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What You Need To Know About Medicare Eligibility at 65

Medicare is a government-funded federal health insurance plan intended for senior citizens and the disabled, but not everyone qualifies for coverage automatically. If you’re approaching the age of 65, then you need to learn more about the qualifications for Medicare and the benefit options you might be entitled to. Below, we explain how Medicare works, how to determine if you’re eligible, and what to do if you believe you’re entitled to coverage.

How Does Medicare Work?

Medicare coverage can be broken down by four parts: Part A, B, C, and D. Typically, Parts A and B come together and cover hospital stays and physician fees, respectively. Part C grants Medicare beneficiaries compensation for medical care from a select list of delivery options, and Part D provides coverage for prescription medications.

In order to receive coverage, you may need to pay certain premiums to gain access to other “parts” of the Medicare plan, though premiums can be waived under certain circumstances. Because the process is so complex, it is always best to discuss the particulars of your situation with an experienced financial advisor.

Medicare Eligibility Requirements

According to the U.S. Department of Health & Human Services, Medicare benefits recipients must be at least 65 years of age and either the recipient or their spouse must have worked and paid Medicare taxes for at least 10 years. Additionally, the qualifying individual must meet one of the following conditions:

  • Receive or be eligible for Social Security
  • Receive or be eligible for Railroad Retirement Board (RRB) benefits
  • Served in a Medicare-covered government job

If you receive benefits for RRB or Social Security Disability at least four months before your 65th birthday, you should automatically receive Medicare Part A benefits. If you do not receive benefits automatically, you must file for benefits with the Social Security Administration.

What’s Next?

If you are nearly 65 and believe you are entitled to Medicare, you must take immediate action to ensure you receive the benefits. Individuals are eligible to enroll for potential benefits three months before they turn 65, and for up to 7 months after during the “Enrollment Period.” Because benefits can begin at age 65, it is extremely important to file for benefits as soon as possible to ensure you receive the coverage you need.

To get a referral for a qualified financial advisor and elder lawyer who can walk you through the Medicare application, please get in touch with Kitzke & Canfield, LLC. Call (262) 387-0706 today to schedule an appointment with our law firm.

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