Am I Eligible For Medicare?

If you’re a U.S. citizen or a permanent legal resident of the United States, then you may be eligible for Medicare if you meet one of the following criteria:

You are 65 years old or older.
You’re younger than 65, but you have a qualifying disability.
You are of any age and have been diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s Disease).

To qualify as a legal resident, you need to have lived in the United States for at least five consecutive years before applying for Medicare.

Health Plans of NC, Kelly Quinn

Aug 26, 2022

What do I need to do once I’m eligible for Medicare?

For Original Medicare (Part A and Part B), enrollment happens automatically for many people once they’re eligible. But it’s not automatic for everyone, so it’s essential to check. If you live in North Carolina, you may wish to seek help from one of our locally-based Medicare agents. They specialize in helping people all over the state. So whether you live in Charlotte, Asheville, Hickory, Greensboro, Southport, or anywhere else in North Carolina, our team can help.

Your enrollment will be automatic in Original Medicare if:

You already receive a Social Security or Railroad Retirement Board benefit when you turn 65, or
You’re already eligible for Medicare because of a disability or medical condition and have met the two-year waiting period.

You will have to enroll in Original Medicare yourself if:

You aren’t receiving Social Security benefits when you become eligible for Medicare. Check your initial enrollment period dates as there can be penalties applied for enrolling late.

You must enroll in Original Medicare yourself if:

You’re not receiving Social Security benefits when you become eligible for Medicare. Make sure you know your initial enrollment period dates.

How to enroll in Medicare

As a North Carolina resident, there are three different ways you can enroll in Medicare:

Create an account online at www.SocialSecurity.gov
Call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7 a.m. to 7 p.m.
Visit your local Social Security office in person.

What are my coverage choices after I have Medicare?

Once you’re enrolled in Medicare Part A and/or Part B, you’ll receive coverage from the federal government. Typically Part A and Part B together cover about 80% of your medical costs which is why additional coverage from private companies is offered. Talk to one of our licensed agents to learn about your options to get the additional coverage you need.

What if I’m still working at age 65?

If you have coverage through your employer or your spouse’s employer, you may or may not be able to delay Medicare enrollment. It depends on the size of the employer. Ask your benefits manager whether you have group health plan coverage as defined by the IRS. They will go over your options with you.

You may be required to enroll in Original Medicare (both Part A and Part B) by your/your spouse’s employer, or
You may be able to enroll in only Original Medicare Part A during your initial enrollment period, then enroll in Original Medicare Part B and/or Part D later during a Special Enrollment Period.