Medicare Part B Eligibility

Medicare Part B (Medical Insurance)

The following groups of people are eligible for coverage under Part B of

Medicare:

  • Persons entitled to premium-free hospital insurance (Part A).
  • Persons entitled to premium hospital insurance (Part A).
  • Railroad retirement beneficiaries.
  • Any person age 65 or over who is a resident of the United States as either a citizen or a lawful alien admitted for permanent residence and having resided in the United States for at least five years.

Persons receiving Social Security or railroad retirement benefits are automatically enrolled in Medicare Part B at the time that they become entitled to coverage under Part A of Medicare.

  • They will receive a form in the mail that allows them to elect not to take coverage under Part B if that is what they so desire.
  • The initial enrollment period runs for seven months from the time that an individual is eligible for Medicare.
  • If a person elects not to enroll during the initial enrollment period, he or she may enroll during the general enrollment period which runs from January 1 through March 31 each year.
  • If one desires coverage as soon as possible, enrollment should take place before the beginning of the month in which a person attains the age of 65.
  • This will provide that coverage will start the first day of the month of one’s 65th birthday.
  • If a person waits until the month that they turn age 65 to enroll, coverage will not commence until the first day of the following month.

Medicare Part B (Medical Insurance) is voluntary, and everyone who elects to take coverage under Part B will be required to pay the monthly premium, with the exception of those who qualify for Medicaid.

  • For those who pay premiums, the premium amount is deducted from their Social Security, railroad retirement, or federal civil service retirement benefit checks.
  • The premium can also be deducted from a group plan provided by the employer if the person over 65 is still working.
  • The beneficiary also has the option of paying the government directly every quarter for coverage.

To summarize in general terms, an individual must be eligible for Social Security benefits or railroad retirement benefits, be age 65, or be eligible by meeting the disability requirements in order to be eligible for Medicare.

Federal government employees have been eligible for Medicare at retirement since 1983. Federal employees hired before 1983 receive retroactive quarters of coverage under Social Security. State and local government employees hired on or after April 1, 1986, are covered under Medicare.