Who Qualifies For Medicare? Do I Qualify For Medicare Benefits?


Medicare can provide you with the health insurance you need to offset the costs of high medical expenses. Before you begin receiving the benefits of Medicare, you should first meet the qualifications.


Parts of Medicare

There are four parts of Medicare that provides different types of coverage:


  1. Part A hospital insurance.
  2. Part B medical insurance.
  3. Part C, Medicare Advantage Plans provide the same coverage as Part A and Part B, and usually, Part D.
  4. Part D prescription drug coverage.


Video: Who Can Qualify for Medicare?

Part A Qualifications

You can receive Part A if you meet the following qualifications:


  1. U.S. citizens who are over 65 who receive or are eligible to receive Social Security or railroad retirement benefits.
  2. You or your spouse, including deceased and divorced spouses, worked a specific amount of time in a government job and paid Medicare taxes.
  3. You are the dependent of someone who worked a specific amount of time in a government job and paid Medicare taxes.
  4. You have received Social Security disability for 24 months.
  5. You receive disability pension from the railroad retirement board.
  6. You have Amyotrpohic Lateral Sclerosis (ALS) also known as Lou Gehrig’s disease.
  7. You have End-Stage Renal disease, a type of permanent kidney failure that requires dialysis or a transplant.

Part B Qualifications


  1. You qualify for Part A, or
  2. You are a U.S. citizen over 65.
  3. medicare and medicaidYou were lawfully admitted into the U.S., have lived here for at least five years, and you are over 65.

Part C Qualifications


  1. You have Part A
  2. You have Part B

Part D Qualifications 


  1. You have Part A,
  2. You have Part B, or
  3. You have Part C


When Does Medicare Become Effective

Some individuals are automatically enrolled in Medicare. This includes those who are already receiving Social Security or Railroad Retirement benefits. Your Medicare plan becomes effective the first day of the month you turn 65. For example, if you turn 65 on September 21, 2009, your Medicare benefits become effective on September 1, 2009.

If you enroll during general enrollment, which is from January 1 to March 31 each year, your coverage will become effective on July 1 of that calendar year.

If you enroll in a Medicare Advantage Plan or prescription drug plan between November 15 and December 31, your coverage becomes effective January 1 the next year.

Required Medicare Paperwork

Whether you enroll in Original Medicare or a Medicare Advantage Plan, you will be required to fill out some applications. Much of this paperwork can be confusing and many people require assistance. If you need help, make sure you use someone you can trust like a family member, a member of the Medicare staff at your hospital or outpatient facility, a member of the Social Security Staff, or staff at the State Health Insurance Assistance Program (SHIP) near you. Staff at your local senior citizen center may also be able to help you fill out the paperwork at no charge. A family attorney can help you with your Medicare paperwork, but may charge a fee.


Video: Medicare Made Easy

When Only One Spouse Qualifies

If you did not work enough to receive Social Security benefits, you can still qualify for free Medicare if your spouse did as long as you do not develop a disability before age 65.


who qualifies for medicare?

Even if you do not qualify for premium-free Medicare, you can purchase Medicare during your initial six month enrollment period which begins three months before your 65th birthday and ends three months after your 65th birthday. You can enroll between January 1 and March 31 each year if you miss your initial enrollment period, but you face a penalty increase on your premiums for that year.