What Is the Suitable Age for Medicare Eligibility?

Feb 15, 2024 By Susan Kelly

Medicare, like Social Security, is a government-sponsored program in the United States that is supported by tax withholding from most employees' paychecks. Medicare benefits are available to people when they reach the age of 65 or fulfill other qualifying conditions. Because of your payroll deductions, you will almost certainly be eligible for free Medicare Part A coverage; nevertheless, other Medicare components will most likely be costly to you.


Suppose you contributed to a retirement system that did not withhold Social Security or Medicare premiums. In that case, you are likely still eligible for Medicare coverage—either via your retirement system or through your spouse's retirement plan. To be eligible for full medicare eligibility coverage at the age of 65, you (or your spouse) must have earned enough Social Security credits to be eligible for benefits.

There are four credits available for each $1,470 in yearly earnings, but you can only earn a total of four credits in any one year. If you have 40 credits—10 years of work—and earned a total of $5,880 or more in each of those years, you will be eligible to collect Social Security payments when you reach retirement age.

Things get a little more difficult if you continue to work after reaching 65. Even though you will be required to enroll in Medicare, you may be allowed to continue to use your employer's health insurance coverage as your main insurer. Alternatively, your employer-sponsored health plan may require you to make Medicare your main insurance plan, or you may be subject to additional restrictions.


Perhaps you were a stay-at-home parent or spouse and had no prior employment experience to draw from. Based on your spouse's employment history, you may still be eligible for Medicare benefits at 65. Your eligibility for benefits is determined by whether your spouse has the requisite 40 credits and if you've been married for at least one year in a row. Those married to someone of the same gender as their spouse have the same privileges as any other married pair when it comes to being covered by their spouse's Medicare benefits.

Suppose you are divorced and do not qualify for Medicare based on your work history. In that case, you may be able to qualify based on your ex-spouse's work history, provided that your marriage lasted at least ten years and that you are presently single.

Benefits for People with Disabilities

If you have a qualifying disability, you may be able to receive full benefits before reaching the age of retirement.

How to Meet the Requirements

Individuals who are qualified for coverage via an employer's health plan or, if they are no longer working, through COBRA may be able to get coverage during this waiting time. End-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS), often known as Lou Gehrig's illness do not need a 24-month waiting period before payments may be collected. A person who has been diagnosed with end-stage renal disease (ESRD) may often begin receiving benefits three months after completing a course of regular dialysis or after having a kidney transplant. Meanwhile, as soon as a person diagnosed with ALS starts earning Social Security Disability payments, they are automatically enrolled in Medicare Part A and Part B benefits if they qualify.

In A Nutshell

People who meet the criteria for disability benefits are subject to the same restrictions as those who get retirement benefits. There is no distinction in terms of coverage.

What Happens If You Continue to Work?

Work incentives and Ticket to Work programs offered by the Social Security Administration allow you to work while receiving Medicare disability payments for some time. Three timelines need to be considered. For the first nine months, you may test your capacity to work while still receiving full benefits. The trial work period is a nine-month period when you can test your Eligibility to work while still receiving full benefits. The nine months don't need to be consecutive. Meanwhile, as soon as a person diagnosed with ALS starts earning Social Security Disability payments, they are automatically enrolled in Medicare Part A and Part B benefits if they qualify. The trial period continues until you have worked for nine months in 60 months.

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