Am I Eligible?

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Who is eligible for Medicare?

What is Medicare-covered employment?

What are the income limits?

What are the asset limits?

Can noncitizens get Medicare?

Can I get Medicare if I have other health insurance?

If I am not eligible for retirement benefits when I turn 65, can I still get Medicare?

Who is eligible for Medicare?

You are eligible for Medicare and will get free Part A coverage if you are in one of the categories listed below:

• 65 or older and you or your spouse is getting (or eligible for) retirement benefits from Social Security or Railroad Retirement

• under 65 and getting Social Security Disability Insurance (SSDI) or Railroad Retirement disability benefits (There is a 24-month waiting period for most people in this category.)

• under 65 years of age with end-stage renal disease (ESRD) and you or your spouse has met the Medicare work requirement. The number of years of Medicare-covered employment that you need to qualify varies, depending on the age at which you got ESRD. Dependent children with ESRD are also eligible if one of their parents has met the Medicare work requirement.

If you are not in one of the above categories, you can still get Medicare, but you must pay for Part A coverage, if you are:

• 65 or older and a U.S. citizen or a lawfully admitted noncitizen who has lived here continuously for five years.

For more information, call 1-800-MEDICARE (TTY: 1-877-486-2048)

To check your eligibility, you may use the online Medicare Eligibility Tool on the U.S. government Medicare web site.

What is Medicare-covered employment?

The Federal Insurance Contributions Act (FICA) is a federal law that requires most employers to withhold two separate taxes from the wages they pay their employees: a Social Security tax and a Medicare tax. If you are self-employed, you must also pay these taxes. If you have worked in a job where FICA taxes have been withheld from your paycheck, or if you have paid these taxes as a self-employed worker, you have worked in Medicare-covered employment.

People under 65 must earn a certain number of credits of Medicare-covered employment to get Medicare benefits (depending on their age). Those 65 and over qualify for free Part A Medicare if they have earned a minimum of 40 credits of Medicare-covered employment. You can earn up to four credits a year, based on your earnings. Most people earn 40 credits in 10 years of work.

If you want to know how many credits of Medicare-covered employment you have, check your most recent Social Security statement. If you have not gotten a statement or would like a more recent one, you may request one by calling Social Security at 1-800-772-1213, or you may request one online: Request a Social Security Statement.

What are the income limits?

Medicare has no income limits.

What are the asset limits?

Medicare has no asset limits.

Can noncitizens get Medicare?

If you are a lawfully admitted noncitizen who meets the Medicare eligibility requirements, you can get Medicare coverage. You must have a Social Security number.

If you qualify based on work credits, you must have been authorized to work at any jobs for which you got Medicare credit.

If you do not have Medicare-covered employment and you are 65 or older, you must have lived in the U.S. continuously for the five years before you apply.

An undocumented noncitizen with ESRD can get Medicare if married to a citizen or eligible noncitizen who has earned enough Medicare-covered work credits. Undocumented dependent children with ESRD can get Medicare if a parent has earned enough Medicare-covered work credits. Undocumented noncitizens who qualify will be given a nonwork Social Security number.

Can I get Medicare if I have other health insurance?

Yes, you can get Medicare if you have other health insurance, as long as you meet the Medicare eligibility requirements. For example, you might have other health insurance if you or your spouse works, or if you have retiree coverage.

When you have another type of health coverage with Medicare, the rules for how these plans work together and which health plan pays first can be complicated.

For more information:

• read the Medicare publication Medicare and Other Health Benefits: Your Guide to Who Pays First. (To view this file, you must have Adobe Reader installed on your computer.)

• call the Medicare Coordination of Benefits Contractor at 1-800-999-1118 (TTY: 1-800-318-8782).

• contact a SHINE counselor at 1-800-243-4636 (TTY:1-800-872-0166) or visit the Shine Program web site.

If I am not eligible for retirement benefits when I turn 65, can I still get Medicare?

Many people who are not eligible for retirement benefits at age 65 can still get Medicare.

Some people are not eligible for retirement benefits at age 65 because the Social Security retirement age is gradually increasing from 65 to 67. Even though the retirement age is increasing, the eligibility age for Medicare will remain at 65. As long as you or your spouse worked at least 10 years in Medicare-covered employment, you will still be eligible for Medicare at age 65 and you will receive Part A coverage for free.

If you have not worked at least 10 years in Medicare-covered employment, you are still eligible for Medicare when you turn 65 if you are a U.S. citizen or a permanent legal resident with 5 years residency in the U.S. You may enroll in Part A Hospital Insurance, Part B Medical Insurance, or both:

• If you choose Part A, you will have to pay a monthly premium for this coverage. (Most Medicare recipients get Part A for free.) The monthly premium for Part A depends on how many credits of Medicare-covered employment you have.

• If you choose Part B, you will pay the same monthly premium that other Medicare recipients pay for this coverage.

You may also choose to enroll in a Part C Medicare Advantage Plan and/or Part D Prescription Drug Plan.

For information about Medicare costs, see How much does Medicare cost?