Requirements to Receive Medicare

The rising costs of medical care mean that health insurance is more important than ever, especially for anyone with a disability or fixed income. Medicare is a program of the federal government that offers low-cost or free health insurance to qualified individuals. While there's no single standard for eligibility, most Medicare recipients need to be over the age of 65.

Qualifications

• There are several forms of eligibility for Medicare. The first, and most common, is based on age: If you're age 65 or over and worked in a Medicare-covered job for at least 10 years, you're eligible. Regardless of age, you're also eligible if you have end-stage renal disease, which means you require a kidney transplant or regular dialysis. Finally, if you've been receiving Social Security benefits or Railroad Retirement Board benefits for a disability for two years or more, you qualify for Medicare.

Expanded Eligibility

• Even if you don't meet the general eligibility requirements to receive Medicare, you may still qualify to receive Medicare benefits. This extended coverage applies to spouses, widows, widowers and dependent parents of Medicare-eligible individuals. Anyone who is eligible for Medicare receives the same access to health insurance, regardless of why they qualify for the program.

Benefits

• Medicare benefits come in several groupings, each with its own benefit structure and cost to recipients. Medicare Part A is hospital insurance and is a free benefit for anyone on the program. Part B covers in-patient hospital care, doctor visits, physical therapy and some forms of home health care. Anyone who is eligible for Medicare can participate in both parts, though Part B carries a monthly premium. As of 2010, the base cost of Medicare Part B was $96.40 per month, with higher-income recipients paying more for the same coverage.

Considerations

• Even if you qualify for Medicare, you may elect to buy additional coverage beyond Parts A and B. Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) offer Medicare Advantage Plans that combine the government-subsidized portion of Medicare with a privately run prescription drug plan. Certain states offer assistance in paying for Medicare Parts A and B and employ their own eligibility guidelines based on income level.

Alternatives

• Medicare isn't the only health insurance option from the federal government. Medicaid is based on income rather than age and available to low-income individuals and families. Each state manages its own Medicaid program and has its own criteria for eligibility.

  If you don't qualify for Medicare you can also elect to purchase private health insurance. High-deductible plans, also known as catastrophic coverage, offer a low premium but require you to contribute more money toward any care you receive. If you're reasonably healthy, a high-deductible plan may be useful between retirement and reaching age 65, when Medicare becomes a better option.