Unlike a basic individual or group health insurance policy, Medicare is not available for everyone. Individuals must meet certain qualifications in order to be covered under a Medicare plan.

You may qualify for Medicare if you:

• Are 65 years of age or older
• You or your spouse paid Medicare taxes through work for at least 10 years
• Have End Stage Renal Disease (permanent kidney failure)

If you do not meet any of the above requirements, you may not qualify for Medicare. Be sure to ask an insurance agent if you have any questions about your Medicare qualifications or policy.

Are Premiums Required for Medicare?

In most cases, you will have to pay premiums for Medicare just as you would for a different health insurance policy. However, there are some instances where you may be eligible for premium-free Part A Medicare. Part A Medicare covers hospital stays, hospice care, skilled nursing care and more.

You may be eligible for premium-free Part A Medicare if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board
• You or your spouse had Medicare-covered government employment
• You are eligible to receive Social Security or Railroad benefits
• You are a kidney dialysis or kidney transplant patient

Keep in mind that even if you qualify for premium-free Part A Medicare, you will still be expected to meet other payments as applicable by your plan, such as deductibles and copayments. This exclusion also only applies to Part A of Medicare plans. Everyone must pay premiums for Medicare Part B and Part D.

When Can You Purchase Medicare?

You are able to purchase Medicare as soon as you are eligible. Those who become eligible through age may enroll in Medicare within six months of their 65th birthday. You must first be enrolled in Original Medicare as well as qualify for Original Medicare before purchasing Medicare Advantage.

Medicare Advantage plans generally require premiums as well as copayments and deductibles as applicable by your plan. Copayments and deductibles may only be covered by a Medigap policy which is available through private insurers.

There may be different enrollment periods for Original Medicare and Medicare Advantage plans, so be sure to speak with your insurance agent and keep track of when you may be enrolled in a Medicare plan. Medicare is crucial for individuals who need health insurance but may be unable to work or no longer working.

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