Medicare is federal health insurance for people 65 or older, some younger people with disabilities, and people with end-stage kidney disease. Most commonly, you are eligible for Medicare when you turn 65, but there are other health insurance options if you are younger and do not have coverage through you or your spouse’s employer.
|1. The typical age requirement for Medicare is 65, unless you qualify because you have a disability.||2. If you retire before 65, you may be eligible for Social Security benefits starting at age 62, but you are not eligible for Medicare.|
|3. You have options for health insurance if you are too young for Medicare. You may obtain it through your employer, or you can purchase from private-sector insurance companies through the health insurance exchange. You may be eligible for Medicaid, which is based on income.||4. If you retire before you are 65, you may be eligible for employer-provided group health insurance under the Consolidated Omnibus Budget Reconciliation Act (COBRA).|
Medicare was established in 1965 in order to provide health coverage for seniors who would otherwise not be covered by employer-sponsored health insurance plans. If you retire at the age of 62, you may be eligible for retirement benefits through social security, but early retirement will not make you eligible for Medicare.
The typical Medicare age requirement is 65, or younger if you qualify for disability benefits. In addition to meeting the age requirement of 65, you must also be a U.S. citizen or legal permanent resident before you are eligible for Medicare.
Most people who are 65 qualify for premium-free Medicare Part A because they have worked for at least ten years (40 quarters) and have paid Medicare taxes. Medicare Part A helps cover hospitalization, skilled nursing facility, home health care, and hospice costs. If you are not eligible for premium-free Part A because you have not worked and paid Medicare taxes, but are a citizen with permanent residency and are 65, you can pay premiums to have Part A coverage. If your spouse has worked long enough to qualify for premium-free Part A, your Part A premiums will be free after your spouse turns 62.
When you meet the requirements for Part A, you also qualify for Medicare Part B which helps cover medical out patient costs such as doctor’s visits, urgent care, durable medical equipment (DME), some preventive care, and more. If you have Part B, there is a monthly premium you pay, which is $148.50 for 2021, and an annual deductible of $203.
When you are 65 and qualify for Medicare coverage, you can choose Original Medicare Parts A and B, with or without Part D (drug coverage), and with or without supplemental insurance (Medigap); or you can choose a Medicare Advantage Plan (Part C) which bundles Parts A, B, and usually D together. You must have Parts A and B in order to enroll in a Medicare Advantage Plan, or a separate Part D or Medigap plan. Part B monthly premiums will still apply.
If you retire earlier than age 65, you will not be eligible for Medicare. Although Medicare is often thought of as insurance for retired people, the Medicare age requirement is still 65. Some people continue to work past age 65 and have insurance coverage through their employer. Many people retire before they turn 65 and must purchase health insurance or are covered on their spouse’s insurance plan. Although you may be eligible for social security retirement benefits if you retire early, it does not change your age requirement for Medicare health insurance coverage.
If you don’t qualify for Medicare, you may be able to get health insurance coverage through other options:
If you are 62 and had employer-provided insurance, but are no longer employed, you may have access to insurance coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA requires most group health plans to provide a temporary extension (usually up to 18 months) of employer-provided group health coverage. COBRA is generally offered by private-sector employers (with at least 20 employees) or by state and local governments. If you elect to continue your health coverage under COBRA after your employment ends, you will likely pay a premium that is higher than the amount you paid while employed. Some states have laws that are similar to COBRA. Check with your employer and your state insurance commissioner’s office to find out if you are eligible for COBRA.
Another option for insurance at age 62 is to purchase private-sector insurance through the health insurance exchange in your state. You must live in the U.S. and be a citizen or legal resident to be eligible to enroll in health coverage through an exchange. The health insurance exchange offers a variety of plans which you can choose from, depending on your anticipated health care utilization and budget. There are typically Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, High-Deductible Health Plans (HDHP) and more. You can compare and shop for plans for your state on Healthcare.gov.
You may be eligible for Medicaid health coverage which is based on your income. You can apply for Medicaid through the health insurance exchange, or through your state Medicaid agency.
LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.
Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.
He’s passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.