Medicare Eligibility

Eligibility to enroll in the Medicare (the federal health insurance program) can be based off your age, work history,  and certain disabilities or conditions, like End Stage Renal Disease (ESRD), and you have been a legal resident of the United States for at least 5 years.

There are different eligibility requirements in place for people age 65 and up and people under 65.

If You Have Celebrated Your 65th Birthday

When you are age 65 or Older and you or your spouse worked for 10 years or more and paid Medicare payroll taxes, you are eligible to enroll in Medicare Parts A and B.

If you are already receiving social security disability benefits or regular social security or railroad retirement benefits when you turn 65, you are automatically enrolled in Medicare Insurance Parts A and Part B.

Most people will not pay a premium for Part A coverage but will pay a premium for Part B coverage that is based on your income. Read More about IRMAA Medicare Part B premium and Part D Premium Adjustments.

If You Are Under The Age of 65, You Can be Eligible

Eligibility rules for people under 65 are different than people 65 and up. You may qualify for full Medicare benefits under 65 under the following conditions:

  • You have been receiving (SSDI) Social Security Disability Benefits for 24 months without gaps.
  • You are entitled to receive Railroad Retirement Board (RRB) disability benefits .
  • Individuals with Amyotrophic Lateral Sclerosis (ALS) can also qualify for Medicare immediately after being diagnosed with the condition.
  • If you have End-Stage Renal Disease (ESRD), you may receive Medicare coverage regardless of age or disability status.
  • You need regular dialysis or your have had a kidney transplant.

Alternative Ways to Get Medicare

If you are 65 and older, but do cannot premium free Medicare due to lack of work credits, you may sign up for Medicare by paying a monthly premium for Part A and Part B.

Medicare beneficiaries that meet certain low income standards may be eligible to enroll in a Medicare Savings Program through their state. This would allow them to enroll in Part B without paying a premium.

We are here to help.

The licensed Medicare insurance agents at American Entitlements are well trained in evaluating the differences of each plan and are ready to help you learn more about Medicare. The Agents at American Entitlements can even help you sign up for Medicare and help with Medicare enrollment during your enrollment period.

We will help to find plans that include your medical providers, prescription drugs, and suit your health care needs.

If you are not sure if you are ready to get Medicare benefits at age 65 but would like to get answers to your questions, we are happy to help, obligation free.

Give us a call now at 469-814-0289 or schedule a call with us by visiting our Contact page.

Still have Medicare Questions?

Find out if you need to enroll in Medicare when you are first eligible.

Is a Medicare Advantage Plan (Part C) right for you?

Medicare Part D Coverage does not pay for every prescription. Learn More here.