Medicare is the federal government’s health insurance program for older citizens and people with disabilities. If you’re age 65 or older, you qualify for Medicare, but that doesn’t mean that you receive it automatically.
Once you meet certain age benchmarks or other criteria for Medicare, it’s up to you to enroll in the program.
Enrolling in Medicare can be a confusing process. It requires understanding some of the basics of how the program works.
If you have insurance through your employer at the time you apply for Medicare, Medicare will become your secondary insurance.
You can apply for Medicare:
- as early as 3 months before the month you turn age 65
- during the month you turn age 65
- up to 3 months after the month you turn age 65
This time frame around your 65th birthday provides a total of 7 months to get enrolled.
Other Medicare eligibility requirements
There are a few other Medicare eligibility criteria in addition to the age requirement.
- You must be a U.S. citizen or a legal permanent resident who has lived in the United States for at least 5 years.
- You or your spouse must’ve paid into Social Security for what amounts to 10 years or more (also referred to as having earned 40 credits), OR you must’ve paid Medicare tax while you or your spouse was an employee of the federal government.
There are a few exceptions to Medicare’s eligibility age requirement. These include:
- Disability. If you’re younger than age 65 but you’re receiving Social Security Disability Insurance, you may be eligible for Medicare. After 24 months of receiving Social Security, you become Medicare-eligible.
- ALS. If you have amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), you’re eligible for Medicare as soon as your Social Security disability benefits begin. You’re not subject to the 24-month waiting period.
- ESRD. If you have end stage renal disease (ESRD), you become Medicare eligible after a kidney transplant or 3 months after dialysis treatment begins.
- Family relationship. In some instances, you may be eligible for Medicare under age 65 based on your relationship with a Medicare recipient. These relationships include:
- widow(er)s who have a disability and are under age 65
- surviving divorced spouses who have a disability and are under age 65
- children who have a disability
You may be able to receive Medicare benefits slightly earlier if you’re at least 62 years old, married to someone who is age 65 or older, and you’ve worked for 40 quarters and you paid Medicare taxes. If you didn’t work or meet the 40 quarters requirement, you may have to wait until age 65 to receive coverage under your spouse’s benefits.
You can also apply for Social Security retirement benefits once you’ve turned 62. However, you’ll receive more money per month if you wait a few years. People who start collecting retirement benefits at 62 will receive 70 percent of their full benefit amount. You can receive 100 percent of your benefit amount if you don’t start collecting until full retirement age.
The Medicare eligibility age continues to be 65 years old. If that ever changes, you might not be affected, as the change will happen in gradual increments.
Enrolling in Medicare can seem complicated, but there are lots of resources to help simplify the process and to get you enrolled.