Take the mystery out of Medicare eligibility

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When are you eligible for Medicare? Aetna can help you find out

Medicare eligibility is based on many different factors, including your age, disability status, and whether you or your spouse qualify to receive Social Security or Railroad Retirement Board benefits. If that sounds a little complicated, don’t worry. Aetna’s friendly, licensed agents can help take the mystery out of your individual Medicare eligibility requirements with just a simple phone call. Speak to an agent today to find out if you qualify for Medicare benefits.

Want more info before you talk to an agent? No problem! Read on to learn more about when you’re eligible to enroll in Medicare health insurance plans.

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What is the Medicare eligibility age?

Generally speaking, the magic number is 65. In other words, the requirements for enrolling in Medicare change depending on whether you’re older or younger than 65.

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Medicare eligibility at 65 or older

If you’re at least 65 years old and a citizen of the US who's been living in the country for at least five years, chances are you’re already eligible to enroll in Medicare Part A and Part B (also called Original Medicare). In fact, if you’re already receiving Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Original Medicare starting the month of your 65th birthday.

In addition, if you’re eligible for Original Medicare (Medicare Parts A and B), you also have the option to enroll in other Medicare plans, such as Medicare Advantage (Part C), prescription drug coverage (Part D), or Medicare Supplement (Medigap). You can do so during any of your eligible Medicare enrollment periods.

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Medicare eligibility before 65

Generally speaking, if you’re under the age of 65, you are only eligible to receive Medicare benefits if you have certain Medicare-recognized disabilities, such as end-stage renal disease (otherwise known as kidney failure or ESRD) or amyotrophic lateral sclerosis (also called ALS or Lou Gehrig’s disease).

Talk to a Licensed Agent

Talk to a Licensed Agent

1-855-399-5318
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Medicare plans eligibility

As you might have guessed, each Medicare plan comes with different eligibility requirements. Tap or click on the plan you’re interested in to learn more.

Medicare Part A eligibility

If you’re an American citizen who’s lived in the US for at least five years, you are eligible to apply for Medicare Part A starting three months before the first day of the month of your 65th birthday. Or, if your birthday happens to fall on the first day of the month, you can apply for Medicare up to four months prior to the month of your 65th birthday.

You may even qualify for automatic enrollment (whether or not you’re still working) in Medicare Part A if you meet the following requirements:

  • You or your spouse have worked and paid Medicare taxes for at least 10 years before you enroll
  • You or your spouse are eligible to receive Social Security or Railroad Retirement Board (RRB) benefits

OR...

  • You or your spouse worked in a job that was covered by Medicare

If you’re younger than 65, you are eligible to apply for Medicare Part A coverage if you:

  • Have a Medicare-covered disability and have received Social Security or Railroad Retirement Board benefits for 24 consecutive months
  • Have been diagnosed with end-stage renal disease (ESRD) and have received a kidney transplant or have been on a regular course of kidney dialysis for at least three months
  • Have been diagnosed with amyotrophic lateral sclerosis (ALS) and have started receiving Social Security disability benefits

Medicare Part B eligibility

The eligibility requirements for Medicare Part B are the exact same as Medicare Part A, but with one exception. If you aren’t receiving Social Security or Railroad Retirement Board benefits when you turn 65 (because you’re still working, for example), you will not be automatically enrolled in Medicare Part B. Instead, you must apply for Medicare Part B coverage yourself during one of your designated Medicare enrollment periods.

  • If you have a disability, you must apply for and receive Social Security benefits for 24 consecutive months before you are eligible to receive Medicare benefits. This isn’t the case if you have ESRD or ALS.
  • If you have ESRD, you will typically become eligible to enroll in Medicare plans after a kidney transplant or three months after you start your regular course of kidney dialysis.
  • If you have ALS, you can enroll in Medicare as soon as you start receiving Social Security benefits.

Medicare Advantage (Part C) eligibility

Unlike Medicare Parts A and B, which are provided by federal and state government agencies, Medicare Part C is only offered through private insurance companies.

You are eligible to enroll in a Medicare Advantage plan if you:

  • Are eligible for both Medicare Part A and Part B (Original Medicare)
  • Live in a location where Medicare Advantage plans are offered

To find Medicare Advantage plans near you, talk to a licensed agent today at 1-855-399-5318.

Medicare Part D (prescription drug) eligibility

Similar to Medicare Part C (Medicare Advantage), Medicare Part D plans are offered exclusively by private insurance companies. You are eligible for Medicare Part D coverage if you qualify to receive Medicare Part A or Part B benefits (or both) and if you live in an area where Part D plans are sold.

To find Medicare prescription drug plans near you, talk to a licensed agent today at 1-855-399-5318.

Medicare Part D (prescription drug) eligibility

You are eligible to enroll in a Medicare Supplement plan if you:

To find Medicare prescription drug plans near you, talk to a licensed agent today at 1-855-399-5318.

  • Are eligible for both Medicare Part A and Part B (Original Medicare)
  • Live in a location where Medicare Supplement plans are offered

To find Medigap plans near you, talk to a licensed agent today at 1-855-399-5318.

Call the Medicare eligibility phone number

Finding out whether you’re eligible for Medicare is quick and easy. A licensed agent from Aetna can help you find out in just a matter of minutes. Talk to one today!

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Apply for Medicare today!

Ready to apply for Medicare? Get started by speaking with a licensed agent today at 1-855-399-5318.

Request your FREE Medicare insurance quote

Frequently asked questions

Can I get Medicare at age 62?

Unless you have been diagnosed with a Medicare-covered disability, the short answer is no, you can’t. Typically, you must be at least 65 years old to receive Medicare benefits. However, under some circumstances, your spouse may qualify for Medicare, even if you’re younger than 65 and retired.

For example, let’s say you retired at 62 years old, but your spouse just turned 65. Let’s further say your spouse hasn’t worked or paid Medicare taxes for at least 10 years (the minimum to qualify for automatic enrollment in Medicare Part A) prior to turning 65. But you, on the other hand, have been working and paying Medicare taxes for more than 10 years.

In this scenario, you would not be able to enroll in Medicare Part A yet, but your spouse would.

That’s just one example, but if you’d like to learn whether you and your spouse’s circumstances may qualify one or both of you for Medicare, talk to a licensed agent today.

I’ve heard you can get Medicare at age 55. Is that true?

Not exactly. The Medicare at 55 Act is a bill that was introduced in the US Senate back in 2017 and that would allow people aged 55 to 64 to enroll in Medicare. In other words, this bill—if passed—would lower the effective Medicare eligibility age from 65 to 55.

As you might imagine, the Medicare at 55 Act is the subject of much debate. It may be some time before this bill is made into law—if it’s ever made into a law in the first place—and changes to the minimum Medicare eligibility age are made.