Medicare Eligibility: Are You Eligible?

The average hospital stay in the USA can cost almost $4,000 per day, so everyone can do with a little help in the event they need advanced medical care. 

Fortunately, in the US, the federal government has made provisions to help out those of us who are more prone to serious health issues. Almost everyone in the USA is eligible for affordable Medicare health benefits once they reach their 65th birthday.

Read on to find out more about Medicare eligibility and if you’re one of the rare exclusions.

Medicare Eligibility Requirements

The essential requirement for eligibility for Medicare Part A and B is U.S. citizenship or permanent legal residency for at least 5 years.

Next, you need to be 65 years old and eligible for social security. In this case, you’ll receive automatic enrolment in Medicare Part A. 

If you’re already getting benefits from social security or the Railroad Retirement Board, you get automatic enrolment in Part A and B on the first day of the month you turn 65. 

If you’re still working and not receiving any retirement benefits, you must sign up for Part B within two months of your 65th birthday. 

Free Medicare vs Medicare With Monthly Premiums

Most people pay Medicare taxes throughout their careers and receive free Medicare Part A and B coverage once they turn 65. If you haven’t paid these taxes for at least 10 years you’ll need to pay monthly premiums for these benefits.

The current monthly cost for Part A is $458 and Part B costs $144.60 per month. 

Private insurers offer Medicare Parts C and D to people already enrolled in Medicare Parts A and B. You can find out more about these optional insurances on websites like Medicare.gov, medicarewire.com, or medicareadvantage.com. 

Medicare Eligibility for People Under 65

There’s a degree of flexibility when it comes to the Medicare eligibility age. Some people under the ages of 65 do qualify for Medicare if they suffer from certain conditions.

Regardless of your age, you could be eligible for Medicare if you meet the following criteria:

You Receive Social Security Disability Insurance

If you qualify for SSDI checks, you’ll receive automatic enrollment for Medicare the month after you get your 24th check.

This two-year waiting period doesn’t apply to people with Amyotrophic Lateral Sclerosis. You’re enrolled in Medicare as soon as you’re diagnosed with this condition. 

You Have End-Stage Renal Disease

If you are under 65, diagnosed with ESRD, and receive dialysis, you could qualify for Medicare benefits depending on your circumstances.

These include when you apply for Medicare, where you get your dialysis, and whether you get a kidney transplant. Those eligible for ESRD Medicare can enroll in Part A and B at any time.

Medicare part A eligibility is retroactive for up to 12 months or until the time you began your treatment for ESRD.

Take Care of Your Health

Medicare eligibility doesn’t mean that you’re covered for all medical eventualities. The best way to avoid expensive medical bills is to ensure you stay as fit and healthy as possible. 

Pay attention to your diet, exercise regularly, and get enough rest and you’re already on the right track towards healthy senior years. 

Keep browsing our blog for more information on the most common health-related topics and advice on where to find help when you need it. 

katy petter

Passionate health content writer dedicated to simplifying complex medical topics and promoting wellness. With expertise in nutrition, fitness, and medical breakthroughs, I create informative and engaging content to empower readers in their journey to better health. Let's inspire a healthier world together.

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