What are the Qualifications for Medicare? 

qualifications for medicare

What are the Qualifications for Medicare? 

Medicare is a Federal form of health insurance for individuals that covers seniors and individuals who are disabled. In this article, we will discuss the qualifications for Medicare in more detail. 

How Old Do You Have To Be To Receive Medicare? 

Age is the factor that qualifies most for Medicare. To qualify for Medicare you must be 65 years or older. 

In addition to being 65, you also need to meet the following conditions

  • You are a US citizen who has lived here for at least 5 years
  • You receive Social Security or railroad benefits or your work history is long enough to be eligible for the 
  • You or a spouse is a government employee/retiree who has not paid into Social Security, however, you have paid Medicare payroll taxes

If You Are Younger Than 65 You Still May Be Eligible For Medicare…

Here is how you qualify for Medicare if you are younger than 65. 

  • You have been disabled and entitled to Social Security disability benefits for 24 months in a row
  • The Railroad Retirement Board provides you with a disability pension
  • You have Lou Gehrig’s disease or ALS. This qualifies you immediately. 
  • You have permanent kidney failure resulting in regular dialysis or a kidney transplant. You or your spouse has paid into Social Security taxes for a specific number of years. This will depend on your age. 

Other Ways to Qualify for Medicare (Buying Into Medicare) 

If you or your spouse do not meet work history requirements, but you have been a U.S. resident for at least 5 years, and you are 65 years or older, you can get full Medicare benefits by “buying into” the coverage. Here is what I mean…

  • Part A PremiumsPart A is the hospital benefit, and the amount you would pay depends on how many “work credits” you’ve obtained. To pay $0 for Medicare Part A you would need to have 40 credits or 10 years of work experience. This is based on you earning a maximum of 4 work credits per year. 
  • Part B Premium – Part B will cover your doctor’s visits and outpatient services. If you have been a resident for 5 years and are 65 years or older you can pay the monthly premium for Medicare coverage. Your income determines how much you would pay. The lowest amount for Part B is $144 per month. 
  • Part D Premium – This Medicare plan covers your prescriptions. You can also pay Part D premiums if you have been a citizen for 5 years and are 65 years or older.

3 More Things To Know

You can enroll in Medicare Part B, without having Part A, but the opposite is not true. You cannot have the hospital benefit, Part A, without having Part B. 

You can enroll in Medicare Part D, the prescription benefit, if you are enrolled in either Part A or B. 

Lastly, you will need to be enrolled in Medicare Parts A and B before you can buy a Medicare Advantage Plan or a Medicare Supplement Plan.

Conclusion  

For most people, turning 65 is the event that qualifies them for Medicare benefits. Others will qualify based on 24 months in a row of a disability, kidney failure, being a 65-year-old citizen for 5 or more years, your spouse paying into Social Security, or a few other events. 

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