How Old to Get Medicare
Medicare eligibility age and options:
- Age 65 or older
- Younger with disability
- End-stage renal disease
- Lou Gehrig's disease
- Special circumstances
- Part A: free
- Part B: monthly premium
- Part D: prescription drug coverage
To learn more, visit the Medicare website or call 1-800-MEDICARE.
``````Age 65 or older
Most people become eligible for Medicare at age 65.
- Automatic enrollment:
If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare Parts A and B. If you are not receiving Social Security benefits, you will need to sign up for Medicare during the Initial Enrollment Period (IEP). The IEP begins three months before the month you turn 65 and ends three months after the month you turn 65. You can also enroll during the General Enrollment Period (GEP), which runs from January 1 to March 31 each year.
- Late enrollment penalty:
If you do not enroll in Medicare Part B during your IEP or GEP, you may have to pay a late enrollment penalty. The penalty is 10% of the Part B premium for each 12-month period that you were eligible for Part B but did not enroll.
- Medicare Advantage:
You can choose to receive your Medicare benefits through a Medicare Advantage plan, also known as Part C. Medicare Advantage plans are offered by private insurance companies and may offer additional benefits, such as prescription drug coverage.
- Extra Help:
If you have limited income and resources, you may be eligible for Extra Help from Medicare. Extra Help can help you pay for your Medicare Part D prescription drug coverage.
To learn more about Medicare eligibility and enrollment, visit the Medicare website or call 1-800-MEDICARE.
``````Younger with disability
If you are under age 65 and have a disability, you may be eligible for Medicare. To qualify, you must have a disability that is expected to last at least 12 months or result in death. You must also meet one of the following criteria:
You are receiving Social Security disability benefits.
You are receiving Supplemental Security Income (SSI) benefits.
You have been diagnosed with end-stage renal disease (ESRD) and are receiving dialysis or a kidney transplant.
You have Lou Gehrig's disease (amyotrophic lateral sclerosis, or ALS).
If you meet one of these criteria, you can apply for Medicare at any time. You do not have to wait for an Initial Enrollment Period or General Enrollment Period.
Once you are approved for Medicare, you will be automatically enrolled in Part A and Part B. You can also choose to enroll in a Medicare Advantage plan or a Medicare Part D prescription drug plan.
To learn more about Medicare eligibility for people with disabilities, visit the Medicare website or call 1-800-MEDICARE.
``````End-stage renal disease
If you have end-stage renal disease (ESRD), you are eligible for Medicare regardless of your age.
- Medicare Part A:
Part A covers hospital care, skilled nursing facility care, hospice care, and home health care.
- Medicare Part B:
Part B covers medically necessary services, such as doctor visits, outpatient hospital care, and durable medical equipment.
- Medicare Part D:
Part D covers prescription drug coverage.
- Medicare Advantage:
You can choose to receive your Medicare benefits through a Medicare Advantage plan, also known as Part C. Medicare Advantage plans are offered by private insurance companies and may offer additional benefits, such as prescription drug coverage.
To learn more about Medicare coverage for people with ESRD, visit the Medicare website or call 1-800-MEDICARE.
``````Lou Gehrig's disease
If you have Lou Gehrig's disease (amyotrophic lateral sclerosis, or ALS), you are eligible for Medicare regardless of your age.
- Medicare Part A:
Part A covers hospital care, skilled nursing facility care, hospice care, and home health care.
- Medicare Part B:
Part B covers medically necessary services, such as doctor visits, outpatient hospital care, and durable medical equipment.
- Medicare Part D:
Part D covers prescription drug coverage.
- Medicare Advantage:
You can choose to receive your Medicare benefits through a Medicare Advantage plan, also known as Part C. Medicare Advantage plans are offered by private insurance companies and may offer additional benefits, such as prescription drug coverage.
To learn more about Medicare coverage for people with ALS, visit the Medicare website or call 1-800-MEDICARE.
``````Special circumstances
In some special circumstances, you may be eligible for Medicare even if you do not meet the age or disability requirements.
- Working past age 65:
If you continue to work past age 65 and your employer does not offer group health insurance, you may be able to delay enrollment in Medicare Part B. However, you must enroll in Part B within eight months of losing your employer-sponsored health insurance.
- Living abroad:
If you are a U.S. citizen or permanent resident living abroad, you may be eligible for Medicare if you meet certain requirements. You must have paid Medicare taxes for at least 10 years and you must be enrolled in a Medicare-approved health plan in the country where you live.
- American Indians and Alaska Natives:
American Indians and Alaska Natives are eligible for Medicare regardless of their age or disability status. They can enroll in Medicare at any time.
- Military service:
If you are a veteran, you may be eligible for Medicare benefits. You may be eligible for Medicare Part A if you served in the military for at least 24 months. You may be eligible for Medicare Part B if you are receiving a military pension or if you have a service-connected disability.
To learn more about Medicare eligibility in special circumstances, visit the Medicare website or call 1-800-MEDICARE.
``````Part A: free
Medicare Part A is free for most people. You do not have to pay a monthly premium for Part A if you are:
- Age 65 or older and receiving Social Security benefits:
If you are age 65 or older and receiving Social Security benefits, you will be automatically enrolled in Medicare Part A. You will not have to pay a monthly premium for Part A.
- Age 65 or older and not receiving Social Security benefits:
If you are age 65 or older and not receiving Social Security benefits, you can still enroll in Medicare Part A. However, you will have to pay a monthly premium for Part A. The premium amount is based on your work history.
- Under age 65 and receiving disability benefits:
If you are under age 65 and receiving Social Security disability benefits, you will be automatically enrolled in Medicare Part A. You will not have to pay a monthly premium for Part A.
- Under age 65 and have end-stage renal disease (ESRD):
If you are under age 65 and have ESRD, you will be automatically enrolled in Medicare Part A. You will not have to pay a monthly premium for Part A.
To learn more about Medicare Part A premiums, visit the Medicare website or call 1-800-MEDICARE.
``````Part B: monthly premium
Medicare Part B has a monthly premium. The standard Part B premium for 2023 is $164.90. However, your premium may be higher if you have a higher income.
- Automatic enrollment:
If you are automatically enrolled in Medicare Part B, your premium will be deducted from your Social Security benefits.
- Voluntary enrollment:
If you voluntarily enroll in Medicare Part B, you will receive a bill from Medicare each month. You can pay your premium online, by mail, or by phone.
- Financial assistance:
If you have limited income and resources, you may be eligible for financial assistance to help pay your Medicare Part B premium. You can apply for financial assistance through the Social Security Administration.
- Late enrollment penalty:
If you do not enroll in Medicare Part B when you are first eligible, you may have to pay a late enrollment penalty. The penalty is 10% of the Part B premium for each 12-month period that you were eligible for Part B but did not enroll.
To learn more about Medicare Part B premiums, visit the Medicare website or call 1-800-MEDICARE.
``````Part D: prescription drug coverage
Medicare Part D is prescription drug coverage. It is available to people who have Medicare Part A and/or Part B. You can choose to get Part D coverage from a stand-alone prescription drug plan (PDP) or a Medicare Advantage plan that includes prescription drug coverage (MAPD).
There are many different PDPs and MAPDs to choose from. Each plan has its own formulary, which is a list of the drugs that the plan covers. The premiums, deductibles, and copays for each plan also vary. You can compare PDPs and MAPDs on the Medicare website or by calling 1-800-MEDICARE.
If you do not enroll in a PDP or MAPD, you will have to pay full price for your prescription drugs. However, you may be eligible for Extra Help from Medicare, which can help you pay for your prescription drug costs.
To learn more about Medicare Part D prescription drug coverage, visit the Medicare website or call 1-800-MEDICARE.
``````FAQ
Have more questions about Medicare eligibility and enrollment? Here are some frequently asked questions (FAQs):
Question 1: How do I know if I'm eligible for Medicare?
Answer: You are eligible for Medicare if you are:
- Age 65 or older
- Under age 65 and have a disability
- Under age 65 and have end-stage renal disease (ESRD)
- Under age 65 and have Lou Gehrig's disease (ALS)
Question 2: How do I enroll in Medicare?
Answer: You can enroll in Medicare online, by phone, or by mail. The easiest way to enroll is online at the Medicare website. You can also call 1-800-MEDICARE (1-800-633-4227) or visit your local Social Security office.
Question 3: What is the Medicare Part B premium?
Answer: The standard Part B premium for 2023 is $164.90. However, your premium may be higher if you have a higher income.
Question 4: What is Part D prescription drug coverage?
Answer: Medicare Part D is prescription drug coverage. It is available to people who have Medicare Part A and/or Part B. You can choose to get Part D coverage from a stand-alone prescription drug plan (PDP) or a Medicare Advantage plan that includes prescription drug coverage (MAPD).
Question 5: How do I compare Medicare plans?
Answer: You can compare Medicare plans on the Medicare website or by calling 1-800-MEDICARE. You can compare plans by premium, deductible, copay, and formulary (list of covered drugs).
Question 6: What is the Medicare Extra Help program?
Answer: The Medicare Extra Help program is a federal program that helps people with limited income and resources pay for their Medicare prescription drug costs.
Question 7: How do I apply for the Medicare Extra Help program?
Answer: You can apply for the Medicare Extra Help program online, by phone, or by mail. The easiest way to apply is online at the Social Security website.
Closing Paragraph for FAQ: These are just a few of the most frequently asked questions about Medicare eligibility and enrollment. For more information, visit the Medicare website or call 1-800-MEDICARE.
``````Tips
Here are a few tips to help you navigate the Medicare system:
Tip 1: Create a MyMedicare.gov account.
A MyMedicare.gov account is a secure online portal that allows you to manage your Medicare benefits and information. You can use your MyMedicare.gov account to:
- View your Medicare coverage and benefits
- Enroll in a Medicare plan
- Compare Medicare plans
- Get help with Medicare costs
Tip 2: Shop around for Medicare plans.
There are many different Medicare plans to choose from. It is important to shop around and compare plans before you enroll. You can compare plans by premium, deductible, copay, and formulary (list of covered drugs).
Tip 3: Take advantage of Medicare's free preventive services.
Medicare covers a wide range of preventive services, such as mammograms, colonoscopies, and flu shots. These services are free to you if you get them from a Medicare-approved provider.
Tip 4: Ask for help if you need it.
If you have questions about Medicare or need help enrolling in a plan, don't hesitate to ask for help. You can call 1-800-MEDICARE (1-800-633-4227) or visit your local Social Security office.
Closing Paragraph for Tips: By following these tips, you can make the most of your Medicare benefits and get the care you need.
``````Conclusion
Medicare is a health insurance program for people age 65 and older, people with disabilities, and people with end-stage renal disease. Medicare is a complex program, but it is important to understand your eligibility and enrollment options so that you can get the coverage you need.
The main points to remember about Medicare eligibility and enrollment are:
- You are eligible for Medicare if you are age 65 or older, have a disability, or have end-stage renal disease.
- You can enroll in Medicare online, by phone, or by mail.
- There are two main parts of Medicare: Part A (hospital insurance) and Part B (medical insurance).
- You can choose to get your Medicare benefits through Original Medicare or a Medicare Advantage plan.
- Medicare Part D is prescription drug coverage. You can get Part D coverage from a stand-alone prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage.
Closing Message: If you have questions about Medicare, visit the Medicare website or call 1-800-MEDICARE. You can also get help from a Medicare counselor.
```