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Medicare Eligibility

Overview

Medicare eligibility is based on several factors, including age, disability status, and citizenship or legal residency. Here’s what you need to know about qualifying for Medicare:

  1. Age: Most people become eligible for Medicare when they turn 65 years old. You can sign up for Medicare during your Initial Enrollment Period, which begins three months before your 65th birthday month and ends three months after. If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Medicare Parts A and B.

  2. Disability: Individuals under 65 may qualify for Medicare if they have received Social Security Disability Insurance (SSDI) benefits for at least 24 months or have certain qualifying conditions, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

  3. Citizenship or Legal Residency: To be eligible for Medicare, you must be a U.S. citizen or legal resident who has lived in the country for at least five continuous years.

  4. Working Spouses: Even if you’re not eligible for Medicare based on your own work history, you may be able to receive coverage through a spouse’s work record if they are eligible for premium-free Medicare Part A based on their employment history.

Medicare Eligibility for Different Parts

Medicare eligibility for Part A

  • Age: Most individuals qualify for Medicare Part A at age 65, as long as they or their spouse worked and paid Medicare taxes for at least 10 years.
  • Disability: Individuals under 65 may be eligible for Part A if they receive Social Security Disability Insurance (SSDI) benefits for at least 24 months or have certain qualifying conditions like end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Medicare eligibility for Part B

  • Age: Individuals are generally eligible for Medicare Part B at age 65, similar to Part A.
  • Disability: Those under 65 may qualify for Part B if they are eligible for Part A due to disability, or if they have ESRD or ALS.

Medicare eligibility for Part C

  • Eligibility criteria for Medicare Advantage plans are the same as for Parts A and B. Individuals must be enrolled in both Medicare Part A and Part B and live in the plan’s service area.

Medicare eligibility for Part D

  • Individuals enrolled in Medicare Part A or Part B are eligible to enroll in a Medicare Part D prescription drug plan. There are no additional age or disability requirements for Part D eligibility.

Am I Eligible for Medicare?

Determining your eligibility for Medicare involves several factors, including age, disability status, and citizenship or legal residency. Here’s a closer look at the criteria:

  1. Age: Most individuals become eligible for Medicare when they turn 65 years old. You can sign up for Medicare during your Initial Enrollment Period, which starts three months before your 65th birthday month and ends three months after. If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Medicare Parts A and B.

  2. Disability: If you’re under 65, you may qualify for Medicare if you’ve received Social Security Disability Insurance (SSDI) benefits for at least 24 months or have certain qualifying conditions, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

  3. Citizenship or Legal Residency: To be eligible for Medicare, you must be a U.S. citizen or legal resident who has lived in the country for at least five continuous years.

  4. Working Spouses: Even if you’re not eligible for Medicare based on your own work history, you may be able to receive coverage through a spouse’s work record if they are eligible for premium-free Medicare Part A based on their employment history.

If you’re unsure about your eligibility for Medicare or need assistance with enrollment, our expert advisors at COSI Agency are here to help. We can guide you through the process and ensure you understand your coverage options based on your individual circumstances.

Steps to Apply for Medicare

Check Eligibility:

Ensure you meet the eligibility criteria based on factors like age, disability status, and citizenship.

Complete Application:

Apply online, by phone, or in person through the Social Security Administration.

Await Confirmation

After submitting your application, wait for confirmation of enrollment and explore coverage options.

Choosing COSI Agency means opting for unbiased choices and personalized solutions. Unlike tied agents, we explore various carriers and coverage options. With no external agendas, we prioritize your well-being and financial goals, providing recommendations solely focused on securing your peace of mind.
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