Are you eligible for Medicare?

Are you eligible for Medicare? This is one of the most asked questions, here are critical facts about eligibility to know.

To qualify for Medicare benefits, you must meet the following criteria:

  • You are age 65 or older.
  • You are a US Citizen or a permanent legal resident and has resided in the United States for at least five consecutive years.
  • You or your spouse has worked at least 10 years or 40 quarters, qualifying you for Social Security or Railroad Benefits.

Please note that the work requirement for credits does not have to be consecutive.

Also, if you or your spouse are current or retired government employees and were not required to pay into Social Security but have paid your Medicare payroll taxes, you also are eligible for Medicare.

You also can qualify for Medicare benefits at any age if you meet one of the following criteria:

  • You have been entitled to Social Security Disability benefits for at least 24 months. You would be eligible for Medicare starting on your 25th month.

Please note that the 24 months that you receive Social Security benefits does not have to be consecutive.

  • You have End Stage Renal Disease (ESRD) and you and/or your spouse have paid Social Security taxes for the required amount of time. That required amount of time is calculated by your age.
  • You have Lou Gehrig’s disease (ALS), which allows you immediate enrollment into Medicare.

What if you do not qualify under these two scenarios?

If you are a US Citizen or permanent legal resident for at least five consecutive years, you can still receive Medicare benefits once you are age 65 or older by:

  • Paying the premiums for Medicare Part A.

The cost for Part A in 2019 is $439/month if you have no work credits. However, if you have 30-39 work credits, your Part A premium is reduced to $239/month. If you continue to work and achieve the 40 credits, you would no longer have to pay the Part A premium.

  • Paying the premiums for Medicare Parts B and D.

Unlike Part A, you would be responsible for Part B and Part D premiums regardless of your work history. Parts B and D are solely paid out-of-pocket unless you are eligible for Medicaid and/or Extra Help.

More important facts to remember…

  • You can enroll in Part B without enrolling in Part A. However, if you enroll in Part A, you must also be enrolled in Part B.
  • By having either Part A or B coverage, you are eligible for a Medicare Part D prescription drug plan as well.
  • To purchase either a Medicare Advantage or a Medicare Supplement/Medigap plan, you must be enrolled in both Parts A and B.

Not sure if you have the required number of work credits to be eligible for Medicare?

Your Social Security statement will indicate if you are eligible for Medicare based on your work record. If you are not receiving Social Security statements, please contact SSA immediately.

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