(800) 439-6916 FIND AN AGENT Text Size Home Insurance Resources How You Save Shop Online Medicare Eligibility: The Basics Do you know how to become eligible for Medicare? More than 18 percent of Americans depend on Medicare for their health coverage, and in 2018 Medicare enrollment nearly reached 60 million. Here’s a straightforward guide to Medicare eligibility and links to specific information for your state. Medicare Eligibility for People 65 or Older When Can I Start Receiving Medicare Part A Benefits? You can start receiving Medicare Part A (hospital insurance) benefits with no premium once you are 65 or older if you or your spouse worked and paid Medicare taxes for at least 10 years. You can know you are eligible for premium-free Medicare A if one of the following applies to you: You currently receive or are eligible for Social Security. You currently receive or are eligible for Railroad Retirement Board (RRB) benefits. You or your spouse served in a Medicare-covered government job. If you received Social Security or RRB benefits at least four months prior to turning 65, you will receive Medicare Part A automatically. If not, you need to file an application with the Social Security Administration. When Can I Start Receiving Medicare Part B Benefits? You can choose to purchase Medicare Part B benefits if you are eligible for Medicare Part A. It is a voluntary program that requires you to pay monthly premiums. For 2020, the standard premium is $144.60 (or higher depending on income). If you do not enroll in Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Part B coverage. If you received Social Security or RRB benefits at least four months prior to turning 65, you will receive Part B automatically (unless you live in Puerto Rico). You will have a choice if you want to keep or refuse enrollment. If you refuse, you can re-enroll during a valid enrollment period, but you will have to pay a late enrollment penalty for as long as you have the coverage. Can I Get Medicare If I Never Worked? Yes, you can get Medicare if you never worked, but you’ll need to pay a premium for Medicare Part A. If you are a U.S. citizen over 65 and you or your spouse did not pay Medicare taxes for at least 10 years, you may be eligible to purchase Medicare Part A health insurance. In 2020, seniors who did not receive premium-free Part A coverage paid $458 per month if they paid Medicare taxes for less than 30 quarters (7 ½ years); those who paid Medicare taxes for 30 to 39 quarters pay $252 per month. You will not be enrolled automatically, so you need to file an application with the Social Security Administration. You can then enroll in Medicare Part A and Part B for a monthly premium during a valid Medicare enrollment period. You will not be able to purchase Part A alone. Medicare Eligibility for People Under 65 You are eligible for Medicare when you are under 65 years old if you: Have received Social Security Disability Insurance (SSDI) for 24 months. Have end-stage renal disease (ESRD). Have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. How to Get Medicare Part A and Part B Coverage If you receive SSDI for 24 months, you will automatically be enrolled in Medicare Parts A and B at the beginning of the 25th month. If you have ALS, you will automatically be enrolled in Medicare Parts A and B as soon as you receive the first month of SSDI benefits. If you have ESRD, you must apply for Medicare benefits. Medicare eligibility depends on a variety of factors, including whether or not you are receiving dialysis, have had a kidney transplant, and/or have paid Medicare taxes sufficiently. Private Insurance Options: Medicare Part C and Part D Medicare Eligibility for Part C (Medicare Advantage) You are eligible for Medicare Advantage (also known as Medicare Part C) if: You are enrolled in Medicare Part A and Part B. The plan you want to join is available in your area. You do not have end-stage renal disease (ESRD). Medicare Advantage plans are run by private insurance companies, so premiums and coverage will vary by plan. Medicare Eligibility for Part D To be eligible for Medicare Part D (drug coverage) you must be enrolled in Medicare Part A and/or Part B. You are not eligible for a Part D drug plan if you are enrolled in Medicare Part C. Medicare Part D plans are run by private insurance companies, so premium prices and covered drugs will vary by plan. You should enroll in a Medicare Part D plan when you are first eligible for Medicare, or risk paying a late enrollment penalty. HealthMarkets Can Answer Your Medicare Eligibility Questions If you are eligible for Medicare and are ready to shop for a plan, HealthMarkets can help. We make it easy to compare plans, get free Medicare quotes, and enroll. Answer a few short questions and to see what kind of Medicare plan might work best for your lifestyle, and which plans make the best fit. Get started now. 46253-HM-0920 References: https://www.kff.org/medicare/state-indicator/medicare-beneficiaries-as-of-total-pop/ | https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Fast-Facts | https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b | https://www.medicare.gov/your-medicare-costs/part-a-costs | https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol/index.html | https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html | https://www.medicare.gov/getting-medicare-if-you-have-a-disability | https://www.medicareinteractive.org/get-answers/medicare-basics/medicare-eligibility-overview/medicare-eligibility-for-those-under-65 | https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/who-can-join-medicare-advantage-plan.html | https://www.medicare.gov/sign-up-change-plans/get-drug-coverage/get-drug-coverage.html The Right Coverage at the Lowest Price Your search for affordable Health, Medicare and Life insurance starts here. Product Please Select Medicare Medicare Supplement Small Business Individual Health Insurance Family Health Insurance Dental Vision Supplemental Life Zip Code Free Quote Call us 24/7 at (800) 439-6916 or Find an Agent near you. Related Information Help With Medicare Premiums: How To Qualify For Assistance Do you need help with Medicare premiums? There are many programs that can help pay some or all of your premiums. Find out what it takes to qualify today. A Guide To The Difference Between Medicare Parts A And B It can be hard to tell the difference between Medicare A and B, or Original Medicare. HealthMarkets makes it simple to understand Medicare parts A and B. How Does Medicare Advantage Work To Your Advantage? How does Medicare Advantage work? And why can it be an advantage for many seniors on Medicare? Learn more with this article from HealthMarkets. What Is Medicare Part C? Explaining Its Features And Benefits This complete guide on what is Medicare Part C explains why you should get it, what it covers, how to enroll, how much it costs, and the types of plans sold. HealthMarkets' Extra Help Calculator Are you on Medicare and wondering if you qualify for help with your prescription drugs cost? HealthMarkets can help you find out! Products Health Medicare Small Business Life Dental + Vision Supplemental Telemedicine Wellness Connect Get Your FitScore® Get a Quote Find an Agent Find Medicare Subsidies Become an Agent HealthMarkets, Inc. Contact Us Customer Service Get Counsel FAQs Get Answers Get Informed What is the FitScore® Glossary Videos News Get to Know Us About Us Testimonials Privacy Policy Terms of Use Legal Best Price Guarantee © 2021 HealthMarkets Insurance Agency. All rights reserved. Attention: This website is operated by HealthMarkets Insurance Agency and is not the Health Insurance Marketplace website. In offering this website, HealthMarkets Insurance Agency is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in a health plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information. Sources: Kaiser Family Foundation (2013). Average Single Premium per Enrolled Employee For Employer-Based Health Insurance. 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