When Is a Person Eligible for Medicare?

Medicare is a health insurance plan that the federal government provides for Americans who are age 65 or older. Other individuals who may qualify are those under age 65 with disabilities or who have permanent kidney failure. To be eligible for Medicare insurance, an individual must be a U.S. citizen or a legal resident for five continuous years. You must be entitled to receive Social Security benefits.

Age 65 or Older

• A person is eligible for Medicare at age 65. Medicare Part A is hospital insurance that helps pay for home health care, hospice care or care you receive in a hospital or skilled nursing facility. You do not have to pay premiums for the Medicare Part A insurance if you already get retirement benefits from Social Security or the Railroad Retirement Board. Even if you haven't filed yet but are eligible to receive retirement benefits, you are eligible for Medicare coverage.

Disability Under Age 65

• If you are younger than age 65, you may qualify to for Medicare Part A without having to pay premiums if you receive Social Security or Railroad Retirement Board disability benefits. Eligibility for most people with disabilities begins 24 months following the onset of the disability. The Social Security Administration will automatically enroll you in Medicare Part A and Part B after you get disability benefits for two years. Given that you must pay a premium for Part B coverage, you have the right to turn it down.

End-Stage Renal Disease

• Individuals of all ages who have permanent kidney failure and are undergoing dialysis or need a kidney transplant are eligible for Medicare. You can enroll in Medicare by contacting your local Social Security Office. You will need to enroll in both Medicare Parts A and B so that Medicare covers your dialysis or kidney transplant services. If you are paying a higher Medicare Part B premium because you did not enroll in Part B when you were first eligible and you now have End-Stage Renal Disease, you can re-enroll. This will allow you to stop paying the higher premium rate. Even after you have had a kidney transplant, you may still qualify for Medicare benefits.

Retirement at Age 62

• A person does not become eligible to receive Medicare benefits until age 65. If you retire at age 62, you may be able to continue health care coverage through your employer. Another option is to purchase individual health coverage from a private insurance company until you turn 65. The initial enrollment period for Medicare begins three months before a person's 65th birthday. This is the time you should sign up for Medicare benefits. The enrollment period includes the month of your birthday and ends three months after you turn age 65. This gives you seven months to enroll in Medicare. If you enroll within the three months prior to your 65th birthday, your coverage will begin the month you turn age 65. Coverage will begin the next month if you wait until the month of your birthday to enroll. Waiting until the last three months of the enrollment period to apply for Medicare could delay coverage for up to three months.

Medicare Part B Enrollment

• Although most Medicare recipients do not have to pay for Medicare Part A, you do have to pay for Medicare Part B. This medical insurance helps pay for doctors, outpatient hospital care and other medical services. If you don't sign up for Medicare Part B when you first become eligible for Medicare, you can usually sign up during the General Enrollment Period. Visit your local Social Security Office from January 1 through March 31. The cost of premiums for Medicare Part B increase by 10 percent for each full 12-month period that you could have the insurance but choose not to take it. You must then pay this increased cost for as long as you have Medicare Part B. If you enroll in Medicare during the General Enrollment Period, your coverage will begin July 1st of that year.