Wise Insurance Logo

Call Us

Medicare Eligibility

Medicare Eligibility

You may have heard about Medicare’s benefits and how it can help you save more on medical costs. Eligibility is not a one-size-fits-all but rather based on individual circumstances. Whatever the case, your ability to sign up for Medicare is just around the corner.

Is There An Age Requirement?

Medicare typically requires applicants to be 65 or over, but you can sign up for Medicare as soon as three months prior to your 65th birthday, during the Initial Enrollment Period (this period lasts until three months after the month of your 65th birthday).

Who Gets Automatic Enrollment?

Eligibility can also be thought of as who can get automatically enrolled in Medicare. Select groups do not have to enroll themselves. This includes those who receive Social Security and Railroad Retirement Board benefits. If you receive either of these, your Medicare card will arrive in the mail within the three months leading up to your 65th birthday.

You’ll be enrolled in Original Medicare (Medicare Part A and Part B together). Medicare Part A covers inpatient costs (hospital and skilled nursing facility stays, for example), while Part B covers outpatient costs (e.g. preventive services, screenings, x-rays, and durable medical equipment).

Is There An Exception To The Age Requirement?

It is possible to get Medicare while under 65. One way to get Medicare while under 65 is if you get disability benefits for 24 months. Like those who receive social security, you’ll automatically be enrolled in Original Medicare.

What Else Can I Be Eligible For?

Because Medicare and its policyholders are so diverse, there are some aspects of it accessible only to those meeting specific guidelines.

For example – not everyone who qualifies for Medicare can get Part A premium-free, just like qualifying for Medicare alone doesn’t guarantee you’ll be able to qualify for a Medicare Special Needs Plan or a Medicare Supplement plan.

Here are those aspects of Medicare and what you need in order to be eligible for them:

  • Premium-free Part A – You have to have been employed in the U.S. long enough to have worked through 40 tax quarters (10 years)
  • Medicare Supplements/Medigap – Join within six months of getting Medicare Part A and Part B; while you may be able to join after six months, the odds are slim
  • Medicare Special Needs Plan – These plans are abbreviated as SNPs, and come in three types – D-SNP, I-SNP, and C-SNP. In order to be eligible, you need to be eligible for both Medicare and Medicaid, live in an institution, and/or have a chronic and disabling condition, respectively

Table of Contents

Still Have Questions?

We strive to educate and empower our clients to make the best decisions for their health insurance coverage.

Still Have Questions?

If you’ve enrolled in Medicare and want to learn more about your coverage, then we’re here to help. Feel free to reach out to us today and we will find a time to talk more about your specific coverage and the ways you can use it.

Let Wise Insurance Help!

If you have any questions about Medicare, please don’t hesitate to reach out to us. Our team of licensed and experienced Medicare agents are well-equipped to help you with your needs or questions.