medicare post-its

When Can You Enroll In Medicare?

Enrolling in Medicare can be confusing. Fortunately, Generations Insurance can help. Located in Idaho Falls, Generations Insurance is here to answer all of your Medicare enrollment questions. Read on to learn more about applying to Medicare below.

People Eligible for Medicare

There are three groups of people eligible for Medicare: people 65 and older, people with a disability, or people with End-Stage Renal Disease (ESRD). The largest group of Medicare recipients is seniors age 65 and older. About 13.7% of the Idaho Falls population is 65 or older, making about 8,616 people eligible for Medicare by age criteria. About 13.3% of Idaho Falls under 65 has a disability, meaning another 8,364 people may be eligible for Medicare.

In general, to be considered eligible for Medicare over age 65, you must:

  • Be a U.S. citizen or permanent legal resident who has lived in the U.S. for at least 5 years.
  • Have worked to earn 40 credits (via you or your spouse) during which you paid Medicare taxes.

For people with disabilities, you do not have a tax requirement to meet. However, you must:

  • Have been entitled to Social Security Benefits for at least 24 months (not necessarily consecutively); or
  • Receive a disability pension from the railroad retirement board and meet certain conditions; or
  • Have Amyotrophic Lateral Sclerosis/Lou Gehrig’s disease.

For people with ESRD, you must additionally: 

  • Have permanent kidney failure requiring regular dialysis or a kidney transplant.
  • Have paid social security taxes (via you or your spouse) for a certain length of time, depending on your age.

How to Apply for Medicare

If you are 65 and older applying to Medicare, you must apply through Social Security if you are not already enrolled in Social Security. You have a 7-month period – 3 months before your birthday month, your birthday month, and then the 3 months after your birthday month. If you have a disability and would like to apply, you also have to apply through Social Security after you meet the requirements. If you have End-Stage Renal Disease, you generally also need to first contact Social Security. 

If you are 65 and older and miss your Initial Enrollment Period or belong to either of the other two groups, you may also apply for Medicare during the Special Enrolment Period or the General Enrollment Period. 

The Special Enrollment Period is for people moving out of their plan’s service area or losing coverage because their plan no longer covers them. The timing is different depending on your situation, but generally, it includes a 2-3 month window surrounding the loss of coverage. The General Enrollment Period is for anyone who missed the Initial Enrollment, this is the only other time they are allowed to enroll in Medicare and occurs between January 1 to March 31st.

Located right here in Idaho Falls, Generation Insurance can help you understand when and how to enroll in Medicare. Call us today!