Healthcare • August 26th, 2020

What Is the Medicare Eligibility Age?

Stephanie Faris

Key Takeaways
  • When you ask, “How old for Medicare eligibility?” the minimum age is 65.
  • You may qualify for Medicare at any age if you’re receiving Social Security Disability Insurance.
  • To receive premium-free Medicare A, you’ll need to meet some basic eligibility requirements.

How old do you have to be to get Medicare? If you’re asking that question, you may be thinking about what your retirement health care situation will look like. Although you can apply for Social Security Disability Insurance at any age, as long as you have a qualifying condition, you’ll need to be at least 65 to be approved as a Medicare retiree.

But age and disability aren’t the only Medicare requirements you’ll need to meet. You’ll also need to have paid into the program during your working years. Here’s what you need to know about your Medicare eligibility.

Who's Eligible at 65?

For most Americans, Medicare eligibility age will determine when benefits are first available. There are two major types of Medicare:

  • Medicare Part A--This is the plan you’re automatically enrolled in when you’re approved for Medicare. It covers hospitalizations, hospice care, and some skilled nursing care. If you meet qualifications, this plan will be premium-free, although some are eligible for the insurance as long as they pay premiums.
  • Medicare Part B--This plan covers your doctor’s visits, lab tests, and other routine procedures. You’ll pay premiums for this part, so if you’re still working at 65, you may opt to defer this part of the plan until you retire.

Retirees

If you’ve worked for at least 10 years, you’ve probably paid taxes into the Medicare system. That means you’ll be eligible for premium-free Medicare Part A. But even if your employer didn’t pay Medicare taxes, you may be eligible for Part A without premiums.

Those reaching Medicare eligibility without paying taxes could be eligible for premium-free Medicare through an employer-sponsored retirement program. You may also qualify for Medicare under your spouse’s work record.

To check your eligibility for Medicare coverage, use the tool at Medicare.gov.

Those Continuing to Work

Even if you’ve reached the minimum Medicare age, you may want to continue to work. As long as you’ve met all other eligibility requirements, you can still get coverage through Medicare. But if your employer provides health insurance, you’ll want to sit down with your HR department to decide whether you should enroll in Medicare Part B.

One thing to note, if you’re still working, you qualify for an exception to the required enrollment period. Normally you’d have to apply within seven months of first becoming eligible, but if you’re still working, you can sign up at any time.

Spouses

If you’ve ever been married, yours isn’t the only Medicare qualifications to consider. You may be eligible for premium-free Medicare Part A if any of the following applies:

  • You’ve been married for at least one year and your spouse qualifies for Social Security benefits.
  • You’re divorced but your marriage lasted at least 10 years, and your spouse qualifies for Social Security.
  • You are widowed and were married for nine months or longer before your spouse died.

To qualify for Medicare insurance under a late spouse or ex-spouse’s plan, you will have to remain single for the remainder of your time on the plan.

Applying for Disability Benefits

A person aged 65 or older isn’t the only one who qualifies for Medicare. If you’re eligible for Social Security Disability Insurance (SSDI), you’re also eligible for Medicare. However, there’s a 24-month wait for benefits. That means once you’ve been approved for disability benefits, you’ll have to wait two full years to see Medicare benefits.

Once approved, you’ll get at least seven years and nine months of continuous Medicare health insurance as long as your qualifying disabling condition persists. You can also buy premium Medicare A, as well as Medicare B, at the same rates paid by uninsured eligible retired beneficiaries.

Disability Benefits If You Still Work

When does Medicare start? Although it can start within 24 months of qualifying for SSDI, things get a little trickier if you continue to work.

After that 24-month qualifying period, you can receive benefits for up to 93 months, as long as you still have the disabling condition. It’s important to note that even if your SSDI stops due to your work situation, you typically won’t lose the insurance coverage you have under Medicare to take care of your healthcare costs.

Final Thoughts

Once you’ve determined at what age you can enroll in Medicare, you can start planning for your retirement. Although premiums for Medicare Part B vary from year to year, you can do a rough estimate of what your monthly expenses will be. We recommend working with a Certified Financial Planner® to make sure you’ll have the income you need to take care of your medical expenses, along with your other costs, after you leave the workforce.

Author

Stephanie Faris

Stephanie Faris has written about finance for entrepreneurs and marketing firms since 2013. She spent nearly a year as a writer for a credit card processing service and has written about finance for numerous marketing firms and entrepreneurs. Her work has appeared on Money Under 30, The Motley Fool, MoneyGeek, E-commerce Insiders, and GoBankingRates.