Medicare Eligibility: When Can I Enroll?

Medicare has specific eligibility requirements that must be met before you can enroll in a plan for coverage. Eligibility can be triggered by age, health condition, retirement, and other life situations. It’s good to plan in advance for your enrollment period and understand when, where, and why you may become eligible for Medicare coverage.

According to Medicare.gov, you qualify for full Medicare benefits if:

  • You are 65 or older; and
  • You are a permanent legal resident who has lived in the United States at least five years or are a US Citizen; and
  • You (or your spouse) are eligible for Social Security or Railroad Retirement Board benefits; or
  • You (or your spouse) are a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working.

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Health Conditions and Disabilities that Impact Eligibility

While Medicare eligibility is generally triggered by age, there are some health conditions that enable you to qualify for Medicare enrollment under age 65. These situations include:

  • You’ve received Social Security disability benefits for at least 24 consecutive (or non-consecutive) months; or
  • You receive a disability pension from the Railroad Retirement Board and meet certain conditions; or
  • You have Lou Gehrig’s disease; or
  • You have permanent kidney failure that requires regular dialysis or a kidney transplant (this usually is contingent upon a certain number of Social Security payments)

What Do I Have To Do?

Many seniors think that they are automatically enrolled in Medicare when they turn 65—but this is not the case! There are some ways in which you automatically receive your Medicare card, such as when you are already receiving Social Security benefits.

Most people need to manually enroll in Medicare during their individual election period (IEP). Your personal enrollment period typically begins three months prior to your 65th birthday, the month of your 65th birthday, and the three months following your birthday. That seven-month window is when you need to take action! You can check your eligibility status at www.Medicare.gov.

What Can I Do Now?

There are other important conditions and situations that open the door for Medicare enrollment prior to the age of 65. Schedule a consultation with us to better understand if you are currently eligible for Medicare enrollment or you think you may be eligible soon. We can help you understand your option, select a plan that works for you, and we will walk you through the enrollment process.

Categories:

  • Medicare
  • Eligibility
  • Enrollment

happy elderly couple with two grandchildren