What Is the Medicare Eligibility Age?

Medicare Eligibility

When are you eligibile for Medicare? For most, right around your 65th birthday.

Congratulations! If you’re reading this, it’s probably because you’re trying to figure out when you can get on Medicare. Your Medicare eligibility age is 65. That means you’re probably turning 65 in a few months! While I congratulate you on the milestone, there certainly are reasons to celebrate (and please pass the cake).

If you already know you’re eligible for Medicare and just want to find out how to sign up, I wrote a nice primer on this a while back. Click here to head on over.

For starters, you made it! For most people, turning 65 can indicate a big milestone in life. If you’ve made it this far (and since you’re reading it, I assume you have) it’s calculated a woman turning 65 years old this year has a 28 percent chance — a little more than one out of four — of living another 25 years to age 90. And she has a 32 percent chance — almost one out of three — that she’ll live only another 15 years to 80.

If you’re a man, a 65-year-old man has a 30 percent chance — nearly one out of three — of living another 22 years to 87. And he has a 24 percent chance — almost one out of four — of living only another 10 years to 75.

No wonder 65 is considered the, “magic” age. For starters, you can get Social Security retirement income benefits at your “full retirement age,” provided that you also had enough work credits. (Today, you can actually begin taking these benefits between the age of 62 and 70+). Although not the same, Social Security and Medicare are definitely related.

For those who are eligible for Medicare based on age, you can enroll in this coverage starting three months prior to your birthday month (before you turn age 65). When you do, your Medicare coverage will start on the first day of your 65th birthday month. If you instead enroll in Medicare during or after your 65th birthday month, then your coverage will start in the following month.

Of course, you can get on Medicare provided that you and / or your spouse paid Medicare taxes during your working years, Medicare’s hospitalization coverage through Part A won’t require you to pay a premium. In fact, you are eligible to receive premium-free Medicare Part A (hospitalization coverage) if you:

  • Are an American citizen or a permanent legal resident of the U.S. for at least five years,
  • Are currently receiving retirement income benefits from either Social Security or from the Railroad Retirement Board (RRB),
  • You are eligible to receive your Social Security or RRB benefits, but you have not filed for them yet, or
  • You and / or your spouse worked in Medicare-covered government employment.
  • If you (or your spouse) are not eligible for premium-free Medicare Part A, you may still be able to purchase this coverage. The monthly Medicare Part A premium (in 2019) is $437 for those who paid Medicare taxes for less than 30 “quarters” and it is $240 per month if you paid Medicare tax for between 30 and 39 quarters.

The criteria for Medicare Part B eligibility are similar to those that are needed for Medicare Part A. In this case, if you are eligible for Part B of Medicare, you may be enrolled in this coverage automatically if you meet any of the following:

  • You are age 65 or older and you are already receiving retirement income benefits from Social Security or from the RRB (Railroad Retirement Board),
  • You are under the age of 65 but you have a qualifying disability,
  • You have been diagnosed with Amyotrophic Lateral Sclerosis (ALS / Lou Gehrig’s disease), or
  • You reside in Puerto Rico and you are receiving benefits either from Social Security or from the Railroad Retirement Board.
  • If you meet the Medicare eligibility criteria, you should receive a Medicare ID card in the mail approximately three months prior to your 65th birthday, or – if you are eligible due to a disability – the ID card will be received on the 25th month of your disabling condition.
  • While Medicare Part B is voluntary, it is important to keep in mind that if you don’t sign up for Part B coverage when you are initially eligible – but you enroll in Part B at a later date – you could incur a late penalty. This will come in the form of higher premiums for this coverage. (These higher premiums are ongoing).

How to Get Medicare If You’re Under Age 65

In some cases, those who are under the age of 65 may still qualify for Medicare benefits. For example, you can automatically receive premium-free Medicare Part A coverage if you have been entitled to either Social Security or Railroad Retirement Board benefits for 24 months, or you are a kidney transplant or kidney dialysis patient. (Note that these 24 months do not have to be consecutive in order to gain Medicare eligibility).

If you have been diagnosed with ALS (Lou Gehrig’s disease), then your Medicare Part A hospitalization benefits will start in the first month that you also start receiving your disability income benefits.

So there you have it. Feel free to now explore how much Medicare part B will cost you, standard Medicare enrollment periods, and why you might want to consider buying a Medicare Supplement policy.

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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.