How to Know If You Are Eligible for Medicare

Medicare enrollment form

Congratulations! You are ready to retire and enter a new phase of your life. However, you’re not sure if you’re eligible for Medicare yet. Once you decide to retire you will no longer be apart of your employer’s health insurance program, so it is important to know where you stand with Medicare eligibility. The simple answer is if you are 65 or older you are eligible for Medicare. However, if you decide to retire before reaching age 65 you may need to seek other health insurance coverage that best fits you and your family until you become eligible for Medicare. 

Are You Eligible for Medicare?

Medicare coverage is only available for those 65 or older. You or your spouse must enroll with Medicare during your Initial Enrollment Period. Your IEP is a seven-month window, the three months before turning 65, the month of your 65th birthday, and the three months following your 65th birthday if you want to be fully covered by Medicare on your 65th birthday. However, if you are 65 and still have satisfactory employer coverage you can opt to delay enrolling in Medicare until you retire. Those who are younger than 65 but have been diagnosed with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) or ALS (Lou Gehrig’s Disease) are also eligible for Medicare. You may also be eligible for Medicare if you are under the age of 65 and have been disabled, unable to work for 24 months and receive disability income from the Railroad Retirement Board or Social Security.

Enrolling in Medicare

If you are eligible for Medicare, you most likely will receive Medicare Part A for no expense. To continue, you can receive Medicare Part A premium-free if you or your spouse has paid Medicare taxes while working. 

Original Medicare has two parts, Part A (hospital insurance) and Part B (medical insurance). You and your spouse can receive Medicare Part A premium-free if you qualify one of these three other ways. One, you are receiving retirement benefits and paid Medicare taxes for at least ten years. Two, you are already receiving retirement benefits from social security or the Railroad Retirement Board. Or three, if you or your spouse had Medicare-covered by government employment. 

If you are not eligible for Medicare Part A for free you can also buy Medicare Part A with a monthly premium charge of up to $458 a month. 

Retired Before Turning 65

If you or your spouse decide to retire before turning 65 you are not yet eligible for Medicare coverage. However, If you still want to maintain the coverage you will have to purchase health insurance until you become eligible for Medicare. Different options for enrolling may vary by state but include:

  • Your former employees’ insurance
  • Medicaid
  • The Marketplace
  • Health Sharing Plan
  • Part-time job
  • Health Savings Account self-fund

To learn more about your options for enrolling in health insurance contact an agent who specializes in Medicare today.


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