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Learn more about your Medicare eligibility.

At SelectQuote, we can help you navigate the complexities of Medicare & find the coverage you need. There’s no obligation to enroll.

Man searching on his laptop finding out if he is eligible for Medicare

Medicare eligibility: Do I qualify for Medicare?

If you’re approaching your 65th birthday, it’s time to start making some important decisions about Medicare. Original Medicare (Medicare Part A and Medicare Part B) only covers 80% of your medical costs, so you may want to protect yourself from unexpected expenses by purchasing supplemental Medicare Insurance. There are two basic options to close the gap: Medicare Advantage plans or standardized Medicare Supplement Insurance Plans.

No one expects you to be an expert on the subject, which is why we’re here to help. We can talk through some key factors you should know about your eligibility for Medicare as you begin to explore your options. There’s no obligation to enroll.

Man searching on his laptop finding out if he is eligible for Medicare

When are you eligible for Medicare?

You’re Turning 65

Turning 65 is the standard age denoting your eligibility for Medicare. This milestone entitles you to enroll in Original Medicare—made up of Part A (coverage for hospital expenses) and Part B (coverage for healthcare expenses). You are generally eligible to receive free Part A coverage (in other words, you pay no monthly premium), if you are 65 or older.

The seven-month period surrounding your 65th birthday is your Initial Medicare Eligibility period for enrollment. That includes the three months before your birthday month, your birthday month and three months after. As an example, if your birthday is in August, you can enroll in May, June, July, August, September, October or November.

You’ve Been Diagnosed with ESRD or ALS

  • End-Stage Renal Disease (ESRD): Medicare benefits can begin as soon as the first day after three months following a course of regular dialysis or kidney transplant. Under certain conditions, Medicare coverage could start on the first month of dialysis.
  • Amyotrophic Lateral Sclerosis (ALS): Medicare benefits can begin at the same time you start collecting Social Security Disability benefits. Coverage is the same for people who qualify based on disability as those who qualify based on age.

You’re Younger than 65 but have a Qualifying Disability

If you’ve been receiving Social Security Disability for 24 months, you now also qualify for Medicare coverage. You should receive a Medicare card in the mail when the required time period has passed.

How does Original Medicare enrollment work?

In some cases, enrollment is automatic. If you collect Social Security or Railroad Retirement Board benefits when you turn 65 or if you’re Medicare-eligible at any age due to a disability or medical condition, you’ll generally be automatically enrolled in Original Medicare, which includes:

  • Part A – coverage for hospital expenses
  • Part B – coverage for healthcare expenses
  • Part A – coverage for hospital expenses
  • Part B – coverage for healthcare expenses

In other cases, individuals must actively enroll. If you’re not currently receiving Social Security benefits or Railroad Retirement Board benefits when you turn 65, you must complete the formal enrollment process.

Learn More About Enrolling in Medicare

The Cost of Medicare

Medicare Part A

In many cases, Medicare Part A is premium-free. This includes:

  • If you are 65 or older and you worked and paid Medicare taxes for at least 10 years (or you’re a government employee who is Medicare-covered).
  • If you are receiving retirement benefits from Social Security or the Railroad Retirement Board (or you’re eligible but haven’t yet applied).
Medicare Part B

Everyone pays a monthly premium for Medicare Part B. The amount is either deducted from your Social Security, Railroad Retirement or Civil Service Retirement check. If you don’t qualify for any of these, you’ll receive a bill every 3 months directly from Medicare.

Original Medicare & Additional Coverages

Original Medicare (Parts A & B) only covers 80% of all healthcare costs. That said, you should consider additional coverage to help with “gap” costs, as well as to help cover prescription drug costs. There are two options to address these costs:

Option 1

Medicare Advantage

An alternative to original medicare offered through private insurers. These plans may offer additional benefits.

Option 2

Medicare Supplement Plans A through N

Sometimes called MediGap or Gap Plans and are offered through private insurers.

Enrollment in these plans is required if you choose to have additional types of coverage. These plans are offered through private insurers who contract with Medicare and benefits vary based on carrier, plan and where you live. It’s important to note that you cannot have a Medicare Advantage Plan if you choose to purchase a Supplemental Insurance Plan.

We can help you navigate all the complexities of Medicare. There’s no obligation to enroll.

Planning to work after turning 65?

Your 65th birthday and your Initial Enrollment Period (IEP) for Medicare are still important Medicare milestones, even if you plan to continue working. Even if you have health coverage through your employer insurance (or your spouse is working and you’re covered through their employer), certain Medicare decisions must be made.

Be sure to check with your employer before your 65th birthday and before your IEP period to confirm the company’s requirements, as some employers require you to enroll in Original Medicare (Part A and Part B) at age 65. You may have the option of only enrolling in Part A (which is free for most people and provides hospital coverage) in addition to your employer’s healthcare plan.

The Coverage You Deserve at a Price You Can Afford

It pays to be informed and proactive when it comes to getting covered. Take the time to familiarize yourself with Original Medicare, additional coverages and alternative coverages to help fill gaps and make the most out of your premiums.

For all of this, SelectQuote can help. We’ll help you save both time and potentially money by navigating Medicare and explaining it to you every step of the way. In just minutes, we can compare options available in your area and there’s no obligation to enroll.

We do the shopping. You do the saving.

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