Age Eligibility for Medicare
The eligibility age for Medicare is sometimes confused with the Social Security eligibility age. the latter having changed in recent years. The Medicare eligibility age is generally 65, although some people may be able to enroll earlier. Following is more detailed information about Medicare eligibility.
If you are 65 or over. you qualify for Medicare if:
- You are a U.S. citizen or permanent legal resident.
- You and/or your spouse have worked long enough to earn Social Security benefits or railroad retirement benefits (usually 10 years or more, earning at least 40 hours of work credits ).
- You or your spouse is a government employee or retired government employee who has paid Medicare payroll taxes while working (even if you haven’t paid into Social Security).
- You are at least age 65 and your spouse is at least age 62 and qualifies for Medicare based on his/her work record. Note that you may also qualify based on the work record of a deceased spouse.
If you are under 65. you may qualify if:
- You have permanent renal (kidney) failure, and you require regular dialysis or a kidney transplant. To qualify under this condition you or your spouse must have paid Social Security taxes for a certain amount of time, depending on your age.
- You have Lou Gehrig’s disease, which automatically qualifies you for Medicare.
- You receive disability benefits from the Railroad Retirement board (must meet certain conditions).
- You have been entitled to Social Security Benefits for at least 24 (consecutive or non-consecutive) months.
If you don’t qualify based on your work record or your spouse’s work record:
- You can still get Medicare if you are 65 or older and are a U.S. citizen, or have been a legal
resident for at least 5 years, but you must pay for Original Medicare Part A (hospital) coverage.
- If you have fewer than 30 work credits, you’ll pay the maximum premium amount of $426 per month for Part A. If you have 30-39 credits you’ll pay $234 per month. Beyond 40 work credits you will no longer have to pay a premium for Part A.
- You don’t have to enroll in part A to get Part B (Part B covers doctor visit and outpatient services).
Nearly all Medicare enrollees pay a premium for Part B, which for most people is $104. Those with annual incomes of $85,000 or higher will pay more. Most people must also pay for prescription drug coverage (Part D). You must be enrolled in either Part A or B to enroll in Part D.
Medicare Advantage Plans (Part C)
Medicare Advantage plans can be purchased/selected in addition to Original Medicare (Parts A and B), and become primary to Original Medicare. Advantage plans are required to cover everything that Original Medicare covers, with the exception of hospice care, which is covered by Original Medicare even if you are in a Medicare Advantage Plan.
Those who are eligible for Medicare can choose a Medicare Advantage plan when they first become eligible, or during any open enrollment thereafter.
Additionally, Medicare supplement (Medigap) plans can be purchased to help cover copayments, deductibles, and coinsurance amounts that aren’t covered by Original Medicare.
Get Help Enrolling in Medicare
Navigating the world of Medicare can feel confusing and overwhelming. Call the experts at CA Medicare to help you understand your Medicare options and find a plan that is right for you. Medicare open enrollment is happening now, through December 15, 2014.
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