Keeping up with the rising cost of healthcare can be difficult, but many seniors turn to Medicare for insurance at the age of 65, if they haven’t qualified prior to that age due to certain disabilities. Medicare helps pay for a range of medically necessary healthcare services and items, including visits with your family physician, surgical procedures and walkers and wheelchairs.
Medicare can also help to offset the cost of hospital care for up to 90 days per benefit period. Prescription medications may also be covered through Medicare Part D. With all that Medicare covers, it’s easy to understand why most people would want to begin taking advantage of benefits as soon as possible, but the Medicare program does impose limitations as to who can apply and when.
The History of Medicare
National healthcare coverage programs have been a topic of discussion in Washington since the early 1900s, but it wasn’t until President Johnson signed the Medicare and Medicaid Act into law in 1965 that Americans over the age of 65 could begin receiving government-sponsored healthcare coverage.
The intent of Medicare is to provide healthcare insurance to Americans who have reached retirement age and are no longer in the workforce. This isn’t to suggest that you must stop working in order to receive Medicare benefits, but this was the original intent of the program.
Do I Have to Be 65 Years of Age for Medicare Benefits?
According to the Centers for Medicare & Medicaid Services (CMS), 65 is the most common age for age for Medicare benefits, but millions of people qualify under the age of 65 due to specific conditions. You can enroll in Medicare during a seven-month Initial Enrollment Period which encompasses the three months prior to the month you turn 65, the month of your 65th birthday and the three months following your birthday month.
If you enroll in Medicare Part B or Part D after the Initial Enrollment Period and did not hold other creditable coverage, you may face penalties for late enrollment. You may be able to enroll in Medicare prior to turning 65 unless you meet certain criteria as discussed below.
Qualifying for Medicare as a Disabled American
There are some situations in which you can qualify for Medicare benefits under the age of 65. If you are diagnosed with certain diseases, such as End-Stage Renal Disease (ESRD) or ALS, for instance. You may also qualify for Medicare if you’ve been getting disability benefits from the Social Security Administration’s Social Security Disability Insurance (SSDI) program or from the Railroad Retirement Board. You are eligible to apply for Medicare 24 months after you begin receiving SSDI or RRB benefits.
Can I Enroll in a Medicare Advantage Plan Before Age 65?
Medicare Advantage plans offer the same benefits as Original Medicare. While a Medicare Advantage plan may offer additional benefits, these plans are still subject to guidance by CMS. If you qualify for Medicare under the age of 65, compare Medicare Advantage plans available in your area.
What Age Do I Have to Be to Qualify for Medicaid and Medicare?
Medicaid is a state-sponsored healthcare coverage option for certain individuals who meet income requirements. Medicaid does not have a specific age to reach before you qualify, but most states have specific children’s healthcare coverage programs for individuals under the age of 21.
You may be eligible for both Medicare and Medicaid if you are age 65 or have a qualifying disability and your income is below the threshold set by your state. If you are dual-eligible for both Medicare and Medicaid, you will need to maintain your income status in order to continue receiving benefits from both programs. In any case, the age for Medicare benefits still remains 65.