Medicare eligibility and enrollment periods

Who qualifies

Most people become eligible at 65 if they or a spouse have paid Medicare taxes for at least 10 years. Eligibility can also begin earlier under specific circumstances.

• People age 65 and older
• People under age 65 with certain disabilities, generally after 24 months of Social Security disability benefits
• People of all ages with End-Stage Renal Disease (ESRD)
• People diagnosed with ALS, who qualify without the 24-month wait

The enrollment windows

Your Initial Enrollment Period is seven months long: the three months before your 65th birthday month, the birthday month itself, and the three months after. Enrolling in the first three months usually means coverage starts the month you turn 65.

The Annual Enrollment Period runs October 15 through December 7 for changes effective January 1. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 for people already in an Advantage plan. Certain events, such as moving or losing employer coverage, can trigger a Special Enrollment Period.

If you are still working at 65

If you have creditable coverage through an active employer group plan, you may be able to delay Part B and Part D without penalty. Whether that is the better financial move depends on the size of the employer and the cost of the group plan compared to Medicare.

This is one of the most common places people get tripped up. Call us at 216-255-6868 before you make a decision and we will walk through the math with you.