The basics of Medicare 

Who’s eligible

You’ll need to meet a few requirements to be eligible for coverage. There are also different times of the year when you can enroll.

Original Medicare

You are eligible for Medicare if you are a U.S. citizen or have been a legal resident for five straight years and meet one of the following criteria:

  • Are age 65 years or older and eligible to receive Social Security
  • Already get retirement benefits from Social Security or the Railroad Retirement Board, or you are eligible for them and have not filed for them
  • You or your spouse had Medicare-covered government employment
  • Are under age 65, are permanently disabled and have received Social Security disability benefits for at least two years
  • Require ongoing dialysis for end-stage renal disease (ESRD) or need a kidney transplant

Medicare Cost plans

You are eligible for a Medicare Cost plan if you:

  • Are eligible for Medicare Part A and enrolled in Part B, (or enrolled in Part B only) and
  • Live in the plan’s service area, and
  • Continue to pay your Part B premium (and Part A if applicable, if not paid by Medicaid or another third party)

Note: If you have ESRD, you may not be eligible.

Medigap (Medicare supplement) plans

You are eligible for a Medigap plan if you:

  • Are eligible for Medicare Part A and enrolled in Part B, and
  • Live in the plan’s service area, and
  • Continue to pay your Part B premium (and Part A if applicable, if not paid by Medicaid or another third party)

Medicare Advantage plans

You are eligible for a Medicare Advantage plan if you:

  • Are eligible for Medicare Part A and enrolled in Part B, and
  • Live in the plan’s service area, and
  • Continue to pay your Part B premium (and Part A if applicable, if not paid by Medicaid or another third party)

Note: If you have ESRD, you may not be eligible.

Medicare prescription drug plans

You are eligible for a Medicare prescription drug plan if you:

  • Are eligible for Medicare Part A and/or enrolled in Medicare Part B, and
  • Live in the plan’s service area, and
  • Continue to pay your Part B premium (and Part A if applicable, if not paid by Medicaid or another third party)

You can join a stand-alone prescription drug plan if you have Original Medicare only or Original Medicare and a Medicare health plan that does not include prescription drug coverage.

What can I do next?

Plans & Services: Medicare