we'll tell you if you qualify for Medicare

Who Doesn’t Qualify For Medicare?

The best way to answer this question is to explain who IS qualified for Medicare.

Under 65

If you are under 65, you can qualify for Medicare if you have been receiving disability benefits from Social Security or the Railroad Retirement Board for a specific period of time or if you have End Stage Renal Disease (kidney failure) or received a kidney transplant.

You can receive premium-free Part A as a person with a disability under the age of 65 if:

  • You have been receiving disability benefits from Social Security or the Railroad Retirement Board for at least 24 months
  • You are the spouse or dependent of someone who has worked for at least 40 quarters (10 years) while paying taxes to Social Security
  • You are a kidney dialysis or kidney transplant recipient
  • You have Amyotrophic Lateral Sclerosis (ALS)

With Lou Gehrig’s Disease, formally Amyotrophic Lateral Sclerosis (ALS), you qualify for Medicare in the first month of receiving your disability benefits.

With kidney failure, you are not automatically enrolled in Medicare and must sign up to receive Part A and Part B, unlocking the full benefits for outpatient dialysis treatments. Your Medicare coverage begins in the fourth month of your regular course of dialysis treatments. With End-Stage Renal Disease, Medicare coverage is retroactive for up to 12 months, beginning after the four-month waiting period. Coverage can begin the first month of your regular course of dialysis if you have been trained by a Medicare-certified training facility and approved by your doctor to perform dialysis at home.

Those who undergo a kidney transplant have hospital inpatient care covered by Medicare up to two months before the transplant. Therefore, if the transplant is delayed you will still have coverage for two months prior to your surgery.

65 and Older

American seniors age 65 and older are eligible for Medicare. You must be a U.S. citizen or legal permanent resident of at least five years to qualify for coverage.

People age 65 and older can qualify for premium-free Part A if:

  • They or their spouse have worked and paid taxes to Social Security for at least 40 quarters (10 years)
  • They are receiving retirement benefits from Social Security or the Railroad Retirement Board
  • They are eligible to receive retirement benefits from Social Security or the Railroad Retirement Board but have not yet filed for them
  • They or their spouse had Medicare-covered government employment

If you have been receiving retirement benefits for at least four months before your 65th birthday, you will be automatically enrolled in Medicare and will receive your Medicare card in the mail.

If you are turning 65 and not already receiving retirement benefits, you will need to enroll. Your Initial Enrollment Period begins three months before the month of your 65th birthday. If you sign up during these three months, coverage begins on the first day of your birthday month unless you were born on the first, in which case coverage begins on the first day of the month prior to your birthday. If you sign up during the month of your birthday, your coverage will begin on the first of the next month. In the month after your birthday, coverage will begin two months after you sign up. Signing up two months or three months after your birthday means your coverage begins three months after you sign up.

We Can Answer Your Medicare Questions

We’re here to answer any Medicare questions you have. If you’re looking for skilled advice, call us at (877) 874-0711.