Medicare Part A Eligibility

Medicare Part A (Hospital Insurance)-All people age 65 and over who are entitled to receive monthly cash benefits from Social Security or who would be entitled except that application has not been filed (regardless of their income or assets), are eligible for benefits under Medicare Part A. People age 65 and over who do not receive Social Security checks—such as those who are deferring retirement—also get Part A coverage without premium payments, but they must fill out an application. Those people who are entitled to cash benefits under the Railroad Retirement Program are also eligible for coverage under Part A of Medicare. Coverage begins on the first day of the month in which the person turns the age of 65. Persons aged 65 and over can receive Medicare benefits even if they continue to work, however Medicare will be a secondary payer to any health insurance plan that is offered by an employer (if the employer has 20 or more employees). Medicare does not provide medical care directly. Instead, it either pays doctors and hospitals directly for their services or reimburses patients who have paid the bills themselves.

Disabled persons under age 65 who have been receiving Social Security disability benefits for at least 24 months are eligible for coverage under Medicare Part A. Those covered include disabled workers of any age, disabled widows and widowers age 50 or over, and beneficiaries age 18 or older who receive benefits because of a disability beginning before age 22.

Persons of any age with permanent kidney failure are eligible for coverage under Medicare Part A if their condition requires a kidney transplant or dialysis.

A person born prior to 1909 who has no quarters of coverage under Social Security is eligible for coverage under Part A. The groups that are mentioned above are eligible for premium-free hospital insurance coverage (Medicare Part A).

Others Eligible for Part A

Persons age 65 and over who do not qualify for Social Security benefits or Railroad Retirement benefits may enroll voluntarily for hospital insurance and pay a monthly premium as long as they are also enrolled for medical insurance (Medicare Part B). In addition, they must be a resident of the United States either as a citizen or as an admitted lawful alien for permanent residence and have been residing in the United States for at least five years.

Disabled persons under age 65 who qualify for Part A due to a disabling physical or mental impairment, but are not entitled to Social Security disability benefits because they have earnings that exceed the limit for eligibility, and are not otherwise entitled to Part A benefits are also eligible for Part A benefits. These individuals are eligible to enroll and pay a monthly premium. However, if these individuals have credits for more than 30 quarters paid into Social Security or their spouses have credits for more than 30 quarters (must have been married for at least one year), they are eligible for reduced premiums under the phased-in rate reduction that began in January,1994. Furthermore, if any of these persons are divorced from a worker who had 30 or more quarters at the time of divorce and they had been married for at least ten years, they too will qualify for the premium reduction.