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Medicare Eligibility

Your Medicare eligibility is dependent on three major factors—age, health status, and work history. While cost, coverage, and availability vary based on plan, location, and provider, your Medicare eligibility does not change. You are eligible for Original Medicare if:

  • You are a U.S. Citizen and 65 or Older
  • You Have End-Stage Renal Disease (ESRD)
  • You Have Lou Gehrig’s Disease
  • You are Receiving/Can Receive Social Security or Railroad Retirement Benefits
  • You or Your Spouse is a Government Employee
  • Are Under 65 and Have Received Certain Disability Benefits from the RRB for at Least 24 Months
  • Are Under 65 and Have Received Disability Benefits from Social Security for 24 Months or More

Premium-Free Medicare Part A Eligibility

A premium is a monthly payment given to your insurance provider. Those who receive Original Medicare are required to pay a premium on their Part B coverage. Many people, however, are eligible for premium-free Medicare Part A. You are eligible for premium-free Part A if:

  • You or your spouse worked and paid Medicare taxes for at least 10 years.
  • You are receiving or are waiting to apply for retirement benefits from Social Security or the Railroad Retirement Board.
  • You or your spouse had Medicare-covered government employment.

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Medigap Eligibility

To be eligible for Medigap, you must first meet the requirements of and have Original Medicare. Once you have met these standards, you are able to apply for Medigap at any point.

It is important to keep in mind, however, that while you have the option to apply for coverage at any point, the best time to do so is six months after your Part B coverage begins. During this window of open enrollment, you may apply to any Medigap plan regardless of your health condition.

You may still apply outside of this initial time, but Medigap providers may alter their costs to fit your medical needs. Be sure to understand the costs of your plan prior to signing up.

Confused by Your Cost and Coverage Eligibility?

We understand that you may still have questions about your Medicare eligibility—that’s why we’re here to help. MedicareMisty is dedicated to providing the best possible coverage in an understandable and friendly way.

If you would like to learn more about your eligibility and coverage options, give us a call.