What Are the Guidelines for CMS Medicare?


Quick Answer

Guidelines for the Centers for Medicare & Medicaid Services (CMS) Medicare program include that the applicant must be age 65 or older or have certain disabilities, such as end-stage renal disease and must have worked and paid Medicare taxes for at least 10 years. Depending on age and medical conditions, an applicant can be eligible for health insurance, hospital insurance and prescription drug coverage, notes CMS.gov.

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Full Answer

To meet general CMS Medicare guidelines, applicants must be at least 65 years old, live in the United States or one of its territories and have paid into Medicare taxes for a minimum of 10 years. Those who are eligible, but have insurance themselves or through a spouse are still eligible for Parts A and B, states Medicare.gov.

Applicants who are less than age 65 are not eligible for CMS Medicaid until they turn 65 even if they receive Social Security or Railroad Retirement Board disability. However, if the disability is end-stage renal disease, and a person worked the necessary amount of time or is the spouse or dependent child of someone who did, there is no age requirement.

Medicare Part A is hospital insurance that helps cover inpatient and skilled nursing facilities. Part B helps pay for outpatient care such as doctor visits. Part D is prescription drug coverage that can help reduce prescription costs.

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