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Can I Afford Medicare Coverage? What Are the Eligibility Requirements?


Medicare is a federal health insurance program for individuals age 65 and older. If you are nearing the age of retirement, you may have questions about your eligibility for Medicare coverage. Could your income or work history impact your Medicare benefits? Are there other factors that could affect your application? What if you do not qualify for full benefits? In this blog, we will cover the general requirements to qualify for Medicare coverage and what to do if you do not meet those requirements.

Are you 65 or older?

If you're 65 or older and still working, there are certain requirements to meet in order to qualify for Medicare. If you are applying for coverage because of a disability, however, these requirements do not apply.

Your age plays a large role in determining if you can be covered by Medicare. If you're younger than 65 but have worked long enough to qualify (40 quarters), then yes! You can apply for coverage regardless of whether or not your condition is considered "permanent."

If it is determined that your disability is permanent by a doctor who has been approved by the Social Security Administration and that it prevents you from working enough hours or earning enough money to be eligible for Social Security disability benefits on their own merit alone (meaning those benefits would reduce their value), then yes! You can apply for coverage regardless of whether or not your condition is considered "permanent."

Are you a citizen of the United States?

All you need is a Social Security number and proof of your citizenship, which can include your birth certificate, passport, or certificate of citizenship.

If you aren't a citizen but still qualify for Medicare due to other requirements, such as being 65 years old and living in the United States for at least five years, then you may be able to receive coverage.

You won't be eligible if:

● You're in jail or prison on a felony conviction (a federal or state prison). Your benefits will start after release from custody (excluding parole) and confinement ends.

Do you meet the Social Security eligibility requirements?

To be eligible for Medicare coverage, you must meet the following requirements according to

● You must be at least 65 years old. (Or have a disability that meets Social Security’s definition of disability.)

● You must be a citizen of the United States.

● You must have worked long enough to qualify for Social Security benefits. If you already receive Social Security Disability Insurance or Supplemental Security Income payments, it won’t affect your ability to sign up for Medicare Part A.

Have you paid Medicare taxes while working?

The first requirement is that you have worked for at least 10 years. If you are working, this can be paid work or a volunteer job. If you do not meet this criterion, then there is no way to get Medicare coverage.

The second requirement is that you must be 65 or older. This means that if you are turning 65 in 2019, then your Medicare coverage will begin on January 1st, 2020. This also means that if someone turns 64 on December 31st, 2019, and then turns 65 on January 1st, 2020, they cannot use their new benefit until January 2021 because they did not reach the eligibility age of 65 before December 31st, 2020 (to avoid confusion).

The third requirement is having paid Medicare taxes while working. This can be done through both employer-based and self-employed paychecks as well as any government pension system like Social Security disability benefits or military retirement pay which was taxed at some point during your employment history with them (note: if none of those things apply to you but did apply for someone else who counts towards determining whether or not their assets are sufficient enough for them before applying for Medicaid).

Does the government owe you money in back pay for Social Security Disability Insurance (SSDI) benefits?

If you have received Social Security Disability Insurance (SSDI) benefits, you may be eligible for Medicare. It's important to note that even if you haven't received SSDI benefits, you may still qualify for Medicare.

Just like with any other insurance package, it's important to know your options before deciding on a plan. If you're eligible for Medicare, there are a few things that might affect your ability to enroll in the program:

● When was the last time I was unemployed?

● What is my tax bracket?

● Do I own my home or rent?

If you do not qualify for full benefits, what are your options?

If you don't qualify for full benefits, there are a few options:

● Medicare Supplement Insurance. Medigap plans help pay for services that Part A and B do not cover. If you want to supplement your coverage, you can purchase a Medigap policy on its own or as part of a Medicare Advantage Plan (a private plan offered by some health insurance companies). These plans come with their own terms and conditions, so be sure to read over them carefully before signing up.

● Medicare Advantage Plans. You can also buy into one of these private health plans if they're available in your area through Medicare Advantage Organizations (MAOs). They cover most services offered by traditional Medicare except prescription drugs—though most offer supplemental drug coverage that might help fill any gaps in your prescription plan coverage.

With Medicare, there are different levels of coverage and price based on your conditions that can be met through the different plans.

Medicare is available to everyone over the age of 65, regardless of whether or not they paid into the program. However, it’s important to note that you must be at least 65 by the end of December in order to enroll in Medicare for 2019.

Medicare is a federal program that provides health insurance to people who are 65 or older, or who have disabilities or end-stage renal disease (ESRD). Medicare offers two main types of coverage: Part A and Part B.


Finding affordable healthcare coverage can be a daunting task, but it doesn’t have to be. Medicare is an affordable and accessible option that can help you with the costs of your medical bills. If you are 65 or older, and meet the Social Security eligibility requirements, then you are eligible for Medicare benefits. However, if you don’t qualify for full benefits there may be additional options available to help cover some of your medical expenses, such as Medigap plans which supplement Original Medicare and cover some out-of-pocket costs. Do your research to find what will work best for you!

About Preferred Senior Benefits in Meridian, Idaho

Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818-2523. We can’t wait to help you learn about your options.

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