Medicare health insurance is available to individuals 65 or older. If you have a disability, End-Stage Renal DiseaseEnd-Stage Renal Disease (ESRD), also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age. (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig’s disease), you may be able to get Medicare earlier.
Here’s how you can determine if you are eligible.
You’re 65 or Older
At age 65 you qualify for full Medicare benefits if:
- You are a U.S. citizen or a legal permanent resident who has lived in the USA for five years or longer and;
- You have Social Security or railroad retirement benefits or have worked long enough for benefit eligibility but are not yet collecting them.
- You or your spouse is a government employee or retiree who paid Medicare payroll taxes while working.
You’re Under 65
You may qualify for Medicare benefits under age 65 if:
- You have been receiving Social Security disability benefits for at least 24 months; or
- You receive a disability pension from the Railroad Retirement Board (with certain conditions); or
- You have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, which qualifies you immediately; or
- You have End-Stage Renal Disease (ESRD) requiring regular dialysis or a kidney transplant, and you or your spouse has paid Social Security taxes for a specified period (depending on your age).
What if I Take My Social Security Retirement Early?
Social Security and Medicare are not linked. They are separate benefits, and Social Security allows you to begin taking your retirement benefits as early as age 62, whereas Medicare does not.
Depending on your age, however, your full retirement age for Social Security will be between age 66 and 67. You can also choose to delay taking your Social Security retirement benefit all the way up to age 70. If you delay your benefits until after full retirement age, you will be eligible for delayed retirement credits that would increase your monthly benefit.
Also See: Medicare at Age 62: Fact or Fiction?
What If I Am Still Working?
If you are still working after age 65, you may be able to delay signing up for Medicare if you have group health insurance through your employer. It all depends on the number of employees your employer has and whether or not their health plan is creditable health coverage.
If your employer has fewer than 20 employees, you must sign up for Medicare at age 65. If your employer has 20 or more employees, you can keep your group health coverage (if it’s creditable) until you retire or leave the company.
The only way to know for certain if your group health planA group health plan is a health plan offered by an employer or employee organization that provides health coverage to employees, their families, and retirees. is creditable or not is to call your plan and ask. Do not take the word of your company’s human resources department. They will not incur a late penalty. You will.
For More Details: Can I Sign Up for Medicare If I Have Employer Health Insurance?
When to Sign Up
You can begin Medicare enrollment three full calendar months before your 65th birthday. When you do, your coverage will begin on the first day of your birth month. This is your Initial Enrollment PeriodThe Initial Enrollment Period is a seven-month period when new beneficiaries can enroll in Medicare without a penalty. Most people enroll in Medicare at age 65., which is seven months in duration.
If you don’t enroll prior to your 65th birthday, you can sign up during the three calendar months after your birth month. When you do, your coverage will begin on the first day of the month after you enrolled.
For More Details: When To Apply for Medicare If You’re Turning 65
How to Sign Up
To sign up for Medicare you will need prove you are eligible. If you are already taking Social Security or Railroad Retirement benefits, this will happen automatically. If not, you will need to initiate the process yourself.
Here’s how it works:
- Eligibility Verification: To enroll in Medicare, you must prove your eligibility, which includes verifying your age, citizenship or residency status, work history, income history, and military service.
- Visit Social Security Administration (SSA): After gathering the required documents, the next step is to visit your nearest Social Security Administration (SSA) office to submit your Medicare application. Appointments may be required, so it’s advisable to call ahead or check the SSA website for their procedure.
- Personal Information: You’ll be asked to provide personal information when applying for Medicare, which typically includes details such as your date and place of birth, Social Security number, marriage and divorce information, children’s details, income history, and more.
- Supporting Documents: While most information can be provided by filling out the application form, some details may require additional documentation, such as birth certificates, proof of citizenship or residency, military service records, income information, and more.
- Complete the Application Form: Carefully fill out the Medicare application form provided at the SSA office, ensuring that all information is accurate and up to date. Don’t hesitate to ask SSA staff for assistance if needed.
- Application Processing: Be patient during the processing of your Medicare application, as the timeframe can vary. Avoid making significant healthcare decisions during this period, as your coverage eligibility is still being determined.
- Receive Your Medicare Card: Once your application is approved, you will receive your Medicare card, signifying your official enrollment in Medicare and granting access to its healthcare benefits. Remember to keep your Medicare card in a safe place and carry it with you when visiting healthcare providers or facilities.
In conclusion, applying for Medicare is an important step to secure healthcare coverage during your eligible years. By gathering the necessary documents, visiting the SSA office, completing the application accurately, and waiting for the processing of your application, you can ensure access to the benefits provided by Medicare.