Do you have to be retired to get medicare

No, you do not have to be retired to get Medicare. While Medicare is often associated with retirees, it is available to eligible individuals under several different circumstances. Here’s a detailed explanation of when and how you can qualify for Medicare without being retired

Eligibility Criteria for Medicare

1. Age-Based Eligibility:

   • Turning 65: The most common way to qualify for Medicare is by turning 65 years old. You can sign up for Medicare during your Initial Enrollment Period (IEP), which starts three months before the month you turn 65, includes your birth month, and extends three months after your birth month.
   • Employment Status: You do not need to be retired to enroll in Medicare at 65. You can be working full-time, part-time, or not at all.

2. Disability-Based Eligibility:

   • Social Security Disability Insurance (SSDI): Individuals under 65 who have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months are eligible for Medicare.
   • Amyotrophic Lateral Sclerosis (ALS): Individuals diagnosed with ALS (Lou Gehrig’s disease) become eligible for Medicare as soon as they start receiving SSDI benefits, without the 24-month waiting period.
   • End-Stage Renal Disease (ESRD): People with ESRD who require dialysis or a kidney transplant can qualify for Medicare regardless of age, usually starting the first month of dialysis or the month of the kidney transplant.

3. Spouse’s Work Record:

   • Spousal Benefits: If you are 65 or older and your spouse is eligible for Medicare based on their work record, you may also qualify for Medicare even if you are not retired and may not have sufficient work credits yourself.
     
     

Enrollment in Medicare While Working

1. Employer-Sponsored Health Insurance:

   • Coordination of Benefits: If you are still working and have health insurance through your employer (or your spouse’s employer), you can enroll in Medicare. Medicare will coordinate with your employer-sponsored plan. Typically, if the employer has 20 or more employees, the employer insurance is the primary payer, and Medicare is secondary.
   • Part B Enrollment: You may choose to delay Part B (which covers outpatient care and physician services) if you have credible employer coverage, avoiding the Part B premium until you retire. You can enroll in Part B during a Special Enrollment Period (SEP) without a late enrollment penalty when you lose your employer coverage.

2. Small Employers:

   • Medicare as Primary: If you work for a small employer (fewer than 20 employees), Medicare generally becomes the primary payer when you become eligible, and the employer insurance is secondary.
     
     

Special Enrollment Periods (SEPs)

1. Working Past 65:

   • SEP for Part B: If you are working past 65 and covered by an employer’s health plan, you can sign up for Part B without a penalty during a Special Enrollment Period. This SEP lasts for eight months starting the month after your employment ends or your employer-provided insurance ends, whichever comes first.

2. COBRA and Retiree Health Plans:

   • Not Credible Coverage: COBRA and retiree health plans do not count as current employer coverage for Medicare SEPs. If you rely on these plans after leaving employment, you should sign up for Medicare when first eligible to avoid late enrollment penalties.

You do not have to be retired to get Medicare. Eligibility is primarily based on age (65 and older), disability status, or certain medical conditions, regardless of employment status. If you are still working and have employer-sponsored health insurance, you have options to enroll in Medicare and coordinate benefits to suit your healthcare needs. Understanding these rules can help you make informed decisions about your Medicare coverage and avoid potential penalties.