How Can Medicare Eligibility Be Determined?


Quick Answer

Medicare eligibility is determined by the Social Security Administration. Individuals who receive Social Security benefits are automatically enrolled in Medicare. Other applicants may apply by calling the Social Security Administration, visiting a local office or completing an application at SSA's official website.

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Full Answer

As of 2015, most U.S. citizens who are age 65 or older are eligible for Medicare. Individuals who are younger than 65 and receiving Social Security Disability Insurance benefits automatically become eligible for Medicare the month they receive their 25th payment. In this case, the individual is mailed his Medicare care three months before eligibility. Individuals receiving SSDI benefits because of Amyotrophic Lateral Sclerosis, also known as Lou Gehrig's disease, are automatically enrolled in Medicare the first month they receive payments. In general, those with end-stage renal disease are eligible for Medicare three months after beginning dialysis but must contact the Social Security Administration to apply.

The initial Medicare enrollment period begins three months before an applicant's 65th birthday and ends three months after. Applicants wishing to enroll in Medicare after the initial enrollment period may apply between January 1 and March 31 of each year thereafter. Medicare coverage for these individuals begins in July of the same year.

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