Medicare Part A. Other parts of Medicare, including Medicare Part B, involve a monthly premium regardless of how long a person has worked in their lifetime.

How Do Sources Of Supplemental Coverage And Prescription Drug Coverage Differ For Medicare Beneficiaries Under Age 65 With Disabilities And Older Beneficiaries

Supplemental coverage

Most Medicare beneficiaries, including those under age 65 with disabilities, have public or private supplemental insurance to help cover Medicares cost-sharing requirements.9 A much larger share of beneficiaries under age 65 with disabilities than older beneficiaries rely on Medicaid to supplement Medicare because of their relatively low incomes .10 Medicaid helps with Medicare premiums and cost-sharing requirements, and covers services needed by many people with disabilities that are not covered by Medicare, particularly long-term services and supports.

Figure 3: Supplemental Coverage Among Medicare Beneficiaries Under Age 65 Compared to Those Age 65 or Older in 2012

Just over 1 in 5 beneficiaries under age 65 has no supplemental coverage, compared with 12% of those age 65 or older. Lack of supplemental coverage among Medicare beneficiaries is associated with higher rates of access problems, but rates of access problems are higher among younger beneficiaries with disabilities who lack supplemental coverage than among older beneficiaries, including not seeing a doctor for a health problem when they think they should and having trouble getting needed health care .12 Regardless of whether or not they have supplemental coverage, however, a larger share of younger beneficiaries with disabilities than older beneficiaries experience access and cost-related burdens .

Prescription drug coverage

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At What Age Do I Qualify For Social Security

You can begin collecting Social Security retirement benefits as early as age 62. Doing so, however, is often not advisable, since it means lowering your monthly benefits potentially for life.

To collect the full monthly benefit your earnings record entitles you to, you must wait until full retirement age to sign up for Social Security. Depending on your year of birth, that age will fall out somewhere between 66 and 67. For each month you file for Social Security ahead of full retirement age, youll face a reduction in your monthly benefits that will likely remain in effect indefinitely, unless you manage to go through the motions of withdrawing your application soon after filing it.

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How Do Beneficiaries Out

Out-of-pocket spending

Although total Medicare per capita spending is higher for Medicare beneficiaries under age 65 with disabilities than for older beneficiaries, younger beneficiaries in traditional Medicare spend significantly less out of pocket, on average. This is likely due to the fact that a greater share of younger beneficiaries with disabilities than older beneficiaries have Medicaid coverage , as well as Part D Low-Income Subsidies , that help cover their premiums and cost sharing. Overall, out-of-pocket spending by younger beneficiaries with disabilities is 40% less than that of older beneficiaries . Younger beneficiaries have lower average out-of-pocket spending than older beneficiaries for insurance premiums and for medical and long-term care services combined .

On average, in 2012 beneficiaries in traditional Medicare with disabilities spent the largest share of their total non-premium out-of-pocket costs on medical providers , followed by prescription drugs and long-term care facility costs . These services also were the top three in terms of out-of-pocket costs for older beneficiaries, but in a different order: older beneficiaries spent the largest share of their out-of-pocket costs on facility costs , followed by medical providers and prescription drugs .

Access to care and cost-related problems

Figure 6: Selected Measures of Access to Health Care for Medicare Beneficiaries Under Age 65 Compared to Those Age 65 or Older

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Should We Lower The Medicare Eligibility Age To 60

Last year, lawmakers in the House introduced the Improving Medicare Coverage Act in an effort to make healthcare more affordable for older Americans by lowering the age of eligibility for Medicare from 65 to 60. That change was aimed to provide coverage for those who retire early or lack robust coverage from their employer. Today, most individuals become eligible for Medicare benefits at age 65, at which point the program covers the costs of hospital stays and gives individuals the option to pay a premium in return for coverage of visits to doctors offices and other outpatient services as well as prescription drugs . A recent report by the Congressional Budget Office and the staff of the Joint Committee on Taxation examines the implications of lowering the Medicare eligibility age from 65 to 60, finding that such a change would increase the number of people covered by Medicare and, as a result, increase federal deficits.

Can You Get Medicare At Age 62

Some retirees begin collecting Social Security retirement benefits at age 62 and assume that they can also apply for Medicare. However, Medicare isnt available to most people until they turn age 65. Again, although this is the general rule, there are some exceptions, and certain people can apply and qualify for Medicare at age 62.

A second scenario is if a person receives a disability pension from the Railroad Retirement Board and meets other specific criteria. Additionally, if a person has ESRD or ALS, they may get Medicare at 62.

However, if you do not meet these specific requirements, you will have to wait until age 65 to receive your Medicare benefits. The good news is you can begin signing up for Medicare three months before your 65th birthday.

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What Are Employment Quarters For Social Security

The Social Security Administration calls employment quarters by several names, such as quarter of coverage and Social Security credits or simply credits.

How credits for Social Security retirement benefits have been calculated has changed over the years. Today, Social Security credits are based on your total income during the year, and the year is divided into four employment quarters.

The dollar amount needed to earn credits may go up slightly each year, according to the Social Security Administration, as average earnings increase. For more information on the current earnings needed to earn Social Security or Medicare work credit, visit the Social Security website.

There are special rules for certain types of jobs, such as domestic work, farm work, and work for a church or similar organization that does not collect Social Security and Medicare taxes. Employment of this sort may count towards your employment quarters for retirement and Medicare benefits, but you should contact the Social Security Administration to confirm. Conversely, some people may not qualify for Social Security retirement credits, such as federal employees hired before 1984, railroad employees with more than 10 years of service, and employees of some state and local governments. Other factors may be used to determine their eligibility for premium-free Medicare Part A.

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Medicare Advantage Eligibility With A Disability

If you have a disability, you may be eligible for Medicare, including Medicare Advantage. To apply for Medicare with a disability, you must have been unable to work for a year or longer, or have been eligible for Social Security or Railroad Retirement Board benefits for 24 months.

To qualify as a disability, a condition must be severe enough to prevent a person from working, and must be on the Social Security Administration’s list of disabling conditions.

Some examples of potentially eligible disabilities include:

• Chronic respiratory disorders such as cystic fibrosis
• Chronic liver disease
• Hearing loss

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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.

Reaching Age 62 Can Affect Your Spouses 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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Medicare With Als Or Esrd

There are two exceptions to the 2-year waiting period. If you have amyotrophic lateral sclerosis , also known as Lou Gehrigs Disease, youll be enrolled in coverage in the first month you receive SSDI.

If you have end stage renal disease , your Medicare coverage normally begins after youve received 3 months of dialysis treatment.

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How Do Medicare Spending And Use Of Services Differ For Beneficiaries Under Age 65 With Disabilities And Older Beneficiaries

Medicare per capita spending

Average total Medicare spending is higher for traditional Medicare beneficiaries under age 65, mainly due to higher Part D prescription drug spending.13 Medicare per capita spending for beneficiaries younger than age 65 averaged $13,098 in 2014, nearly one third more than average per capita spending for beneficiaries over age 65 .14 Excluding Part D drug spending, the difference narrows considerably to $9,281 for beneficiaries under age 65 and $8,814 for those over age 65, on average. On average, beneficiaries under age 65 have higher per capita spending for drugs covered under Part D and for inpatient and outpatient services, but lower spending on post-acute and hospice care than beneficiaries over age 65 .

Figure 5: Average Medicare Per Capita Spending for Beneficiaries Under Age 65 With Disabilities and Over Age 65, by Type of Service, 2014

Use of medical services

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What Are The Characteristics Of Medicare Beneficiaries Under Age 65 With Disabilities Compared To Beneficiaries Age 65 Or Older

Medicare beneficiaries under age 65 with disabilities differ from beneficiaries age 65 or older in several ways, including their demographic, socioeconomic, and health status profiles.

Income: In 2012, a much larger share of beneficiaries under age 65 with disabilities than older beneficiaries had low annual incomes . Nearly one quarter of younger beneficiaries with disabilities had incomes less than $10,000 per year and two-thirds had incomes less than $20,000 per year, compared to 13% and 39%, respectively, of older beneficiaries.7

Figure 1: Selected Characteristics of Medicare Beneficiaries Under Age 65 Compared to Those Age 65 or Older

Race/ethnicity and gender: A larger share of beneficiaries under age 65 than older beneficiaries are black and Hispanic , and a larger share are male .

Health status: Nearly two-thirds of all younger Medicare beneficiaries had a cognitive or mental impairment in 2012, compared to 29% of older beneficiaries . This includes memory loss that interferes with daily activity, difficulty making decisions, trouble concentrating, and loss of interest within the past year.8 Nearly 6 in 10 reported their health status as fair or poor and almost the same share reported having one or more limitations in their activities of daily living, compared to 20% and 34% of beneficiaries age 65 or older, respectively. But roughly the same share of both younger beneficiaries with disabilities and older beneficiaries report having five or more chronic conditions .

When Your Coverage Starts

The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month.

If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

Part B : Coverage starts based on the month you sign up:

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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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Will I Be Enrolled In Medicare Automatically

You will generally be automatically enrolled in Medicare if:

• Youâre receiving Social Security retirement benefits when you turn 65.
• Youâre younger than 65 and youâve been getting Social Security disability benefits for 24 months. Youâll typically be enrolled in Medicare in the 25th month of getting these benefits.
• Youâre younger than 65 and have amyotrophic lateral sclerosis , also known as Lou Gehrigâs disease. Youâre automatically signed up for Medicare the same month your Social Security disability benefits start

You typically have to sign up for Medicare yourself if:

• Youâre not yet receiving Social Security retirement benefits when you turn 65.
• Youâre under 65 and have end-stage renal disease, a type of kidney failure. You might qualify for Medicare at any age, but you are not signed up automatically.
• You live in Puerto Rico. You may be automatically enrolled in Medicare Part A when you turn 65, but youâll need to sign up for Part B.

You might have to pay a late enrollment penalty if you donât sign up for Medicare when youâre first eligible. Learn more about the late enrollment penalties.

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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.