Medicare Eligibility

Who is eligible for Medicare?

(Medicare Eligibility Checklist)

  1. Age 65 and older
  2. Younger People with disabilities
  3. People with End Stage Renal Disease (ESRD) Disease (permanent kidney failure requiring dialysis or transplant)

You can get Part A at age 65 without having to pay premiums if:

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
  • You or your spouse had Medicare-covered government employment.

Medicare Eligibility Requirements Is it Automatic?

One wrong belief about Medicare eligibility is that everyone receives their benefits upon turning 65. This is not true. Age-related Medicare eligibility requires meeting the following:

  • You are either an American citizen or a permanent, legal resident who has resided in the U.S. for at least five years.
  • Either you or your spouse worked for at least 10 years to earn the 40 credits necessary to receive railroad retirement or Social Security benefits. One credit equals three months (one-quarter of a year). You receive Part A services without paying a premium only if you earned 40 credits.
  • Either you or your spouse is employed by or retired from the government and did not pay into Social Security but did pay Medicare taxes while employed.

If you did not earn 40 credits, you must pay a monthly premium for Medicare Part A hospital insurance. You can also apply for Part A coverage without paying a premium based on your spouse’s work record if you are at least 65 and your spouse is at least 62.