What Is the Medicare Eligibility Age? - SmartAsset

For just about everyone, the Medicare eligibility age is 65. At that point, you’ll have access to Medicare Part A and are able to purchase Medicare Part B. For some with disabilities or End Stage renal disease, though, eligibility may come at a younger age. Most people are eligible to receive part A without having to pay for it, but there are a few exceptions, which we’ll note in further detail below. For help with healthcare planning and other questions about finances and retirement, consider working with a financial advisor.

Medicare Eligibility Age

The current Medicare eligibility age is 65. This means that people 65 and over are eligible to begin receiving Medicare benefits.

Besides your age, you must also meet further requirements to receive Medicare benefits. First off, you must be a U.S. citizen or a permanent legal resident in the U.S. for at least five years. You may also qualify if you or your spouse has worked long enough to be eligible for Social Security benefits. Lastly, you can qualify if you or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes.

The Congressional Budget Office (CBO), which aims to provide impartial research and analysis for Congress, has introduced a plan that would gradually increase the eligibility age by two months each year until it reaches 67 for people born in 1966 and after. This is a very similar plan to what took place with the Social Security Full Retirement Age in 1983. However, no official action has been taken on this plan. For the foreseeable future, you’re eligible for Medicare once you hit 65.

Medicare Before the Medicare Eligibility Age

There are also ways an individual under the age of 65 can be eligible for Medicare. For one, you may qualify if you have been eligible for Social Security benefits for at least 24 months. If you have a Railroad Retirement board disability pension you can also qualify. Or, if you have end-stage renal disease or Lou Gehrig’s disease, you may qualify for Medicare benefits below the eligibility age.

You can also still get full Medicare benefits even if you don’t qualify based on your work record or your spouse’s. However, you still must be at least 65 and a U.S. citizen or a legal resident of the U.S. for at least five years. To qualify, you must pay premiums for hospital insurance (Medicare Part A) and pay the same monthly premiums that other enrollees pay for doctor visits (Part B) and prescription drug coverage (Part D).

How to Enroll for Medicare

If you meet the requirements for those 65 and older, you can receive Medicare Part A without paying any premiums. However, if you or your spouse did not pay Medicare taxes, you may have to pay for Part A. Medicare Part A covers hospital insurance. Medicare part B covers things like outpatient care, preventive services and medical equipment. It can also cover part-time home health services and physical therapy. Should you decide you also want Medicare Part B, you must pay a monthly premium.

If you have received Social Security disability benefits for 24 months, you will automatically be enrolled in Medicare at the start of the 25th month. If you have Lou Gehrig’s disease, you are automatically enrolled the first month you begin receiving benefits. For these situations, enrollment includes both Medicare Part A and Part B. However, if you have end-stage renal disease, your Medicare benefits are determined on a case-by-case basis. In this case, you will need to manually apply.

Bottom Line

It’s important to know when you reach the Medicare eligibility age. That way you can apply for Medicare as soon as possible. Even if you qualify for an exception, you won’t always automatically receive Medicare benefits right away. Staying educated about your Medicare eligibility status will ensure you’re receiving the benefits you need. To better understand Medicare coverage specific to you, be sure to contact Social Security and head to Medicare.gov.

Tips for Getting Retirement Ready

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