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Qualifying for Medicare

How do you qualify for Medicare?

Four ways to qualify

WHICH APPLIES TO YOU?

Qualifying for Medicare is pretty straightforward. There are four ways for an individual to qualify for Medicare benefits:

1. Turn 65 years old
Once you reach your 65th birthday, you qualify for Medicare benefits.

Now, you must be a U.S. citizen or permanent legal resident who has lived in the U.S. for at least 5 years AND contributed to the Medicare system for at least 40+ quarters (10 years).

If you have been married for a least a year and your spouse is at least 62 years old, you may qualify with your spouse’s work history if he or she has 40+ quarters of work.   

2. Disability
You can qualify before age 65 if you are disabled and receiving Social Security Disability Insurance (SSDI).

Medicare will start after 24 months of disability.

Your Medicare card will automatically arrive in the mail about 3 months prior to the 25th month of Social Security Disability benefits.

You will have both Part A & Part B coverage.  

3. End Stage Renal Disease (ESRD)
ESRD, also known as kidney failure qualifies you for Medicare.

If your kidneys no longer function and you need dialysis, or you have already had a kidney transplant, you qualify for Medicare.

Coverage usually starts the 4th month of dialysis treatments, but may start immediately depending on your circumstances.

If you are on a group health insurance plan, the first 3 months of dialysis are covered by the group plan.

The next 30 days are referred to as the Coordination Period where your group plan is primary and Medicare is secondary.

After the Coordination Period, Medicare becomes primary and the group health plan is secondary.

4. Lou Gehrig’s Disease (ALS)
If you have ALS aka Lou Gehrig’s Disease you are automatically eligible for Medicare the month your Social Security Disability Insurance benefits begin. 

With automatic enrollment, your Medicare card will arrive in the mail at the start of your SSDI benefits.

You’re about to qualify, now what?

FIND OUT IF YOU SHOULD MOVE TO MEDICARE OR STAY ON YOUR CURRENT PLAN.

 

Use our Decision Support tool:

Qualifying for Medicare: Video

WHO CAN GET MEDICARE


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