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Medicare 101

Eligibility

Who is eligible for Medicare?

U.S. citizens and legal residents
Note: Legal residents must have lived in the U.S. for at least 5 years in a row before applying for Medicare.

Plus, one of the following:

Age 65 or older
Younger than 65 with a qualifying disability
Any age with a diagnosis of End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s Disease)

What do I need to do once I’m eligible for Medicare?

Most people are automatically enrolled in Original Medicare (Part A and Part B) once they’re eligible. But not everyone is.

You’ll be automatically enrolled in Original Medicare if: 

You have been receiving Social Security or Railroad Retirement Board benefits when you turn 65, or, you are eligible for Medicare because of a disability or medical condition.

You must enroll in Original Medicare yourself if:

You are not receiving Social Security benefits when you become eligible for Medicare. You can enroll by visiting the ssa.gov/medicare website, or by calling or stopping into your local Social Security office.

Working past 65:  Do I still need to sign up for Medicare?

It depends on how you get your health insurance now and the number of employees that are in the company where you (or your spouse) work.

Generally, if you have job-based health insurance through your (or your spouse’s) current job, you don’t have to sign up for Medicare while you (or your spouse) are still working. You can wait to sign up until you (or your spouse) stop working or you lose your health insurance (whichever comes first).

If you’re self-employed or have health insurance that’s not available to everyone at the company: Ask your insurance provider if your coverage is employer group health plan coverage, as defined by the IRS. If it’s not, sign up for Medicare when you turn 65 to avoid a monthly Part B late enrollment penalty.

If your employer has less than 20 employees: You might need to sign up for Medicare when you turn 65 so you don’t have gaps in your job-based health insurance. Check with your employer.

If you have COBRA coverage: Sign up for Medicare when you turn 65 to avoid gaps in coverage and a monthly Part B late enrollment penalty. If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up.

Source: https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65 August 9, 2022

Confused? Have Questions?

We are here to help.  From our contact us page you can set a no-cost, one on one appointment or request a Medicare Made Clear booklet or you can attend one of our Understanding Medicare meetings (see our Events page.)

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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