How To Know If You’re Eligible For Medicare

Medicare is an excellent option for those needing health insurance, but how do you know if you’re eligible to enroll in such a program?

Well, for many, their Medicare eligibility starts when they meet one of these requirements:

You’re 65 or older
You’re younger than 65 with a disability
You have End-Stage Renal Disease (ESRD) or ALS

How Do I Know If My Disability Qualifies?

Most people get Medicare by being 65 or older, which is fairly straightforward. But if you’re younger than 65 with a disability, how do you know if you qualify?

Typically, you qualify due to a disability if you have been receiving Social Security Disability Insurance (SSDI) checks for more than 24 months. This is also known as the two-year waiting period, which begins the first month you receive a check from SSDI. At the beginning of your 25th month of receiving SSDI checks, you will be automatically enrolled in Medicare.

However, if you receive SSDI checks because you have ALS (Amyotrophic Lateral Sclerosis), you do not have the two-year waiting period. Medicare automatically begins the first month you receive SSDI.

Medicare doesn’t determine whether or not you qualify for SSDI and they don’t administer the program that provides the checks. Social Security handles the determination and administration of SSDI.

If you were diagnosed with ESRD, you will become eligible for Medicare if your kidneys are no longer functioning and you need dialysis or a kidney transplant.

I’m Eligible for Medicare. Now What?

Once you become eligible for Medicare, you can enroll. Some people will be enrolled in Original Medicare automatically, while others need to sign up for it. Usually, it depends on whether you’re getting Social Security benefits or not.

Suppose you’ll be receiving Social Security benefits or Railroad Retirement Board (RRB) benefits for at least 4 months before you turn 65. In that case, you’ll usually get automatically enrolled in Part A and Part B starting the first day of the month you turn 65. If you’re not receiving those benefits for four months before turning 65, you’ll need to sign up.

If you don’t get automatically enrolled and become eligible when you turn 65, you can enroll during what’s known as the initial enrollment period, which begins three months before your 65th birthday month and ends three months after. During these 7 months, you can sign up for Medicare Part A and/or Part B.

So if you turn 65 in September, your initial enrollment period runs from June of the year you turn 65 through the end of December.

If you have ALS, you automatically get Original Medicare the month your disability benefits begin. With other disabilities, you’ll automatically be enrolled in Medicare at the beginning of your 25th month of receiving SSDI.

Need Medicare Support?

We can help you enroll in the right plan for you when you become eligible, avoiding late enrollment penalties and coverage gaps. At Simple Retirement Benefits, we help you make educated choices about your Medicare coverage so you can get back to enjoying your life stress-free. Reach out to us today at 512-432-5414 for your free quote.