| Thu, Jan 27, 2011 @ 09:00 AM

Medicare Eligibility: Your Questions Answered

Posted by Medicare Made Clear

Medicare EligiblityMedicare is the nation’s largest health insurance program, and helps millions of Americans get the health care they need. If you or your spouse have worked for a Medicare-covered employer for at least 10 years, you may qualify if you have certain disabilities or are 65 or older. If you “age into” Medicare (rather than qualifying due to disability) you can begin the Medicare enrollmentprocess at age 64 and 9 months. You then have a six month window in which you can enroll. This window begins three months before the month you turn 65 and ends three months after your birthday month.

What if my spouse is eligible for Medicare?

Medicare eligibility is based upon personal age not on that of your spouse. If your spouse qualifies for Medicare before you, you’ll still have to wait until you reach age 65 to begin receiving benefits.

You are eligible for Medicare if:

1. You are 65 or older or have a qualified disability and

2. You are a United Stated citizen or have been a legal resident for at least five consecutive years

Am I eligible for Medicaid?

Medicaid is not a part of the Medicare program. Medicaid is a program run in each state designed to provide medical care for families and individuals with low incomes. You may be eligible but it is important to keep in mind that the two programs are separate entities.

What are the different Medicare Plans am I eligible for?

Original Medicare Parts A (hospital coverage) and B (doctors visits) are available to all beneficiaries and are provided by the federal government.

Medicare Part C plans are offered through private insurance companies approved by Medicare and combine coverage of hospital visits, doctor visits and other medical services in a single plan. You can also include prescription drug coverage, often at no additional premium.

Medicare Part D plans, also offered by private insurance companies, help with the cost of your prescription drugs. These plans are optional, so if you don’t sign up when you first become eligible you may pay a higher premium.

Depending on your specific needs, you may want to consider a Medigap, or Medicare Supplement Insurance plan. Private insurance companies offer this type of coverage to help pay for some or all of the costs that Medicare Parts A and B do not.

Contact your local Social Security office to learn about the plans available in your area.

To learn more about Medicare eligibility, contact the Medicare helpline 24 hours a day, 7 days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

Additional Resources



The family of UnitedHealthcare® Medicare Solutions plans are insured or covered by an affiliate of UnitedHealthcare, a Medicare Advantage organization with a Medicare contract and Medicare-approved Part D Sponsor.


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