So who is eligible for Medicare?
The easy answer is people 54 and older who have worked and paid into the program. This also includes their spouses.
Ok. Who else?
Disabled persons who have paid into the program at some point in their lives as well. You have to be considered permanently disabled to be eligible. This means you have to go through the Department of Social Security and be awarded disability status from them. This also entitles you to draw on your Social Security benefits as well. Remember Social Security and Medicare are two different things.
Ok. Who else?
Did you know that children and spouses of disabled persons are also eligible? You also have to take into consideration things like whether the spouse is working, and how old the children are as well.
Great. Anything else?
Well yes. If you are an End Stage Renal Disease patient (kidney transplant candidate) then your private insurance (if you have any) is considered prime for the first 36 months (33 months plus a 3 month waiting period) and then Medicare becomes the primary payer. These are coordinated between the insurance carrier and Medicare to determine the date which Medicare becomes prime.
As you can see, there are a number if situations that affect eligibility for the Medicare program. If you have any questions, contact your local Social Security Administration office, or visit:
Until next time:
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Author, Medical Billing, Coding, and Reimbursement
A medical billing professional for over 30 years now, I have seen a lot of changes in this field, and there are a lot more on the horizon. Follow me as we see what they mean and for who.