Paul Sanchez
Medicare is a federal health insurance program that covers health care costs for most older Americans and some people with disabilities. To qualify for Medicare, you must be a US citizen or a permanent resident, and be 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's disease). Additionally, you must have worked for a sufficient time in a Medicare-covered job and paid Medicare taxes. If you are already receiving Social Security or Railroad Retirement Board (RRB) benefits, you may be automatically enrolled in Medicare Parts A and B when you turn 65.
| Characteristics | Values |
|---|---|
| Age | 65 or older |
| Citizenship | Must be a US citizen or permanent resident |
| Social Security Benefits | Receiving Social Security benefits or Railroad Retirement Board (RRB) benefits |
| Medicare-covered job | You or your spouse worked for a sufficient time in a Medicare-covered job |
| Medicare Taxes | Paid Medicare taxes through the job |
| Disability | Having a disability, End-Stage Renal Disease (ESRD), or ALS |
| Monthly Premium | Depends on income |
| Enrollment | Automatic or active |
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What You'll Learn
Aged 65 or older
If you're 65 or older, you qualify for Medicare. This is true even if you are still working or don't receive Social Security retirement benefits. You are still able to sign up for Medicare Part A, Part B, or both.
If you are already receiving retirement benefits before turning 65, you will be automatically enrolled in Medicare Parts A and B. If not, you will need to sign up manually. You can do this by contacting Social Security or signing up online at socialsecurity.gov. The initial enrolment window begins three months before the month of your 65th birthday and ends three months after it.
If you or your spouse worked for at least ten years (40 quarters) and paid Medicare taxes during that time, you will likely receive premium-free Part A coverage. If you did not pay Medicare taxes, you may still be able to buy Part A coverage. However, you will have to pay a monthly premium for it.
If you are working past the age of 65 and have employer health insurance, you may want to delay enrolling in Medicare. If your employer has fewer than 20 employees, you will need to enrol in Medicare when you turn 65 to avoid late penalties. If your employer has more than 20 employees, you may choose to delay enrolling in Medicare until later, as your employer's insurance may pay first, with Medicare paying second.
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Under 65 with a disability
Medicare is a federal health insurance program for people aged 65 and over. However, individuals under 65 with a disability may also be eligible for Medicare. To qualify for Medicare under 65, you must meet specific criteria and conditions. Firstly, you must have received Social Security Disability benefits for at least 24 months. There is a five-month waiting period after being recognised as disabled before you can begin collecting these benefits. Once you have received disability benefits for 24 months, you will automatically become eligible for Medicare Parts A and B. Part A covers hospital insurance, while Part B covers medical insurance. Most people do not have to pay for Part A, but there is usually a monthly premium for Part B.
If you have been diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease, you are not required to wait 24 months. In these cases, you will become eligible for Medicare Parts A and B as soon as you start receiving Social Security disability benefits.
It is important to note that your eligibility for Medicare under 65 is dependent on your continued disability status. Even after the initial 8.5-year period of extended Medicare coverage, you can continue receiving benefits as long as you remain medically disabled. During this time, you may be required to pay premiums for both Part A and Part B. The cost of these premiums can be subsidised through state-run programs for low-income individuals with limited resources.
Additionally, if you are under 65, have Medicare, and have a Medigap policy, you have the right to suspend your Medigap policy without penalty while enrolled in an employer's group health plan. This allows you to take advantage of your employer's insurance coverage without losing your Medigap policy.
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Receive Social Security benefits
Medicare is the federal health insurance program for people aged 65 and over in the US. If you are receiving Social Security retirement benefits at least four months before turning 65, you will be automatically enrolled in Medicare Parts A and B when you turn 65. If you apply for Social Security three months before turning 65 or later, you can sign up for Medicare when you apply for Social Security.
If you are not yet 65, you may still be eligible for Medicare if you are receiving Social Security disability benefits. In this case, you will automatically get Medicare after receiving disability benefits for 24 months. If you have ALS (Lou Gehrig's disease), you will be enrolled in Medicare Parts A and B as soon as you start receiving disability benefits.
If you are receiving Social Security retirement benefits after turning 65, you will need to contact Social Security to sign up for Medicare. You may not want to sign up for Medicare as soon as you become eligible if you are still working and have health coverage through your employer.
It is important to understand the different parts of Medicare before deciding how to get coverage. Medicare Part A covers hospitalization, home or skilled nursing, and hospice. Medicare Part B covers medical insurance.
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Paid Medicare taxes through your job
Medicare is a federal employment tax that funds the Medicare health insurance program for the elderly, those with disabilities, and people with qualifying health conditions. Nearly every American worker and business must pay Medicare taxes due to the Federal Insurance Contributions Act (FICA). This is a federal law that mandates the collection of taxes to fund Social Security.
Medicare tax is withheld from an employee's paycheck or paid as a self-employment tax. In 2024, the Medicare tax rate is 2.9%, split evenly between employers and employees. W-2 employees pay 1.45%, and their employer covers the remaining 1.45%. Self-employed individuals are considered both employee and employer and must pay the entire 2.9%.
The additional Medicare tax rate is 0.9% but only applies to income above the taxpayer's threshold limit. For an individual earning $225,000 a year, the first $200,000 is subject to a Medicare tax of 1.45%, and the remaining $25,000 is subject to an additional Medicare tax of 0.9%.
If you've worked and paid Medicare taxes for at least 10 years of your life, you'll generally qualify for premium-free Medicare Part A when you reach age 65. Part A covers hospital insurance for individuals age 65 or older and those with certain disabilities or medical conditions. Medicare hospital insurance covers hospital visits, hospice, nursing home care, and some home healthcare.
Medicare Part B (Medical Insurance) is optional. You can choose to enrol in it or decline it altogether. Part B covers doctor visits, outpatient care, and other medical services. You can decline Part B, but if you choose to enrol in it later, you may be charged a late enrolment penalty.
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Receive Railroad Retirement Board benefits
If you receive Railroad Retirement Board benefits, you will be automatically enrolled in Medicare Parts A and B when you turn 65. This means that Medicare will serve as your primary insurance, covering your healthcare expenses, while Railroad Retirement benefits will act as secondary insurance, helping with deductibles, copayments, and other costs that Medicare does not fully pay.
If you are under 65 and have a disability, your eligibility for Medicare depends on the Railroad Retirement Board's (RRB) classification of your disability. In this case, you must contact your local RRB field office to discuss the details. If you have end-stage renal disease (ESRD) and qualify for Medicare, you must go through the Social Security Administration, even if you are a railroad worker.
If you are already receiving railroad retirement benefits when you become eligible for Medicare, the RRB should automatically enrol you in Medicare Parts A and B. You should receive a red, white, and blue Medicare card, and a letter from the RRB explaining that you have been enrolled. Your Medicare card will say "Railroad Retirement Board" at the bottom.
If you are not collecting Railroad Retirement benefits when you turn 65, you should contact your local RRB field office to enrol in Medicare. If you are a retired railroad worker, you can start receiving your benefits at age 60 if you have 30 or more years of qualified work. However, applying before full retirement age may result in a reduction in benefits if you do not have enough years of service.
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Frequently asked questions
You may qualify for Medicare under 65 if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's disease). You may also qualify if you have received Social Security Disability Insurance (SSDI) benefits for at least 24 months.
Yes, Medicare is a federal health insurance program that covers most older Americans and some people with disabilities, regardless of pre-existing conditions.
To qualify for Medicare, you must be a US citizen or a permanent resident of the US.
To qualify for Medicare, you or your spouse must have paid Medicare taxes through your job for a sufficient period.
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