Generally, yes, when an individual turns 65 he or she is eligible for Medicare.
Listed below are the individual eligibility and premium requirements for Medicare. Note that whether you have worked and paid Medicare taxes, and for how long, can affect whether you're automatically enrolled in Medicare and whether you pay a premium for Medicare Part A.
Individual Eligibility for Original Medicare, Part A and Part B
- Medicare recipient needs to be an American citizen or legal permanent resident of at least five continuous years.
- Recipients must be age 65.
- Individuals receive Medicare regardless of marital status.
Premiums for Individuals
- If you have worked 40 quarters (10 years) while paying Medicare taxes, you will typically not need to pay a monthly Medicare Part A premium.
- Everyone pays a monthly premium for Medicare Part B.
Spousal Eligibility and Premium for Medicare, Part A and B
- For those who are age 62 or older, have worked for at least 10 years while paying Medicare taxes, and has a spouse who is age 65 or older, the spouse is eligible for premium-free Medicare Part A.
- For those who are not yet age 62, but have worked at least 10 years while paying Medicare taxes, and has a spouse who turns age 65, the spouse is eligible for Medicare Part A but will need to pay a premium until you turn 62.
Because everyone must pay a premium for Part B, some beneficiaries (the employee or a non-working spouse) who are still receiving employer-based health insurance may decide to postpone enrollment. Beware of the late-enrollment penalty. Be sure to check with your group health plan administrator to determine if this penalty would apply to you.
