Like receiving birthday cards from your grandkids, qualifying for and enrolling in Medicare isn’t automatic. You need to understand whether and when you are eligible so you can take the steps necessary – during Medicare’s limited enrollment windows – to sign up for coverage.
Here is what you need to know if you are wondering whether you are eligible to enroll in Medicare:
If You’re 65 or Older
You qualify for full Medicare benefits if:
• You are either a U.S. citizen or a permanent legal resident who has resided in the U.S. for at least five years and
• You are currently receiving Social Security or railroad retirement benefits or have worked long enough to be eligible for those benefits even if you are not collecting them.
• You or your spouse is a current or retired government worker who did not pay into Social Security while working but has paid Medicare payroll taxes
If You’re Younger than 65
You can qualify for full Medicare benefits if you are younger than 65 and:
• You have been entitled to Social Security disability benefits for at least 24 months (consecutively or otherwise); or
• You receive a Railroad Retirement Board disability pension and meet certain specific conditions; or
• You have amyotrophic lateral sclerosis (Lou Gehrig’s disease); or
• You have permanent kidney failure and require regular dialysis or a kidney transplant — and you or your spouse has paid enough Social Security taxes during a specified period that depends on your age.
Other Ways To Enroll In Medicare
If you are a U.S. citizen or have been a legal resident for at least five years, you can sign up and receive full Medicare benefits at age 65 or older even If you don’t qualify under any of the bases listed above. You just have to buy into the program by paying premiums for your coverage. Specifically:
• Part A. How much you’ll pay in premiums for the hospital coverage included in Part A depends on how long you’ve worked and how many work credits you will earn. You earn work credits based on your income, and the amount of income it takes to earn a credit changes every year. In 2023, you receive one work credit for every $1,510 in earnings, up to a maximum of four credits per year. If you have accrued less than 30 work credits, you pay 2023’s maximum premium of $499. If you have 30 to 39 credits, you will pay $274 a month in 2023. You will no longer need to pay these premiums if you continue working until you earn 40 credits.
• Part B. For Part B’s coverage for doctor visits and other outpatient services, you simply need to pay the same premiums as other enrollees. For 2023 the premium is $170.10 for individuals with a yearly income of $91,000 or less or couples filing a joint tax return with $182,000 in income or less. People with higher incomes pay higher premiums.
• Part D. For prescription drug coverage under Part D, pay the same premiums as others enrolled in the drug plan you select.
Importantly, you cannot purchase a Medigap or Medicare Advantage plan unless you’re enrolled in both A and B.
Questions About Medicare Eligibility? Contact Every Way Health To Get Answers.
If you have questions about qualifying for and enrolling in Medicare, please contact Every Way Health at 877-460-3943.