Medicare Eligibility

If you are 65, a U.S. citizen, or a permanent resident who has lived here continuously for five years, you are eligible for Medicare. If you are under 65 but are permanently disabled, received Social Security disability for at least 24 months, have End-Stage Renal Disease or Lou Gehrig’s disease, you are also eligible.

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Medicare Part A and Part B eligibility

Medicare Part A and Part B have the same requirements regarding eligibility. If you or your spouse has worked at least ten years or you receive Social Security benefits, you will be eligible for Part A at no cost to you. If you are 65, but these scenarios do not apply to you, you can still invest in Part A, but there will be a monthly premium. Even if you are able to receive Part A coverage premium-free, you will still have a premium payment for Part B. 

Medicare Part C eligibility

Medicare Part C, also known as Medicare Advantage, is a Medicare plan that offers you the same coverage as Medicare Part A and Part B. Part C also provides coverage for dental, vision, hearing, and prescription drugs. To be eligible for Part C, you must be enrolled in Medicare Part A and Part B and live within the service area of the plan you are wanting. 

You may not be eligible for a Medicare Advantage Plan if you have End-Stage Renal Disease. However, there is a specific Medicare Advantage Plan, known as the Special Needs Plan, that you can be eligible for. The Special Needs Plan is used for individuals with chronic or disabling health conditions, dual-eligibility in Medicaid and Medicare, or live in medical institutions, such as nursing homes.

Medicare Part D eligibility

Medicare Part D, also known as the prescription drug coverage plan, can be administered through a standalone plan or a Medicare Advantage Plan. If you are enrolled in Medicare Part A and/or Part B and live within the service area, you are eligible for Part D. 

If you want to enroll in a Medicare Advantage Plan that offers prescription drug coverage, you need to be enrolled in both Part A and Part B, as well as live within the service area.

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Should I enroll in Medicare?

It is not required to enroll in Medicare if you already have health insurance coverage. However, if you do not have other health insurance and miss the enrollment period, you will be charged penalties.

If you have any questions about enrolling for Medicare, give us a call at 877-885-3484 or send us an email at [email protected]. Our mission is to provide you with the help you need to protect you from out-of-pocket costs and provide added benefits.