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Medicare Eligibility Requirements

March 31, 2016

Some people are automatically enrolled in Medicare and this can lead those not enrolled automatically to believe they are not eligible.

This is often not the case.

Bigstock-Doctor-with-female-patient-21258332People are often confused by the rules for Medicare eligibility because people are only eligible for the program when certain requirements are met. Some who meet the eligibility requirements are enrolled automatically while others are not and they must apply for benefits.

This seeming inconsistency was the subject of a recent article in My San Antonio entitled "Who Is Eligible for Medicare?"

As the article explains, the rules are actually pretty simple.

People who are 65 or older are eligible for Medicare if they or their spouse are eligible to receive Social Security or Railroad Retirement benefits. Typically, this means they have done full-time work for the equivalent of 10 years.

Government employees or their spouses who did not pay into Social Security but did pay into Medicare are also eligible. People under 65 are eligible if they have been permanently disabled for two years, have end stage renal failure that requires dialysis, have had a kidney transplant, or have Lou Gehrig’s disease.

People over 65 who do not meet the requirements can still participate in Medicare, but they may need to pay premiums for the coverage.

Eligible people will normally be automatically enrolled in Medicare Parts A and B when they turn 65 if they are already receiving Social Security benefits, have been disabled for two years or have Lou Gehrig’s disease. Those who are not automatically enrolled need to apply for benefits.

While you do not have to apply as soon as you become eligible, there might be penalties for waiting. Contact an elder law attorney before you decide to delay your application.

Reference: My San Antonio (Feb. 21, 2016) "Who Is Eligible for Medicare?"