Who Qualifies for Medicare

Who Qualifies for Medicare? Learn who qualifies and what the limitations are for Medicare eligibility.

A person qualifies for Medicare through any one of the following conditions:

  • Upon reaching 65 years of age, and a citizen of the United States or legal resident for 5 years (continuous), and them or there spouse has paid Medicare taxes for a minimum of 10 years.
  • For individuals under 65 years old and disabled, and receiving Social Security or Railroad Retirement Board disability benefits for a minimum of 24 months from the date of first receiving disability payments.
  • Receive continuing dialysis for kidney disease (progressive loss of renal function) or are in need of a kidney transplant as a result of a gradual progressive loss of kidney function over months or years.
  • Receive Social Security Disability Insurance as a result of being unable to work because of a disability and have Lou Gehrig's disease (ALS).

The 2 year exclusion for disabled individuals means they must wait 2 years before receiving Medicare insurance coverage unless they meet the conditions above or qualify for Medicaid.

If an individual meets the conditions above, they do not have to pay a premium for Part A Medicare. However if coverage under Part B does require payment of a premium.

Eligible Age
Although full retirement age for Social Security is currently 67, eligibility for who qualifies for Medicare still remains age 65. So a person can qualify for Medicare when not yet eligible for Social Security. You do have to meet the requirement of paying Social Security taxes for a minimum of 10 years or be eligible on your spouse's (or former spouse's) earnings. Even if a person doesn't meet those requirements, Part A Medicare coverage can still be obtained by paying the monthly premium for U.S. citizens or qualified aliens who have legally resided in the U.S. for at least 5 years.

Anyone who is a U.S. citizen or lawful alien (with 5 years of United States residency) and age 65 can apply for Medicare Part B - but must pay the monthly premium.

Part B enrollment can begin during the 7-month period beginning 3 months before age 65. If a person is eligible and decides not to enroll in Part B, but changes their mind later, they can enroll during the annual General Enrollment Period between January 1 through March 31.

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