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Medicare Eligibility

If you meet one of the following criteria, then you are eligible to enroll in Medicare:

  • U.S. citizen age 65 years old or older
  • Permanent legal resident in the U.S. for five continuous years & 65 years or older

If you are age 65 and currently receiving Social Security or Railroad Retirement Benefits, you are eligible for Medicare and you will be automatically enrolled in Medicare Part A and Part B. However, because Part B has a premium, you have the option of declining Part B coverage. In addition, Part B does require payment of a monthly premium of $104.90, barring certain exceptions, for individuals enrolling in Part B January 1, 2014 or later. These premiums can change on an annual basis.

If you are not currently receiving Social Security or Railroad Retirement benefits, you may visit your local Social Security office and request enrollment in Medicare Part A and Part B assuming you meet Medicare eligibility rules.

Eligibility for Disabled

There are a collection of chronic conditions and disabilities that qualify individuals for Medicare benefits. Medicare eligibility rules dictate that a person can enroll in Medicare before the age of 65 if one or more of the below criteria are met:

  • You are a U.S. citizen or legal resident under 65 years old but have a qualifying disability (e.g. blindness) or a qualifying medical condition (e.g. Lou Gehrig's Disease)
  • You have received disability benefits from Social Security or the Railroad Retirement Board for 24 months
  • You are a disabled widow or widower between age 50 and age 65 but have not applied for disability benefits because you're already getting another kind of Social Security benefit
  • You have permanent kidney failure (i.e. End Stage Kidney Disease) and you receive maintenance dialysis and/or have received a kidney transplant and you (or your spouse or parent if you are a dependent) meet certain work conditions


Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.

 
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