Are you eligible for Medicare? If you're not sure whether you qualify for this federally funded insurance program or not, take a look at the need-to-know facts.
Even though other insurance policies (such as private self-pay insurance or employer-sponsored policies) are open to most adults regardless of age, Medicare is not. Only people 65 and over qualify for this federal health insurance program by age. But this doesn't necessarily mean you won't qualify if you're 65 or under. While this may seem confusing, some other non-age-related qualifications may make you eligible immediately.
Even though your insurance isn't active until you're 65, you can sign up for this federal program before your 65th birthday. The enrollment period starts three months before you turn 65. If you choose to wait until your birthday to enroll, make sure you don't miss your opportunity. You have until three months after you turn 65 to sign up—under most circumstances.
You may also sign up or choose a Medicare Advantage program outside of the Initial Enrollment Period (the three months before you turn 65, the month you are 65, and the three months after your 65th birthday). The General Enrollment Period starts January 1 and ends March 31 annually.
Along with this period, some people may qualify for Special Enrollment Periods. These apply to some people who are working and have another insurance policy, who are covered under some employer or union-based plans, or who have recently stopped working. Talk to your insurance agent about the specific qualification requirements to sign up during a Special Enrollment Period.
Social Security or Railroad Benefit Eligibility
Do you qualify for Social Security or Railroad Retirement benefits? If you answered yes, but haven't filed for these benefits yet, you may qualify for Medicare insurance. Even though you may also meet age qualifications, if you aren't getting Social Security benefits, you will have to sign up for this federally funded health care program to get insurance. This means the government won't automatically enroll you based on age alone.
Some adults under age 65 with disabilities may qualify for this type of federal insurance program. If you're entitled to Social Security or Railroad Retirement benefits based on your disability and have received benefits for at least 24 months, you may qualify. This excludes children with disabilities.
End-Stage Renal Disease Eligibility
Adults with end-stage renal disease and need regular dialysis or have had a kidney transplant may apply for Medicare. To qualify for renal disease-related coverage you must also have worked as a government employee or for the necessary amount of time required for Social Security or Railroad Retirement benefits—or you're already eligible for those benefits. If you're the spouse or dependent child of someone who meets either of these conditions, you may also qualify.