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Who is eligible for Medicare?
Most people will be eligible for Medicare at age 65. You can qualify for Medicare coverage at age 65 (or older), if you are a U.S citizen, or a permanent resident and you have lived here continuously for 5 years or more. There are certain circumstances when people may be entitled earlier.
Those that are under 65, can also qualify if they meet these criteria:
-You are permanently disabled, and you have been receiving Social Security disability income benefits for 24 months.
-You have end-stage renal disease (ESRD).
-You have ALS (Amyotrophic Lateral Sclerosis or Lou Gehrig’s Disease).
Do not confuse your Medicare eligibility date with your Social Security Full Retirement Age (FRA). There are two separate things. The FRA depends on the year you were born but it does not impact your ability to take Medicare at age 65. You do not have to take Medicare and Social Security at the same time unless you choose too.
Medicare Part A Eligibility
You are entitled to premium-free Part A if you have worked for 40 quarters or more (10 years) and paid in Medicare taxes. Through that tax taken from your wages, you have been paying in so that you will receive Part A at no cost.
If you have not worked for 10 years you are able to purchase Medicare Part A.
Medicare Part B Eligibility
You are eligible at 65 for Part B but will have a premium associated with it. Learn more on our Medicare costs page.
Some people turning 65 will still have health insurance through an employer. If this employer is considered creditable by Medicare standards, they can delay their enrollment into Part B in favor of their group health insurance without fear of a late enrollment penalty. You would have to prove to Social Security that you had creditable coverage for the time that you did not enroll in Part B. Consult your HR Benefits Coordinator at your place of employment to verify if your group coverage is deemed creditable. If it is not creditable then you need to apply for Medicare A and B.
Medicare Part C Eligibility
There are no medical questions on a Medicare Part C, also known as a Medicare Advantage plan. Once you are 65 or qualify for Medicare due to disease or disability you are eligible to enroll in a Medicare Advantage. If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period (SEP), then you must wait until the Annual Enrollment Period to enroll in coverage. It is important not to miss your enrollment windows. Note: If you do not enroll when you are first eligible, into a plan with creditable prescription drug coverage, you will likely be charged a Late Enrollment Penalty.
Medicare Part D Eligibility
You are eligible to select a prescription drug plan during your initial enrollment into Medicare Part A and Part B, or if you qualify for a SEP. You can also enroll anytime during the annual open enrollment period (Oct. 15 to Dec. 7 each year), if you missed your deadlines for IEP or SEP. You cannot get Part D drug coverage outside of specific enrollment periods. Note: If you do not enroll when you are first eligible, into a plan with creditable prescription drug coverage, you will likely be charged a Late Enrollment Penalty.
Medicare Supplement Eligibility
If you are turning 65, you have a 6-month window called the Medicare Supplement Open Enrollment Period. This period begins the 1st day of the month you turn 65 and are enrolled in Medicare Part B. During this period, you can enroll in a Medicare Supplement without the risks of being turned down or charged more due to health conditions. During this window, there are no medical questions asked and you cannot be declined for coverage.
After the time frame expires if you did not select a plan you would have to pass medical underwriting that will evaluate your health conditions before a policy is issued. Insurance can decline you for coverage at this time if they do not wish to insure you.
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The information presented on this website is for informational or illustrative purposes only. Safeguard Insurance is operated by licensed insurance agents who can help you enroll in an insurance policy. Safeguard Insurance, and any agents or employees, are not affiliated with or endorsed by the United States government, Medicare, or the Social Security Administration. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options. When you request to be contacted about Medicare Advantage, Medicare Part D, or Medicare Supplement plans, you acknowledge that a licensed insurance agent may contact you by phone, email, mail, or in-person to offer additional assistance or to discuss all your Medicare health insurance options.
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