How To Determine Eligibility For Medicare Health Insurance

What Is The Criteria To Qualify In An Arizona Medicare Program

Medicare is a government-funded healthcare insurance program that is designed to provide coverage for Americans who fit certain criteria. In a nutshell, Medicare is available for most people who are age 65 and older. Coverage is also available for people who are younger than 65 and have certain disabilities or health conditions including end stage renal disease and Lou Gehrig’s disease. Consult with experienced Mesa Medicare insurance agents to learn more about Medicare, find out if you qualify, and get enrolled in a Medicare program. 

How to Determine Eligibility for Medicare Health Insurance In Phoenix, AZ

Details About Medicare Eligibility

There are a number of conditions that you must meet in order to qualify for full Medicare health insurance. 

  • You must be age 65 or older. 
  • You must be a U.S. Citizen or permanent legal resident who has lived in the United States for at least five years. 

Additionally, you can qualify for Medicare benefits if:

  • You receive Social Security or railroad retirement benefits, or have worked long enough to be eligible for those benefits even if you are not yet collecting them. 
  • You or your spouse is a government employee or retiree who has not paid into Social Security, but paid Medicare taxes while employed.

Some people who are younger than age 65 may be eligible for Medicare benefits if they meet one of the following criteria:

  • You have been entitled to or received Social Security disability benefits for at least 24 months total throughout your lifetime.
  • You receive a disability pension from the Railroad Retirement Board and meet specific conditions. 
  • You have amyotrophic lateral sclerosis (ALS), which is also known as Lou Gehrig’s disease, and are any age.
  • You have permanent kidney failure which requires regular dialysis or a kidney transplant, as long as you or your spouse has paid Social Security taxes for a specified period of time, depending upon your age. 

Since these guidelines may require additional conditions, it’s best to talk with your Scottsdale Medicare insurance brokers to verify your eligibility and learn more about which program options are available to you.

Other Ways You Can Receive Medicare Benefits

If you do not qualify through your own work record or your spouse’s work record, but you are a U.S. citizen or a legal resident for at least five years, you can get Medicare benefits as soon as you reach age 65. In this situation, you can buy into a Medicare program through your Queen Creek Medicare insurance brokers by paying monthly premiums. There are different programs available so that you can choose the best option to meet your healthcare needs. 

Overview of Medicare Programs

Medicare Part A provides hospital insurance. Your premium amount for Medicare Part A will depend on your work history. This is calculated through work credits that depend upon how many years you were employed and your income. The more years you have worked throughout your lifetime, the more work credits you will earn. Each year the criteria for work credits may change; in 2022, every $1510 in earnings means you earn one work credit, with a maximum of four credits available to you per year. People who have accrued fewer than 30 work credits will pay the maximum premium, which is $499 for 2022 year. People who have 30-39 credits will pay $274 per month in 2022. If you continue working and gain 40 credits, you will not need to pay any premiums. Since calculating your work credits can be confusing, consult with Glendale Medicare insurance agents to help you determine the exact premium you would need to pay for Medicare coverage.

Medicare Part B is another type of Medicare coverage that pays for doctor visits and other outpatient services along with emergency room visits, diagnostic and screening procedures, and some other healthcare services. If you earned under $91,100 or filed a joint tax return with an income under $182,000, your premiums for 2022 would be $170.10. People who earned more income will pay higher premiums.

Medicare Part D is an optional add-on that provides prescription medication coverage and is paid for at a fixed rate.

People can enroll in Medicare Part B without buying into Part A. However, if you purchase Part A, you must also enroll in Part B so that you will have adequate coverage. Part D is available whether you’re enrolled in Part A or Part B.

If you are feeling overwhelmed or unsure about your Medicare insurance options, schedule your appointment with the experienced agents at Phoenix Health and Life Insurance. We specialize in a wide variety of insurance plans and take pride in helping families understand their options so they can get the best coverage.



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Phoenix, AZ 85024
Phone: (480) 680-8120