Medicare Eligibility

It’s a question that plagues the search pages and Q&A pages of forums and medical sites all over the nation – how do you know if you are eligible for Medicare?

First and foremost, Medicare is designed as a federal-run insurance system for healthcare needs in the United States. It covers those aged 65 and over who have been paying their Medicare payroll taxes and working in the United States for at least ten years upon turning 65.

If you don’t tick all of these boxes, then the immediate indication is that you will likely have to sign up for Medicare rather than expecting to get coverage automatically.

There are other instances where an individual may be eligible prior to reaching the age of 65, with the 2019 Medicare Trustees report stating that while 52 million Medicare beneficiaries in 2018 were over the age of 65, a further 8 million were young people who were eligible under different circumstances. These include:

Those living with disabilities
Those who have permanent kidney failure

Once you have ascertained whether you are eligible or not, it’s time to choose your coverage. Most individuals tend to opt for the Original Medicare package, which includes Parts A and B, with additional private insurance taken out to cover the remaining costs. Others may choose to implement Part C or Part D to establish a more comprehensive coverage plan.

What Factors Affect Your Eligibility?

The biggest obstacle which can get in the way of receiving Medicare coverage is the time spent in the United States and the amount contributed as part of the compulsory taxes. Those who have not worked in the United States for at least ten years, or who have not paid towards the Medicare payroll tax will find that their plan comes equipped with a premium which must be paid monthly.

It is also worth noting that while you become eligible for all plans when you hit 65, you do not have to sign up for them at that time. You can choose to bypass Plan B and simply move forward with Plan A if you wish; however, if you do this, you will have to pay a penalty if you decide to sign up for Plan B sometime in the future. This penalty will likely be an extra 10% on your premium.

Are you ready for your game changing experience?


Get the Support You Need with Game Changing Benefits

Finding out you are eligible for Medicare benefits is both an exciting and nerve-wracking time. While qualifying for coverage is a great first step, deciding what plans you will need for comprehensive insurance coverage can be stressful. The Game Changing Benefits agents make it our mission to alleviate this stress and set you on the best path for health insurance. Through a free consultation, we will determine your goals and which plans make the most sense for your current needs. 

To get started, give us a call today at 972-331-1060.