Your Medicare Eligibility

When are you eligible for Medicare?

Your Medicare eligibility age is 65. Eligibility age simply means that you qualify for Medicare once you reach 65. You also need to be a US citizen, permanent resident or have lived in the US for over five years continuously. You can enroll in Medicare during what is known as your Initial Enrollment Period. This period covers the three months before your 65th birthday, the month of your birthday, and three months after your birthday. 

Medicare for people aged under 65 years

If you meet certain medical conditions, you also qualify for Medicare even if you haven’t yet turned 65 years old. These include: 

• Permanently disabled: if you are permanently disabled and have been receiving Social Security disability income benefits for a minimum of 24 months.

• Renal disease: if you have been diagnosed with end-stage kidney failure (renal disease), requiring either a kidney transplant or dialysis.

• ALS: if you’ve been diagnosed with ALS (Amyotrophic Lateral Sclerosis), commonly referred to as “Lou Gehrig’s disease.”

The different parts of Medicare

There are four different parts of Medicare, each of which comes with varying eligibility requirements. 

Medicare Part A eligibility

You’re automatically eligible for Medicare Part A at age 65 if you or your spouse has worked for at least 10 years in the US. You’re eligible because you’ve paid taxes during your employment, which automatically qualifies you to enroll in Medicare.

If you haven’t worked the required number of years, you can still arrange to purchase Medicare Part A by contacting your Social Security office. However, there are costs associated, so it’s essential to understand these costs before making any decisions. You may be eligible to pay only partial premiums if you’ve worked more than 30 quarters but less than the required 40 quarters. If you’ve got any questions about costs for Medicare, our local Medicare agents NC, can help. Get in touch with us to find out more.

If you’ve already received Social Security income benefits, you’ll be automatically enrolled in Medicare Part A once you turn 65. So look out for your Medicare card in the mail around four to six weeks before your birthday. 

Medicare Part B eligibility

Like Medicare Part A, once you turn 65, you’re eligible for Medicare Part B. However, the main difference is that, unlike Part A, you will be required to pay a monthly premium for Part B, which covers you for various outpatient medical services, such as doctor appointments and lab tests. 

Suppose you’re still working when you turn 65 and have employer-sponsored health insurance. In that case, you can delay enrolling in Medicare Part B without receiving any late penalties. If you’re looking to defer enrolling, it’s worth chatting with a Medicare agent in North Carolina first to answer all your questions. Give us a call to find out all you need to know about the special election periods you’ll need to use later to help you avoid paying any late enrollment fees.

Medicare Part C eligibility

You’re only eligible for Medicare Part C, also known as Medicare Advantage if you’re enrolled in Medicare Parts A and B. You’ll need to live in the service area of the plan you choose, based on the address you have listed with Social Security. So when you’re looking for available plans, be sure to check which ones are available in North Carolina. Some plans are limited by state and even counties within the state. 

Alternatively, get in touch with one of our North Carolina Medicare agents who can answer any of your questions about Medicare Advantage plans in North Carolina.

Medicare Part D eligibility

Medicare Part D helps to cover costs for your prescription drugs. Like Medicare Advantage, to be eligible for Medicare Part D, you need to select an available plan in North Carolina. You’ll also need to have enrolled in either Medicare Part A or Medicare Part B (or both). If you don’t enroll in Medicare Part D during your Initial Enrollment Period and want to enroll later, be aware that late enrollment penalties can apply.

Your Medicare eligibility questions answered

Our experienced Medicare agents often get asked questions like ‘Who is eligible for Medicare?’ and ‘What is Medicare age eligibility?’ They can help explain the different requirements of each of the different parts of Medicare and specialize in North Carolina Medicare plans. We can help you with any of your questions, so get in touch with us today to find out about your eligibility for Medicare.