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Medicare Eligibility

Who’s Eligible for Medicare?

TURNING 65

To be considered eligible for Medicare, you must meet one of the following:

  • You’re a United States citizen or a legal resident who has lived in the U.S. for at least five consecutive years.
  • You’re 65 and worked long enough to be eligible for Social Security or railroad retirement benefits — usually having earned 40 credits from about 10 years of work — even if you are not yet receiving these benefits; or.
  • You or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working.


Under 65

You qualify for full Medicare benefits under age 65 if:

  • You have been entitled to Social Security disability benefits for at least 24 months (which need not be consecutive); or
  • You receive a disability pension from the Railroad Retirement Board and meet certain conditions; or
  • You have Lou Gehrig’s disease (amyotrophic lateral sclerosis), which qualifies you immediately; or
  • You have permanent kidney failure requiring regular dialysis or a kidney transplant — and you or your spouse has paid Social Security taxes for a certain length of time, depending on your age.

When Do I Enroll If I’m Turning 65?

When you turn age 65, Medicare provides a window of time to enroll in Medicare Part B with no-penalty. You may also enroll in a Medicare Supplement Insurance Plan with Guaranteed Issue and you do not have to answer medical questions.

Turning 65 7-month window:

  • 3 months before your birth month
  • 1 Your birth month
  • 3 months after your birth month

Take a Look at the Turning 65 Table  

Month
1

Month
2

Month
3

3 Months Before Your 65th Birthday

Sign up for Part A and Part B. Learn more at medicare.gov (external site) and socialsecurity.gov (external site).

Consider enrolling in the Medicare Advantage Plan (Part C), Medicare or Supplement Insurance Plan, and/or Medicare Part D (Prescription Drug) plan that fits your budget and needs. Note that your plan won’t be effective until you turn 65.

If you are considering a Medicare Supplement Insurance plan, you may be subject to a waiting period and a medical questionnaire if you wait too long after your birthday.

 

BIRTH
Month
4

YOU
TURN

65

Month
5

Month
6

Month
7

3 Months After Your 65th Birthday

If you are thinking about enrolling in a Medicare Advantage Plan (Part C) or a Part D (Prescription Drug) plan, make sure to do so by this time.

If you don’t enroll in Part D Prescription Drug plan when you are first eligible, you may have to pay a penalty if you enroll later.

If you are thinking about enrolling in a Medicare Supplement Insurance plan, make sure to do so no later than 6 months after your 65th birthday.

 

6 Months Before Your 65th Birthday

Schedule your Welcome to Medicare visit. The purpose of this visit is to create a record of your health and family history; check measurements like your blood pressure and weight; ensure that you’re up to date with preventive screens, and order any necessary tests based on your health.

October 15 – December 7 Open Enrollment

If you enroll during this period, your plan will be effective on January 1. During this time each year, you can make changes like the following:

  • Switch from original Medicare to a Medicare Advantage plan and vice versa
  • Change to a different Medicare Advantage plan
  • Purchase a Part D Prescription Drug plan or drop Part D coverage
  • Change to a different Part D Prescription Drug plan

Disenrollment Period

January 1 – February 14

For Medicare Advantage Plan (Part C) Plans. During this time you can choose to drop your Medicare Advantage plan and switch back to Original Medicare. If you do, you have the option to enroll in a Part D prescription drug plan

Special Enrollment Period

For Medicare Advantage Plan (Part C) and Part D (Prescription Drug) Plans You can make changes to your Medicare Advantage Plan or Part D prescription drug plan when certain types of events certain types of events happen in your life such as moving or dropping coverage provided by an employer or union.

Medicare Supplement Insurance Plan (Medigap Insurance Plan)

Year Round and Turning 65

You can apply for a Medicare Supplement Insurance Plan at any time of the year. The best tine to enroll is when turning 65 or retire after age 65 with an employer health plan.

You Will Love Your Choices and Easy Online Enrollment

  • No More Pen and Paper – No more paper applications. Everything is electronic which means you spend less time fiddling with insurance.
  • Telephonic Enrollment – You can enroll and sign your application online or by phone. Telephonic enrollments are typically approved within hours, not days.
  • Plans Your Doctor Accepts -You can choose different plans from nationwide, no network, go anywhere plans to smaller network or nearly free cost plans.
  • Top Rated Companies – You have over 30 carriers to select from. National brands, years of experience.
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