Health coverage for seniors and those with disabilities is provided by Medicare, a federally run health care insurance program. You can qualify for Medicare if you are 65 or older, but that doesn't mean you will immediately receive it. Your age and other factors determine Medicare eligibility, but you must take the initiative to enroll in the program.
Medicare enrollment is not always straightforward. Having a fundamental knowledge of the program's structure and operation is important. Some people automatically become eligible for Medicare at age 65, but that number has been shrinking as the Medicare eligibility age has continued to diverge from the Social Security eligibility age.
It is generally true that getting Social Security benefits for four months before turning 65 is a requirement for Medicare eligibility. Traditional Medicare payments are taken out of Social Security payments. For a long time, anyone who reached 65 and became eligible for Social Security and Medicare could retire and begin receiving their full benefits upon entering the system.
What Is The Typical Medicare Eligibility Age?
To qualify for Medicare, you must be 65 years old unless you are disabled, and then you can qualify at a younger age. To qualify for Medicare, you must be a U.S. citizen, a lawful permanent resident, and a U.S. resident alien. Medicare Part A is available at no cost to most persons aged 65 and older because of the Medicare taxes they paid during their working years.
Medical care in a hospital, nursing home, at home, or hospice facility may be partially or fully covered by Medicare Part A. If you are a U.S. citizen or permanent resident over the age of 65 and you have not worked long enough to have Medicare taxes deducted from your paychecks.
In that case, you may still be able to purchase Medicare Part A coverage by paying a monthly premium. After your spouse hits 62 and has worked for Medicare long enough, you won't have to pay the Part A fee any longer. Part B of Medicare kicks in once you've met the criteria for Part A, and it helps pay for things like doctor's visits, durable medical equipment (DME), urgent care, some preventative care, and more.
Who Is Medicare Eligible For Under 65?
Permanently disabled individuals receiving SSDI benefits for 2 years are eligible for Medicare and will automatically enroll in Medicare Parts A and B. No matter your age, if you have End-Stage Renal Disease (ESRD), you are eligible for Original Medicare (Parts A and B).
If you want to participate in Medicare, you'll need to join once you become eligible. Regardless of your age, if you have ALS (Amyotrophic Lateral Sclerosis), popularly known as Lou Gehrig's illness, you will be enrolled in Medicare Parts A and B in the month your disability benefits begin.
What Happens If You Don't Get Enrolled When You Turn 65?
If you are not automatically qualified for Medicare at age 65 and would like to be, here are some key figures to keep in mind. Medicare eligibility begins on the first of the month of the beneficiary's 65th birthday. Therefore enrollment is open for three months before that month.
The Initial Enrollment Period is seven months long, and you have already used the first three. You have the three full months leading up to your 65th birthday, the month you turn 65, and the three months following your 65th birthday to enroll in Medicare.
If your birthday is the first of the month, your Expiration Period (IEP) spans the four months before your birth month, your birthday month, and the two months following your birth month. If you enroll in Medicare Part B during the month, you turn 65. Your coverage will start on the first day of your turn 65 (or the month prior if your birthday is the first day of the month).
What If MEA Is Raised?
It is estimated that some persons would delay claiming retirement benefits if the MEA was raised, which would reduce outlays for such payments from 2023 to 2028. Under the first option, the savings would be $4 billion over that time, whereas under the second option, they would be $5 billion.
Costs would increase over time regardless of the option chosen because receiving benefits later will result in a larger monthly payment. Since raising the MEA would have little impact on people's decisions about when to claim retirement benefits, the reduction in Social Security spending would be relatively small.
Evidence from the past suggests that people are more likely to wait until the FRA rather than the MEA to begin collecting their retirement benefits. Increased availability of health care via Medicaid and the nongroup market will cause retirement benefits to be less related to the MEA than has traditionally been the case.
The ACA has increased access through this program by allowing but not obligating states to extend Medicaid eligibility to include low-income individuals under age 65. In the individual market, more people may afford health insurance thanks to tax credits for marketplace plans and the ban on health-related underwriting and rating decisions. As a result, those retirees who previously had difficulty obtaining Medicaid or affordable health insurance in the nongroup market can now do so.
Conclusion:
Medicare, the government health insurance program, mainly aids senior citizens and the disabled. Though certain exceptions exist, there is a general age requirement of 65 to get benefits. Those under 65 who have been receiving Social Security disability payments for at least 24 months or who have the end-stage renal disease are Medicare eligible.
Medicare spending will likely expand quickly over the next few decades due to the aging of the baby boomer population and the continued outpacing of healthcare cost increases by per capita GDP growth. In addition, Medicare's average coverage period has grown substantially since the program's inception due to improvements in life expectancy.
