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Learn About Medicare Requirements

To get coverage, you need to understand how to qualify for Medicare. Income does not affect your coverage application. Instead, you qualify based on your age or a health condition. For some people, Medicare can only be available around retirement. For others, having a disability can secure them coverage at a younger age.

Overall, your Medicare qualifications and the amount you pay for benefits will depend on your individual situation. For example, you may qualify for Medicare at no cost if you worked and paid income taxes for enough years, whereas people who did not work long enough will have to pay a premium.

Discover at What Age You Can Apply for Medicare

The age to qualify for Medicare is 65 because, in the past, the average retirement age was 65. This number has increased over the years, but to make sure you get Medicare right away when you retire, you should start applying and avoid late application penalties.

Although most people first meet Medicare requirements at 65 years of age, you can also receive coverage at a younger age if you have a disability or health condition. You can also qualify for coverage if you are in any of these situations:

  • You have been getting Social Security Disability Income (SSDI) benefits or railroad retirement board disability benefits for two years.
  • You have amyotrophic lateral sclerosis (ALS).
  • You have permanent kidney failure, also known as an end-stage renal disease (ESRD).

Find out If You Can Automatically Meet the Medicare Requirements

Depending on your situation, you may qualify for Medicare and get coverage automatically without applying. If you think you qualify for Medicare, check to make sure that you are on schedule to get any benefits you deserve.

If you think you meet the basic Medicare requirements because of a health condition or disability, it’s possible that you do not qualify immediately. Depending on your situation, you may need to wait up to two years to get coverage, even if you currently have a qualifying health condition. Other times, you can get coverage as little as a month after you are diagnosed with a qualifying condition.

To learn more about automatic enrollment and how to apply, download or helpful Medicare guide.

Note: Even if you are enrolled in the program as soon as you qualify, you will only get Parts A and B automatically. If you want Part D coverage or would rather sign up for a Part C (Medicare Advantage plan) instead, you will need to take the steps to do this on your own.

Learn About Qualifying for Medicare With a Disability

Most people who qualify for Medicare will no longer work after they start receiving benefits, either because of retirement or because of a medical condition that prevents them from returning to work. However, if you have a disability, you may be able to return to work as long as you do it without losing your Medicare coverage. You will enjoy Medicare benefits as long as your condition still qualifies you for them.

If you plan on returning to work permanently, you can continue getting Part A coverage at no cost for the first few years. Afterward, you may keep your benefits, but you will have to pay a premium.

Qualifying for Medicaid Vs. Medicare

Many people believe that Medicare is an income-based program, but it is not. Medicare can sometimes be confused with Medicaid, a separate government-run health care program that is available for low-income families and other specific people. But there is no income limit for Medicare like there is for Medicaid. As long as you meet the age, health or disability requirements for Medicare, you can get benefits.

Find Out If Income Affects Medicare Coverage

Although there are no income requirements for Medicare, you need to understand that your income may affect how much you pay for coverage. For example, premiums for Medicare Part B are adjusted based on your income. The more you earn, the more you can pay for coverage when it comes to Medicare Part B.

If you are currently paying a higher premium based on your income, your premiums can be adjusted if your income changes because of marriage, divorce, death, natural disaster or changes in your employee benefits. In those cases, you can provide the documents showing your new situation and ask to get Medicare benefits at a lower premium.

Discover Whether You Can Apply for Medicare If You Have Another Insurance

It is possible to meet Medicare qualifications even if you already have other insurance. When you have different types of coverage, every insurer is considered a “payer,” and a specific set of rules determines who pays first. Depending on your specific policy and situation, who pays first will vary.

In some situations, Medicare will pay first, and then your other insurance will. Other times, Medicare will pay second after you have met the limits of your other insurance. The rules for who pays first also take into account if your husband or wife has coverage and ifr you are still employed.

As mentioned before, Medicare is separate from Medicaid. But you can qualify for both if you meet all the requirements. If you are enrolled in both programs, know that Medicare and any other plans that you may have will always pay before Medicaid.

It is also possible to meet the Medicare criteria as well as the requirements for other government programs like veteran’s benefits, but these particular programs work a little differently together. If you qualify for both veteran’s benefits and Medicare, you have to choose which coverage if you want to use when you are being treated, because Medicare will not share the costs with veteran’s benefits or vice-versa.

To learn more about supplemental insurance and how it works with your Medicare benefits, download our free Medicare guide.