You may still be eligible for Medicare even if you are not automatically enrolled.

The rules for Medicare eligibility are sometimes confusing because some people are automatically enrolled while others must apply. This seeming inconsistency was the subject of a recent article in My San Antonio entitled “Who Is Eligible for Medicare?” And, as it turns out, the rules are actually pretty simple.

People who are 65 or older are eligible for Medicare if they or their spouse are eligible to receive Social Security or Railroad Retirement benefits. Typically, this means they have done full-time work for the equivalent of 10 years.

Government employees or their spouses who did not pay into Social Security but did pay into Medicare are also eligible. People under 65 are eligible if they have been permanently disabled for two years, have end stage renal failure that requires dialysis, have had a kidney transplant, or have Lou Gehrig’s disease.

People over 65 who do not meet the requirements can still participate in Medicare, but they may need to pay premiums for the coverage.

Eligible people will normally be automatically enrolled in Medicare Parts A and B when they turn 65 if they are already receiving Social Security benefits, have been disabled for two years or have Lou Gehrig’s disease. Those who are not automatically enrolled need to apply for benefits.

There can be penalties enforced if a person who is eligible waits to apply so it might be best to meet with an elder law attorney before delaying your application.

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Philip J. Kavesh
Nationally recognized attorney helping clients with customized estate planning guidance for over 40 years.
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