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Who Qualifies and is Eligible For Medicare Insurance?

Medicare Part A Plan

Consumers can get Medicare Part A at age 65 without having to pay premiums if:

  • The consumer already receives retirement benefits from the Social Security Administration or the Railroad Retirement Board.
  • The consumer is eligible to receive Social Security or Railroad benefits, but hasn’t yet filed for them.
  • The consumer or their spouse had Medicare-covered government employment.
  • If the consumer is under 65, he/she can get Medicare Part A without having to pay premiums if they have:
  • Received Social Security or Railroad Retirement Board disability benefits for 24 months.
  • End-Stage Renal Disease and meet certain requirements.

Note: While consumers don’t have to pay a premium for Part A if they meet one of these conditions, consumers must pay for Medicare Part B if they want it.

Medicare Part B Insurance

  • Consumers are automatically enrolled in Medicare Part B starting the first day of the month they turn 65 years old (if their birthday is on the first day of the month, their Part B will begin the first day of the prior month).
  • Consumers who are under the age of 65-years old and who are disabled will automatically receive Part B after they receive disability benefits from the Social Security Administration or certain disability benefits from the Railroad Retirement Board for 24 months.
  • Part B premiums are deducted from the consumer’s Social Security, Railroad Retirement or Civil Service Retirement check. If the consumer does not receive any of the above payments, Medicare will mail the consumer a bill for their Part B premium every 3 months.

Medicare Part C
A Medicare Advantage Plan is another health coverage choice consumers have and is sometimes referred to as Medicare Part C.

Consumers may generally join a Medicare Advantage Plan if they meet these conditions:

  1. Consumer has Part A and Part B coverage.
  2. The consumer permanently resides in the service area of the plan.
  3. The consumer does not have ESRD.

*NOTE: In most cases, consumers may only join a Medicare Advantage Plan at certain times during the year.

Medicare Part D Plans
Medicare offers prescription drug coverage (Part D) to consumers with Medicare. To join a Medicare Prescription Drug Plan the consumer must have:

  • Medicare Part A and/or Part B

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