At What Age Can You Get Medicare?

Usually, Medicare eligibility starts at the age of 65. However, some people can get it early in certain situations. Continue reading to learn more details.

At what age can you get Medicare? Medicare is the United State’s health insurance program for people who are 65 years old or more. Some people younger than 65 are also eligible for Medicare, such as those with disabilities and those who have permanent kidney failure. The program helps with the expense of health care, but it does not provide coverage for all medical costs or the cost of most long-term care. You have a choice regarding how you get Medicare coverage. If you opt for Original Medicare (Part A and Part B) coverage, you can purchase a Medicare Supplement Insurance (Medigap) policy from a private insurance organization. Let us jump straight into it to find more!

What age can you get Medicaid?

Typically, Medicare is only available for people who are 65 years old or more, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) can also qualify. Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). You are qualified for premium-free Part A if you are 65 years old or more and you or your spouse worked and paid Medicare taxes for at least 10 years.

If you are 65 years old

You are eligible for full Medicare benefits if:

  • You are a citizen of the United States or a permanent legal resident who has been living in the United States for at least five years.
  • You are getting Social Security or Railroad Retirement Benefits, or have been working long enough to be qualified for those benefits (but are not yet collecting them).
  • You or your husband/wife is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working.

In most situations, people turning 65 will have to get Medicare during their 7-month Initial Enrollment Period (IEP) to steer clear of financial penalties for enrolling late. Your IEP starts 3 months before the month of your 65th birthday and ends 3 months after.

Medicare age eligibility exceptions

You may sign up for Medicare at any age if you meet one of the following criteria:

  • A family member is enrolled in Medicare
  • You get Social Security disability or Railroad Retirement Board (RRB) disability insurance
  • You have certain medical conditions, such as amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD)

Social Security disability

In case you are under age 65 and have been getting Social Security disability benefits for two years, you meet all the requirements to be eligible for Medicare. You can enroll in your 22nd month of getting these benefits, and your coverage will start in your 25th month of getting them. In case you are qualified for monthly benefits depending on an occupational disability and have been allowed a disability freeze, you become qualified for Medicare on the 30th month after the date of the freeze.

RRB disability

If you get a disability pension from the RRB and meet specific criteria, you may be qualified for Medicare before the age of 65.

Specific health conditions

In order to get Medicare disability benefits, you need to first be receiving Social Security Disability Insurance (SSDI) benefits for 2 years. There is usually a five-month waiting period after a worker or widow(er) is classified as disabled before they can get SSDI benefits. During this waiting period, the individual may be qualified for coverage under an employer’s health plan or, through COBRA, if they are not employed anymore. You may be qualified for Medicare if you have either:

  • If a person is suffering from Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig’s disease, there is no 24-month waiting period for benefits. If you have been diagnosed with ALS, you immediately become qualified for Medicare upon collecting Social Security disability insurance (SSDI) benefits. As soon as you start collecting Social Security Disability benefits, you would be enrolled in Part A and Part B Medicare benefits.
  • If a person has End-Stage Renal Disease (ESRD), there will be no 24-month waiting period for benefits. If you have ESRD and need regular dialysis or a kidney transplant, you are qualified for Medicare and your coverage can begin in a short while after your first dialysis treatment. A person diagnosed with ESRD can usually start getting benefits three months after a course of regular dialysis or after a kidney transplant.

Family relationship

Under specific circumstances, and usually following a 2 year waiting period, you may be qualified for Medicare when you are under the age of 65 based on your relationship with a Medicare recipient, including:

  • disabled children
  • disabled surviving divorced spouses under age 65
  • disabled widow(er) under age 65

Do I automatically get Medicare when I turn 65?

If you are getting Social Security benefits, the Social Security Administration (SSA) will automatically enroll you in Medicare parts A and B when you turn 65 years old. At the start of your initial enrollment period (IEP), you will be sent sign-up instructions by Social Security. Your initial enrollment period begins three months before the month of your 65th birthday.

Medicare Part A covers fundamental hospital visits and services and some home health care, hospice and skilled-nursing services. If you are getting or are qualified for Social Security retirement benefits, you do not have to pay premiums for Part A. Medicare Part B includes standard health insurance and comes with a premium. The base rate in 2021 is $148.50 each month. Individuals with higher income pay more based on the amount of income.

You can choose not to get Part B — for instance, if you already have “primary coverage” via an employer, spouse or veterans’ benefits and you want to keep it. (Get in touch with your current insurance provider to make sure your coverage meets the standard.) Choosing not to get Part B will not have an impact on your Social Security status. However, you might pay a penalty in the form of permanently higher premiums if you decide to sign up for Part B later.

On the other hand, if you want to sign up for Medicare Part C (also known as Medicare Advantage), an alternative to Part B that is offered by private insurance providers, you would have to enroll on your own. The same is the case for Medicare Part D, which is prescription drug coverage.

Can you get on Medicare at age 62?

Generally speaking, you cannot get Medicare at the age of 62. However, you may choose to retire at 62 because you can start collecting Social Security at that age and you feel like you are ready to move on to the stage in life. As per the Social Security Administration, you can begin receiving retirement benefits as early as age 62. Your employer health benefits will probably end when you retire and you may be thinking about your Medicare eligibility age. You can only enroll in Medicare at the age of 62 if you meet one of the following criteria:

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  • You are on SSDI because you suffer from Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s disease. (The two-year requirement mentioned in the next bullet point is waived in this case.)
  • You have been on Social Security Disability Insurance (SSDI) for at least two years.
  • You suffer from end-stage renal disease.

Otherwise, your initial enrollment period for Medicare starts three months before the month of your 65th birthday. For instance, if you turn 65 on July 4, 2021, the enrollment window opens on April 1.

In case you are getting Social Security benefits, the Social Security Administration, which handles Medicare enrollment, will send you a data bundle and your Medicare card toward the beginning of the sign-up period. You will be automatically enrolled in Medicare Part A (hospitalization) and Part B (standard health insurance) in the month you turn 65.

Meanwhile, consider investigating other alternatives for health insurance to overcome any barrier until you are qualified for Medicare. Contingent upon your financial and marital status, these might include Medicaid, private insurance through the Affordable Care Act marketplace or coverage through a spouse’s workplace plan.

In the event that you resign at the age of 62, you might have the option to keep on getting medical insurance coverage through your employer, or you can buy coverage from a private insurance organization until you turn 65. While waiting for Medicare enrollment qualification, you might contact your State Health Insurance Assistance Program to talk about your options.

What is the earliest age to qualify for Medicare?

Well, keep in mind that qualifying for Medicare at 62 years old or prior can only occur under very specific conditions. Usually, Medicare benefits start once you reach the age of 65 (except if you qualify by disability). Thus, in the event that you retire at the age of 62 and do not have a disability, you will have to wait for three years for Medicare coverage. Keep in mind that there are certain benefits to waiting to retire after the age of 62 other than reaching the Medicare qualified age. In the event that you retire early, your benefits are decreased by a fraction of a percent for every month before your full retirement age, as indicated by the Social Security Administration. The sum your benefit will be reduced relies upon your year of birth.

What age can you get Social Security?

The minimum age to get Social Security benefits is 62. You can apply when you turn 61 years and 9 months of age. If you are turning 62 and you need the income from Social Security to support yourself, then you can start claiming your benefits now. Nevertheless, if you have enough income from other sources to keep you going until you are older, then it is suggested that you delay increasing the size of your monthly benefit. (Keep in mind that if you are currently not getting Social Security when you turn 65, you will need to sign up for Medicare yourself. You can do that online, by phone at 800-772-1213, or by visiting your local Social Security office.)

What is Full Retirement Age (FRA)?

Apart from how much you have earned over the years, the size of your monthly Social Security benefit is based on when you were born and the age at which you start claiming — down to the month. You will get your full monthly benefit if you start claiming when you reach something that Social Security considers to be your full retirement age (FRA). It is also often referred to as “normal retirement age.” FRA was 65 when Social Security started, but it has been raised to 67 for anyone born in 1960 or later. To find your FRA, see below.

  • Year of Birth: 1937 or earlier
  • Full (Normal) Retirement Age: 65

 

  • Year of Birth: 1938
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  • Full (Normal) Retirement Age: 65 and 2 months

 

  • Year of Birth: 1939
  • Full (Normal) Retirement Age: 65 and 4 months

 

  • Year of Birth: 1940
  • Full (Normal) Retirement Age: 65 and 6 months

 

  • Year of Birth: 1941
  • Full (Normal) Retirement Age: 65 and 8 months

 

  • Year of Birth: 1942
  • Full (Normal) Retirement Age: 65 and 10 months

 

  • Year of Birth: 1943–1954
  • Full (Normal) Retirement Age: 66

 

  • Year of Birth: 1955
  • Full (Normal) Retirement Age: 66 and 2 months

 

  • Year of Birth: 1956
  • Full (Normal) Retirement Age: 66 and 4 months

 

  • Year of Birth: 1957
  • Full (Normal) Retirement Age: 66 and 6 months

 

  • Year of Birth: 1958
  • Full (Normal) Retirement Age: 66 and 8 months

 

  • Year of Birth: 1959
  • Full (Normal) Retirement Age: 66 and 10 months

 

  • Year of Birth: 1960 and later
  • Full (Normal) Retirement Age: 67

What happens if you claim after your FRA?

Assuming that you delay until you are at the age of 70 to begin claiming benefits, you will get an extra 8% each year — or, altogether, 132% of your primary insurance sum ($2,640 each month) for the remainder of your life. Claiming after you turn 70 does not build your benefits further, so there is zero excuse to wait longer than that.

The more you can afford to wait after the age of 62 (up to 70), the bigger your monthly benefit will be. All things considered, postponing benefits does not really imply that you will outpace the competition generally speaking. You additionally need to weigh in some other components, including your expected life span and regardless of whether you (or your spouse) plan to file for spousal benefits. You will likewise have to think about taxes, investment opportunities, and health coverage suggestions.

Your likely longevity

Most of the strategies on how to amplify Social Security retirement benefits rely upon guesses regarding how long we will live. Obviously, we could die anytime, be it in an accident or because of a complicated health issue. However, putting these wild possibilities to one side, how long do you think you will live? How is your blood pressure, cholesterol, weight, and other health markers? How long have your parents or other family members lived? On the off chance that you anticipate an above-average life expectancy for yourself, you might beat the competition by waiting to claim benefits. If not, you might need to claim your benefits when you are qualified.

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To make an educated estimation regarding when to guarantee, have a go at doing a breakeven analysis. That will tell you when the total benefits that you would get by waiting will start to surpass the total that you would get by taking benefits earlier. On the off chance that, for instance, you would get $1,500 a month beginning at age 62 or $2,000 a month beginning at age 66, then, at that point you will have gotten about the same sum in total benefits by the age of 77 or so. By then, the higher monthly benefits that you would get because of waiting will start to pay off. The Social Security site will tell you that regardless of when you begin claiming, your lifetime benefits will be comparable on the off chance that you live as long as the average retiree. The issue is that not every person will have an average life expectancy, henceforth all the various claiming strategies.

Some exceptions

The starting age can vary for other kinds of Social Security benefits:

  • Spousal benefits can start at 62, given that the spouse on whose work record you are claiming them is getting retirement benefits.
  • There is no minimum age requirement for Social Security Disability Insurance. You can be eligible for disability benefits with less time in the workforce than you need to collect retirement benefits, However, you must also demonstrate that your medical condition meets Social Security’s strict definition of disability and show proof that it prevents you from working. The agency is facing a huge backlog of pending disability cases, as per a 2018 report by its inspector general.
  • You can apply for survivor benefits on the record of a deceased spouse or ex-spouse at 60; 50 if you are disabled; or any age if you are caring for the deceased’s under-16 or disabled child.

How to calculate Social Security benefits?

Suppose your FRA is 66. In the event that you begin claiming benefits at the age of 66 and your full monthly benefit is $2,000, then you will get $2,000 each month. In the event that you begin claiming benefits at age 62, which is four years ahead of schedule, then your benefit will be decreased to 75% of your full monthly benefit — additionally called your “primary insurance sum.” All in all, you will get 25% less each month, and your check will be $1,500.

That decreased benefit will not increase once you turn 66 years old. Maybe, you will keep on getting it for the rest of your life. It might go up over the long run because of cost-of-living adjustments (COLAs), however just marginally. You can figure it out for your own situation using the Social Security Administration (SSA) Early or Late Retirement Calculator, one of various benefit calculators given by the SSA that can likewise assist you with finding your FRA, the SSA’s estimate of your future for benefit computations, rough estimates of your retirement benefits, individualized projections of your benefits dependent on your own work record, and more.

Your health coverage and timing

Your health insurance coverage plays a huge part in figuring out when to claim Social Security benefits. If you are 65 years old or more, and have a health savings account (HSA) to which you would like to keep contributing, then receiving Social Security benefits requires you to enroll in Medicare Part A, and once you do, you will no longer be permitted to add funds to your HSA.

The SSA likewise warns that even if you delay getting Social Security benefits until after you turn 65, you might still need to enroll for Medicare benefits within three months of turning 65 to steer clear of paying higher premiums for life for Medicare Part B and Part D. However, if you are still getting health insurance from your or your husband/wife’s employer, then you might not yet have to sign up for Medicare.

You do not have to take Social Security just because you have retired. If you can live without the income until the age of 70, then you will ensure the maximum payment for yourself and lock in the maximum spousal benefit. Just make sure that you have enough other earnings to support you and that your health is good enough (so that you will benefit from the wait). When you are prepared, you can apply for benefits online, by phone, or at your local Social Security office.

Who is eligible for Medicare and Medicaid?

Medicare

You are qualified for premium-free Part A if you are 65 years old or more and you or your husband/wife worked and paid Medicare taxes for at least 10 years. You can get Part A at the age of 65 without having to pay premiums if:

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
  • You are qualified to receive Social Security or Railroad benefits but you have not yet filed for them.
  • You cannot contribute to a health savings account (HSA); however, you can still use existing funds in your HSA.
  • You must be a citizen, or you must have been a legal resident for a minimum of 5 years
  • You must have a stable U.S. address
  • You or your spouse had Medicare-covered government employment

To find out if you are qualified and your expected premium, go to the Medicare.gov eligibility tool.

If you (or your spouse) did not pay Medicare taxes while you worked, and you are 65 years old or more, aling with being a citizen or permanent resident of the United States, you may be able to purchase Part A. If you are less than 65 years old, you can get Part A without paying premiums if:

  • You have been getting Social Security or Railroad Retirement Board disability benefits for 2 years. (Note that if you have Lou Gehrig’s disease, your Medicare benefits start on the first month you get disability benefits.)
  • You are a kidney dialysis or kidney transplant patient.

While most individuals do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare will send you a bill for your Part B premium every 3 months.

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Medicaid

You may be eligible for free or low-cost care through Medicaid depending on your income and family size. In all states, Medicaid gives health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.

  • First, find out if your state is expanding Medicaid and learn what that means for you.
  • If your state is expanding Medicaid, find out what you may be eligible for depending on your income and family size.

Even if you were told that you did not qualify for Medicaid in the past, you may be eligible under the new rules. You can see if you are eligible for Medicaid in two ways:

  • Visit your state’s Medicaid website. Through the drop-down menu at the top of the page, choose your state. You can apply right now and find out if you are eligible. If you qualify, coverage can begin immediately.
  • Fill out an application in the Health Insurance Marketplace. When you complete the application, you will be told which programs you and your family are eligible for. If it looks like anyone is qualified for Medicaid and/or CHIP, the state agency will be informed so that you can enroll.

Conclusion

Medicare is the U.S. government’s medical coverage program for individuals aged 65 or more. This applies whether you are still working at the time of your 65th birthday. You could be qualified for Medicare before you reach the age of 65 on the off chance that you have Social Security disability, RRB disability benefits, specific health conditions like ALS or ESRD, a family relationship with somebody getting Medicare. Note that the age when you retire does not factor into Medicare qualification. On the off chance that you have insurance through your employer when you apply for Medicare, it will remain your primary insurance and Medicare will be viewed as secondary insurance.

Tony Bennett

Tony Bennett

Tony Benett makes his living in the insurance industry by teaching and consulting. He is also recognized by the legal profession as an expert on insurance coverages. His insurance experience includes having worked at the company level, owned an independent general agency and having worked for an insurance association. He has received various certificates over the past few years and helps his clients and readers by giving them a realistic outlook on what they can expect to achieve within their set targets. At Insurance Noon, he is known for his in-depth analysis and attention to details with accuracy. He has been published as one of the most referred agents by his peers in the insurance community. Tony loves the outdoors and most sport events. His passion other than providing excellent advice is playing golf.

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