Original Medicare (Part A and B)
Original Medicare (Part A and B) Eligibility and Enrollment
Medicare Part A and Part B Eligibility and Enrollment
On this page, you’ll find details on how to apply for Medicare Parts A and B and how to enroll. Visit our Employer Page or our I’m 65 and Still Working page to learn more about Medicare’s provisions for the working-age population.
This page is constantly being improved, so please check back for updates.
The following persons are eligible for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
- Age 65 or older
- End-Stage Renal Disease (ESRD)
Medicare Part A (Hospital Insurance)
Most people are covered by Part A for free, but some must pay a supplemental fee.
Part A premium-free coverage is only available to those who qualify for Medicare through their own or a family member’s earned income, including but not limited to spouses, parents, and children. In order to be eligible for premium-free Part A, a worker must meet the QC requirements and apply for Social Security or RRB benefits. No matter what type of application for Part A the individual submits (older or disabled or end-stage renal disease), the actual number of QCs required will vary (ESRD). Earning QCs is done through FICA tax payments made during the working years of a person’s life. Most people pay the full FICA tax so that the QCs they receive can be used to meet both monthly Social Security payments and premium-free Part A requirements.
NOTE: Only the Part A of the FICA tax is paid by some employees of the federal, state, and local governments. To qualify for premium-free Part A, you must utilize your QCs; you cannot use them to qualify for monthly Social Security payments using your QCs.
People over 65 and enrolled in Part B qualify for premium Part A coverage. You can only sign up for premium Part A and Part B at particular dates and times of the year. (The times during which a person can enroll are detailed in the section labeled Enrollment Periods and When Coverage Begin).
More Information on Enrolling in Part A
Prior to being eligible for Medicare, individuals who have received Social Security or RRB benefits for at least four months prior to their eligibility are automatically enrolled in both premium-free Part A and Part B. Only those qualified for automatic enrollment in Puerto Rico are enrolled in premium-free Part A.
Enrollment for people who do not receive Social Security or RRB benefits is not automatic Social Security must be contacted by these individuals in order to apply for benefits.
Medicare Part B (Medical Insurance)
In order to be eligible for Part B, an individual must either have premium-free Part A coverage or pay a premium for Part A coverage.
In order to enroll in Part B, individuals must first have been granted premium-free eligibility for Part A. Part B enrollment is restricted to specific times of the year.
Participants in Part A must meet the following criteria before they can enroll in Part B:
- Be age 65 or older;
- Be a U.S. resident; AND
- Be either a U.S. citizen, OR
- Be an alien who has been lawfully admitted for permanent residence and has been residing in the United States for 5 continuous years prior to the month of filing an application for Medicare.
NOTE: Those who choose to participate in Part B must pay a premium each month for the duration of their coverage.
More Information on Enrolling in Part B
Prior to being eligible for Medicare, individuals who have received Social Security or RRB benefits for at least four months prior to their eligibility are automatically enrolled in both premium-free Part A and Part B. There is a choice for those who are automatically enrolled in Part B coverage. In Puerto Rico, automatic enrollment only covers premium-free Part A; those eligible for automatic enrollment must enroll in Part B if they want this coverage.
Enrollment for people who do not receive Social Security or RRB benefits is not automatic Part B can only be re-enrolled in by individuals who previously refused or cancelled their participation in Part B. Most people who do not enroll in Medicare Part B (Medical Insurance) as soon as they are eligible will be subject to a late enrollment penalty for as long as they have Part B.
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