Stethoscope on table
Medicare is a government program that is funded by withholding tax from the paycheck of most workers.

A lot of people believe that Medicare is only for those who are close to their retirement. It is true to some extent, but the program covers more than only those who have worked their entire life. There are many who might be eligible but do not know it. This is because the majority of beneficiaries who are medicare age are 65 or more. Many others receive services at a young age because of a qualifying disability. 

When individuals turn 65 or meet the other eligibility criteria, they will receive Medicare services.

What is the medicare age eligibility?

Medicare is a government program that is funded by withholding tax from the paycheck of most workers. When individuals turn 65 or meet the other eligibility criteria, they will receive Medicare services. Medicare Part A can be received free of charge but the other aspects will cost you. You will be eligible if you receive Social Security or Railroad Retirement benefits and have worked long enough to be eligible for these benefits. Additionally, if you or your spouse is an employee with the government and has not paid into Social Security but have paid Medicare payroll taxes when in service, you are eligible. 

If you get benefits from Social Security, you will get Medicare Part A and Part B automatically when you are eligible. You need not sign up for it. You will receive a welcome packet 3 months before you turn 65 which is the medicare age. 

Still working and retirees

Those who paid into a retirement system that did not withhold medicare payments, you are eligible for Medicare through your spouse or through the retirement system. In order to receive the coverage, you need to have earned adequate credits for Social Security. In 2020, every $1,410 you earn will mean one credit and you can earn a maximum of four credits in one year. So in order to receive complete benefits, you need to have earned 40 credits over 10 years of work.  

Individuals who continue to work beyond the age of 65 can face some complications. You need to file for Medicare but you may keep the health insurance policy of the company as your primary insurance. The company-sponsored insurance plan might also force you to make Medicare primary. It helps to talk to the Medicare expert about the available choices before you make a decision. 

Spouses

If you have no work history and were a stay at home parent, you are still eligible for Medicare benefits at the age of 65. However, it depends on the work record of your spouse. If your spouse has 40 credits and you have been married for at least one year, you will be eligible for the benefits. If you are divorced, you will not qualify for Medicare under your work record but you can qualify based on the ex-spouse’s record if the marriage lasted at least for ten years and you are single now. 

Younger than 65

If you are younger than 65, and have not reached the medicare age, you will qualify for Medicare benefits if:

  • You receive a disability pension from the Railroad Retirement Board,
  • Are entitled to Social Security disability benefits for 2 years,
  • You have permanent kidney failure. Due to the same, you require regular dialysis or kidney transplant and your spouse has paid the Social Security taxes for a certain period, and
  • Have Lou Gehrig’s disease which immediately qualifies you. 

Other ways to get Medicare coverage

Individuals who do not qualify through their employment or the work record of the spouse but are a U.S. citizen and a legal resident for at least five years can get full Medicare benefits at the medicare age of 65 or above. The benefits can be purchased by:

  • Paying a premium for Part A which is the hospital insurance. The amount you pay for the premium will depend on how long you have worked. The longer you work, the more work credits you will have. A lot will also depend on income. Your work credit is based on the income and it changes each year. 
  • Paying the same monthly premiums for Part B, which covers the visits of the doctor and other outpatient services. This amount is $144.60 for individuals with an annual income of $87,000 or less or those who file a joint return with $174,000 in income or less. This is applicable in 2020 and the rates are higher for people with high income. 
  • Pay the same monthly premium for Part D which covers prescription drugs for the drug plan chosen by you. 

It is possible to buy Part B without buying Part A. However, if you buy Part A, you must buy Part B. Part D can be bought if you are enrolled in either A or B. Unless you are enrolled in Part A and B, you cannot enroll in a Medicare Advantage plan or buy a Medigap supplemental insurance policy. 

Key Takeaways

  • Medicare is a national health insurance plan for those aged 65 and above and for those with qualifying disabilities. 
  • It is important to have earned enough credits to get full coverage of the plan.
  • It is possible to keep private health insurance if you work beyond the age of 65 but making Medicare a primary coverage will be essential.
  • Individuals with no work history can be eligible for Medicare benefits based on the work history of their spouse.

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