What Are the Medicare Eligibility Requirements?

Keys for Determining Medicare Eligibility Requirements

Medicare is a federal insurance program for certain qualified individuals. The most basic medicare eligibility requirement is to be 65 years of age or older. However, there are other populations that qualify for medicare coverage. Persons under 65 with certain disabilities and those who are in end-stage renal disease. Medicare consists of four parts: A (Hospital Insurance), B (Medical Insurance), C (Advantage Plans), and D (prescription drug coverage). Each plan may have slightly varying eligibility requirements, the above information has been based off the most common variety of medicare coverage, part A.

65 Years Old Or Older

Once reaching the age of 65 years old a person qualifies for medicare. One must also be a US citizen or a permanent legal resident. One of the last requirements is having paid into the medicare system while working. The general rule is having paid into the social security system with approximately 10 years of work, or 40 credits. An individual may also qualify off of their spouses working if necessitated. The spouse must be at least 62 and the qualifying individual must still meet the 65 year requirement. With additional proof an individual may also qualify based on the work benefits of a deceased or divorced spouse.

If You Or Your Spouse Have Not Earned Enough Credits

If do to various circumstances an individual or their spouse has not earned enough credits for Medicare eligibility, but have reached the age of 65, alternatively options are available. The difference is that these options often require the individual to pay a certain premium to join one or all of the different Medicare plans, whether focused on hospital stays, doctors visits, or prescriptions.

Under 65 Years

An individual who is under 65 years of age may still qualify for medicare benefits based on various factors. If the individual qualifies for social security disability benefits and has Lou Gehrig’s disease; has received social security disability benefits for at least 24 months, or has worked in a local, state or federal government job for a minimum time period and qualifies for disability payments. Lastly, if an individual is suffering from permanent kidney failure then, at any age, a person meets medicare eligibility requirements.

Medicare requirements henge on the age of the person requesting benefits or a substantiated disability and the number of hours worked and paid into the benefits program. The requirements may also vary depending on the plan options an individual is requesting, however, the basic requirements are fairly straightforward.

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