Medicare Eligibility

For anyone turning 65, the option to enroll in Medicare is available if you meet all of the additional qualifying factors. However, what additional criteria you need to meet depends on which parts of the plan interest you. Below is a breakdown of each section of Medicare and what it takes to qualify for coverage.

Original Medicare - Part A and Part B - Eligibility

Individuals who elect to enroll in Medicare insurance will automatically be given coverage under Part A and Part B of the plan as long as they meet a few guidelines. First, to receive benefits you must be a U.S. citizen or a permanent legal resident for a minimum of five continuous years. Second, you must be eligible for Social Security and already be getting benefits from either the Railroad Retirement Board or Social Security in order to be automatically enrolled in Original Medicare. If you aren’t receiving these benefits because you are working then you will need to sign up for Medicare Part B after meeting the 65-year-old age requirement.

Alternatively, you will qualify for Original Medicare benefits if you meet any of the following factors as well:

  • You’re permanently disabled and have been getting disability benefits from Social Security for 24 months
  • You have an end-stage renal disease that requires dialysis treatment or a kidney transplant. (It is important to note, you will need to sign up for benefits as enrollment won’t be automatic.
  • You are diagnosed with Lou Gehrig’s disease. (Benefits start the very first month you get disability benefits.

Medicare Part C Eligibility

If you are thinking of going another route, Medicare Part C or Medicare Advantage is another way to receive benefits under Medicare. In order to obtain Part C you will need to already be enrolled in Original Medicare and live within the service area of the Medicare Advantage plan. Enrollment periods typically coincide with the Initial Enrollment Period for Medicare Part A and Part B. 

Medicare Advantage is also optional, so if you feel that you have proper coverage under Original Medicare you don’t need to sign-up for this portion. One major thing to note is that since Medicare Part C is available through private insurers, individuals with End-Stage Renal Disease might not qualify for coverage.

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Medicare Part D Eligibility

The last option for coverage under Medicare is Part D, which covers prescription drugs. Much like Medicare Part C, this section is offered through private insurers and is an optional coverage that you can decide to decline if you want. The qualifications for Part D include, already having Parts A and B of Medicare and living in the specified service area of the drug plan.

iHealthcare is Here to Help

To find out what Medicare plans you qualify for or to schedule a free consultation with one of our agents, call us today at 713-900-1901.