Medicare Eligibility

Who is eligible for Medicare anyway? Medicare eligibility begins for most people at age 65. Individuals who have been entitled to Social Security disability for at least 24 months also qualify.

Many people confuse their Medicare Eligibility date with their Social Security date. They are different. A person can apply for full retirement income benefits at age 66. However, this does not affect the age at which they qualify for Medicare. Everyone who has worked at least 40 quarters (10 years) in the United States during their lifetime can qualify for Medicare at age 65.

Eligibility for Medicare Part A
medicare eligibility
Medicare Eligibility begins at age 65 for most people.

You are eligible for Medicare Part A at age 65 if you or your spouse has legally worked for at least 10 years in the U.S. During those years, you paid taxes toward your Part A hospital benefits. This is why most Americans pay no Part A premiums when they become eligible for Medicare. Part A mainly covers your hospital stays.

If you have not worked the required 10 years, Part A may be available for you to purchase. Contact Social Security to find out the cost. If you must purchase Part A, the coverage will cost over $400/monthly. In some cases, however, there are partial premiums for people who have worked over 30 but less than 40 quarters.

Eligibility for Medicare Part B
You are eligible for Medicare Part B at age 65 as well. However, you must pay a monthly premium for Part B. This provides for your outpatient benefits such as doctor visits, labwork, surgery fees, and more. Check out our Part B page for more on what Part B covers.

Some people turning 65 still health insurance through an employer. They can delay their enrollment into Part B in favor of their group health insurance without fearing a late penalty.

If you delay enrollment into Part B, consult with an insurance agent who specializes in Medicare. He or she can explain the special election periods which you must use later on so that you won’t be subject to a late enrollment penalty.

Eligibility for Medicare Part C
Medicare Part C is another name for the Medicare Advantage program. You can enroll in Part C if you wish to get your benefits through a private insurance company instead of Original Medicare. Usually these plans have smaller networks than Medicare, but some of them include built-in Part D coverage.

To be eligible for Part C, you must first be enrolled in both Medicare Parts A and B. You must also live in the plan’s service area.

Many people think that if they enroll in a Medicare Advantage plan, they can drop their Part B and escape paying Part B premiums. This is NOT the case. You must have both A and B to even be eligible to enroll in either a Medicare Advantage plan or Medigap plan. You must continue to be enrolled in Parts A and B during the entire time that you are enrolled in a Medicare Advantage plan.

Learn more about Part C Advantage plans here.

Eligibility for Medicare Part D
You are eligible for Medicare Part D as long as you are actively enrolled in either Part A and/or B. You must also live in the Part D plans’s service area. Though Medicare Part D is voluntary, we strongly recommend it if you have no other drug coverage. Part D provides your insurance against future catastrophic medication costs. It will also help give you lower copays on medications you take now.

Find out about your Medicare Eligibility
Determining your Medicare eligibility is sometimes tricky. We get many questions about how to qualify, when to enroll in Medicare, and how to set up Medicare supplement insurance. Though the process may seem overwhelming to you, our experts deal with these processes every day. We can guide you easily through the process.