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Continuing our guest column from last week, let’s ask our friend, Jim Merriman, our friendly medicare advisor to help us understand the eligibility criteria for medicare. Last week, we learnt about the enrollment procedures for Medicare. In consideration of the upcoming enrollment deadline of March 31st we chose to share with you the enrollment procedures first. Now let’s go back to the basics and understand the eligibility criteria.

The Background:
Originally, Medicare was targeted for people over age 65, on the assumption that they would be retirees and would be without the benefit of employer-sponsored medical care. The program has never covered people who take early Social Security retirement, although it does cover Social Security disability qualified individuals that are younger than 65 years of age.

Who is eligible?
Eligibility for Medicare is tied closely to the Social Security benefits eligibility. It must however be noted here that people can qualify for, and receive Medicare without actually enrolling for Social Security at age 65. They simply enroll in Medicare and pay the Part B premium as if they had also enrolled in Social Security.

Qualifying Social Security wages are earnings that had Social Security payroll taxes or Social Security self-employment taxes paid on them. Earnings can qualify if one worked for someone else or for self. One needs to have accumulated 40 quarters of qualified credits to be entitled to Medicare coverage. Generally, one is eligible for Medicare if he (or she) or the spouse worked for at least 10 years in Medicare covered employment, and is 65 years old and is a citizen or permanent resident of the United States.

One might also qualify for coverage if he or she is younger than 65 years, but has a disability or has chronic kidney disease. In addition, people can buy into Medicare without having the 40 quarters of Social Security eligible work credits; but the premiums are high for both Part A and Part B, and the premiums will increase every year over the age of 65.

To be eligible for Medicare, an applicant must be 65 years of age or older and be either:
• a United States citizen (either by birth or naturalization)
• a legal resident alien who has lived in the United States for at least five years.

Who is eligible for Part A premium exemption?
One can get Part A at age 65 without having to pay premiums if:
• he/she is already receiving retirement benefits from Social Security or the Railroad Retirement Board
• he/she is eligible to receive Social Security or Railroad benefits but have not yet filed for them
• he/she or their spouse had Medicare-covered government employment
• he/she has received Social Security or Railroad Retirement Board disability benefits for 24 months
• he/she is a kidney dialysis or kidney transplant patient

This concludes today’s post on medicare eligibility. For more information, you can visit the FAQ page on medicare website.