Medicare Eligibility

Medicare is federal healthcare administered by the Social Security Administration. Seniors can start receiving benefits when they reach age 65. Americans who have received disability insurance through Social Security for at least two years can start Medicare regardless of age.

For Seniors

Once you near the age of 65, you should begin to explore what Medicare offers. Three months before the month you turn 65, your Initial Enrollment Period begins. You have seven months to sign up during this period, which you can do by contacting your local Social Security office or filling out enrollment paperwork online at Medicare’s website. If you have already been receiving Social Security benefits, you will be automatically enrolled and notified through the mail. Your Medicare card will arrive in the same mailing: you should keep this in a safe place.

If you or your spouse are still working when you reach age 65 and have health coverage through the employer, you do not have to sign up for Medicare when you first become eligible. This qualifies you for a Special Enrollment Period, meaning you will owe no late enrollment penalties when you enroll. When you are no longer employed, or your coverage ends, you will have eight months to sign up for Medicare.

For most people, it would be beneficial to sign up for Medicare Part A during the Initial Enrollment Period, regardless of their employment status. This is because most people qualify for premium-free Part A. Part A is hospital insurance, and you qualify for zero monthly premiums if you have worked and paid Social Security through payroll taxes for at least 40 quarters (ten years). Signing up for Part A, then, is added coverage in the case of an emergency. 

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For Those With Disabilities

Medicare is not only for seniors but also for those with chronic disabilities. You become eligible for Medicare once you have received Social Security Disability Insurance for 24 months. Those with ALS (Lou Gehrig’s Disease) or End-Stage Renal Disease (ESRD) do not have to wait 24 months. Those with ALS can receive Medicare immediately upon receiving Social Security benefits. Those with ESRD can begin receiving Medicare benefits three months after beginning a course of dialysis. With ESRD Medicare, Part A coverage is retroactive for twelve months, beginning no earlier than the first month you become eligible for ESRD Medicare. Children with ESRD can qualify for Medicare benefits if they need dialysis regularly, require a kidney transplant, or have a parent who receives or is eligible for Social Security benefits.

Health coverage can be confusing, and you want advice from those you trust. For all of your Medicare questions, consult the experts at Swisher Insurance.