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Medicare Eligibility

Medicare Eligibility Requirements

While turning 65 years old will make you eligible for Medicare benefits, it does not mean that you will meet all the qualifying factors right away. Below is an outline of criteria that must be met for individuals looking to obtain coverage through Medicare.

Individuals 65 or Older

For anyone who is 65 years of age or older, you may be eligible for full Medicare benefits if you meet the following criteria:

  • You were born in the United States and are a U.S. citizen or a permanent legal resident that has lived within the United States for the last five years
  • You have been receiving either Social Security or railroad retirement benefits or have enough years worked to be eligible to receive benefits but have not started collecting them yet
  • Either you or your spouse is an employee or retiree of the government who has not paid into Social Security but paid Medicare payroll taxes during their career.

Individuals 65 or Younger

If you are under the age of 65, you still may be eligible for full Medicare benefits if you meet the following criteria:

  • For at least 24 months you have been entitled to Social Security disability benefits
  • You are currently receiving a disability pension from the Railroad Retirement Board while meeting certain conditions
  • You have amyotrophic lateral sclerosis (ALS)
  • You are required to undergo regular dialysis or a kidney transplant as a result of permanent kidney failure, and you or your spouse has paid Social Security taxes for a specific period of time.

Alternative Ways to Acquire Medicare Coverage

If you find that you do not qualify on your own or through your spouse, you may still be eligible for full Medicare benefits at the age of 65 or older. The only difference is that you will need to buy into the Medicare programs. 

As you work, you are credited with work credits based on the number of years you have been in the workforce that can be used towards Medicare Part A premiums. As of 2020, an individual would earn one work credit for every $1,410 in earnings, with a maximum of four credits earned per year. If after adding up the number of work credits you have had over the years is less than 30, you will have to pay the maximum premium, $458 in 2020. Between 30 to 39 credits, you will pay $252 a month, and anything over 40 credits will result in no premium.

If you are interested in buying into Medicare Part B, you will pay the same as other enrollees. For 2020, if your yearly income is less than $87,000 or $174,000 if you file jointly, then the monthly premium is $144.60.

How We Can Help

Hitcho Insurance has supported clients and their families through the Medicare enrollment and coverage process for over 20 years. We get to know your goals and needs on a personal level through an in-depth one-on-one consultation process. It is our mission to work with you one step at a time until you are comfortable and understand all of the options available to you. To schedule a consultation with us, give us a call at (610) 694-9435.

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