Who is eligible for Medicare in 2024? (Get the Facts)
Seniors who are 65 or older are eligible for Medicare. Requirements for Medicare also include being a U.S. citizen and receiving Social Security benefits. You can get Medicare early with a qualifying disability, such as End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS).
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Brad Larson
Licensed Insurance Agent
Brad Larson has been in the insurance industry for over 16 years. He specializes in helping clients navigate the claims process, with a particular emphasis on coverage analysis. He received his bachelor’s degree from the University of Utah in Political Science. He also holds an Associate in Claims (AIC) and Associate in General Insurance (AINS) designations, as well as a Utah Property and Casual...
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UPDATED: Jun 27, 2024
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
UPDATED: Jun 27, 2024
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes should be easy. This doesn’t influence our content. Our opinions are our own.
On This Page
You could automatically receive Medicare if you’re over 65 and already receiving Social Security benefits, but what about everyone else? Who is eligible for Medicare?
Only seniors over 65 are eligible for Medicare. You can get coverage at a younger age if you have a qualifying disability. People with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS) qualify for Medicare at any age.
You can sign up for Medicare as early as three months before your 65th birthday, but you’ll have to wait until your actual birthday month to start coverage.
Keep reading to learn who is eligible for Medicare and what you need to verify your age and medical history. Enter your ZIP code above to find affordable Medicare plans in your area.
- Most seniors automatically get Medicare coverage when they turn 65
- No one younger than 65 can get Medicare without a qualifying disease or disability
- Original Medicare typically costs $174/mo
Medicare Eligibility Requirements
The three requirements for Medicare eligibility are:
- Age: You must be 65-years-old to qualify for Medicare (unless you have a qualifying disease or disability).
- Citizenship: You must be a U.S. citizen or lived in the United States for at least five years before enrolling in Medicare.
- Social Security: You must be eligible for Social Security or railroad retirement benefits.
If you aren’t eligible for Social Security or retirement benefits, you’re still eligible for Medicare as long as your spouse worked and paid Medicare taxes. Otherwise, you can still enroll but must pay higher premiums for Medicare Part A and Part B.
Here is a breakdown of how much Medicare costs by plan:
Medicare Plan | Monthly Premium | Deductible | Out-of-Pocket Max |
---|---|---|---|
Part A | $0-$505 | $1,632 | None |
Part B | $174 | $240 | None |
Part C | Varies | Varies | Varies |
Part D | $34 | $0-$545 | $2,000 |
Medigap | $35-$488 | Varies | Varies |
You can’t sign up for Medicare until your Initial Enrollment Period (IEP), which starts three months before your 65th birthday. You will not be able to access Medicare benefits until then, although you can research and compare health insurance plans online to get Medicare eligibility verification.
How to Get Medicare Before You Turn 65
Age is the most important Medicare eligibility requirement. You must be 65 or older to enroll. Learn why in our expert guide to Medicare.
However, individuals under 65 can get Medicare if they’ve been diagnosed with end-stage renal disease or Lou Gehrig’s disease. You can also sign up for Medicare if you’ve received Social Security Disability Insurance (SSDI) over the past two years. Run a Medicare eligibility check on the official website to verify.
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What Medicare Covers
Medicare is made up of four parts:
- Medicare Part A: Covers hospital, hospice, and skilled nursing facility stays, including in-home healthcare.
- Medicare Part B: Covers 80% of doctor’s visits and medical equipment.
- Medicare Part C: Combines Part A and Part B coverage with Part D and other benefits. Coverage varies by company and state.
- Medicare Part D: Covers prescription drug costs
Medicare Part C is also known as a Medicare Advantage Plan. Medicare Advantage eligibility requirements are the same as Original Medicare, but you have the flexibility to choose more comprehensive healthcare if you need it.
For instance, Medicare Advantage combines all of Original Medicare coverage into one policy:
Then you can choose between different types of plans to find one that fits your needs and budget:
Compare Medicare Advantage vs. Original Medicare to learn more.
Bottom Line on Who is Eligible for Medicare
Medicare provides essential health coverage primarily for seniors aged 65 and older, though individuals under 65 with qualifying disabilities or specific conditions like End-Stage Renal Disease or Lou Gehrig’s disease can also enroll.
Who is eligible for Medicare? Your Medicare eligibility hinges on meeting the age and citizenship requirements.
You can sign up for Medicare during the Initial Enrollment Period (IEP), which starts three months before your 65th birthday. You must be a U.S. citizen or have lived in the country for at least five years, and you or your spouse must have paid Medicare taxes.
Start comparing Medicare insurance companies online to see if you’re eligible and find out which plans are available near you.
Frequently Asked Questions
Do I automatically get Medicare when I turn 65?
You will be automatically enrolled in Medicare if you’re already receiving Social Security benefits before or when you turn 65. Otherwise, you can sign up for Medicare as early as three months before your 65th birthday.
What are the three requirements for Medicare?
The three Medicare eligibility requirements are being at least 65-years-old, being a U.S. citizen, and having paid Medicare taxes.
What qualifies a person to be on Medicare?
Turning 65 is the most common way to qualify for Medicare. You’ll also be eligible for Medicare if you have a qualifying disease or disability, including End-Stage Renal Disease (ESRD).
Who is ineligible for Medicare?
Anyone under the age of 65 is ineligible for Medicare unless they have a qualifying disease or disability.
How much will Medicare cost me when I turn 65?
How much Medicare costs depends on the plan you choose. Original Medicare costs are around $174/mo for Part B while Part A is usually premium-free.
Is Medicare Advantage or Original Medicare with Medigap cheaper?
You will always pay at least $174/mo for your Part B premiums with either plan, but Medicare Advantage is cheaper if you require additional coverage for dental or vision insurance.
How do I check my Medicare eligibility?
You can check your eligibility at Medicare.gov.
Why would someone be denied Medicare?
Anyone under the age of 65 will be denied Medicare coverage. Get all the requirements in our expert Medicare guide.
What documents do I need to apply for Medicare?
You will need to provide proof of residency and citizenship. Pay stubs, birth certificates, and passports are all acceptable. Enter your ZIP code to start shopping for plans today
Enter your zip code below to view companies that have cheap insurance rates.
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Brad Larson
Licensed Insurance Agent
Brad Larson has been in the insurance industry for over 16 years. He specializes in helping clients navigate the claims process, with a particular emphasis on coverage analysis. He received his bachelor’s degree from the University of Utah in Political Science. He also holds an Associate in Claims (AIC) and Associate in General Insurance (AINS) designations, as well as a Utah Property and Casual...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.