Medicare Qualifications

2014 Medicare and Medigap Updates

Medicare Qualifications

Medicare is a social health insurance program that is administered by the federal government. This health insurance program was started in 1965 and is funded by taxes. Even though Medicare is a social health insurance program, it is not open to everybody as there are a number of Medicare qualifications.

Perhaps the most important of all Medicare qualifications is age. To be eligible for Medicare coverage, an individual needs to be at least 65 years old. Being 65 years old is a minimum requirement but attaining this age does not automatically qualify you for Medicare coverage. You will also need to have worked at a local government, state or federal job for a qualifying period of time which is at least 10 years, or are receiving railroad retirement benefits or social security benefits or are eligible to receive these benefits, or you have a spouse over 62 years of age whose work record entitles you to receive social security benefits.

You can qualify for Medicare based on the work experience of a divorced spouse or even a dead one as long as they are over 62 years old.

You however do not have to be 65 years old to meet Medicare qualifications. This age qualification is waived for persons under 65 who have a qualifying disability and are receiving social security disability payments, or have been receiving social security disability benefits for at least 24 months. Qualifying disabilities include Lou Gehrig’s disease also known as amyotrophic lateral sclerosis and end stage renal disease (ESRD) which requires dialysis or a kidney transplant.

Medicare qualifications regarding age were altered in 1972 to include people under 65 with permanent disabilities and in 2001 to include people suffering from Lou Gehrig’s disease.

Another one of the very important Medicare qualifications is with regard to citizenship and residency. To be eligible for Medicare you need to be a United States citizen and a legal resident in the country.

If you do not meet Medicare qualifications on your own work record or based on your spouse’s work experience you can still get Medicare coverage by paying monthly premiums for Medicare part A, B and D. You will still however need to be a United States citizen or have been a legal resident in the United States for a minimum 5 years. The premium payable is determined by the number of work credits you have. Work credits are determined by the number of years worked and can be increased by continuing to work. Once you get 40 work credits, you will no longer need to pay a monthly premium for Medicare part A.

A number of people do qualify for both Medicare and Medicaid and are referred to as dual-eligible persons. To qualify for Medicaid, you need to have limited resources or income.

Even though you meet Medicare qualifications, Medicare will not pay all medical expenses. Most citizens choose to have a Medigap supplement policy to cover any bills not taken care of by Medicare. You can check on Medigap cost on line or with a local insurance agent.