What do I need to enroll?
Medicare eligibility
Citizens or permanent residents of the U.S. who are 65 or older are eligible for Medicare. If you meet one of the following criteria, you’re eligible to receive Medicare Part A at no cost:
- You receive or are eligible to receive Social Security or Railroad Retirement Board benefits
- Your spouse (living, deceased or divorced) receives or is eligible to receive Social Security or Railroad Retirement Board benefits
- You or your spouse met the time requirement for working a government job through which you paid Medicare taxes
- You are the dependent parent of a fully insured deceased child
People not meeting this requirement may still be eligible for Medicare Part A by paying a monthly premium.
If you are younger than 65, you may be eligible for Medicare if one of the following applies:
- You’ve been eligible for Social Security Disability Insurance (SSDI) for two years
- You receive a disability pension from the Railroad Retirement Board and meet certain requirements
- You receive SSDI and have ALS (Amyotrophic Lateral Sclerosis; also known as Lou Gehrig’s Disease)
- You met the time requirement at a government job where you paid Medicare taxes, and have met the requirements of the SSDI program for two years
- You meet the requirements of the SSDI program, and you’re the child or surviving spouse (including divorced) age 50 or older or a worker who has worked long enough under Social Security or in a Medicare-covered government job
- You have permanent end-stage renal disease and you receive a kidney transplant or maintenance dialysis, and have met one of the requirements above
If you’re not eligible for Part A at no cost, you can pay for Part B without paying for Part A. Requirements to pay for Part B on its own include:
- Age 65 or older
- A U.S. citizen or a lawfully admitted noncitizen who has lived in the U.S. for at least five years
What does Medicare cover?
Medicare coverage can vary depending on the plan that you have. If you receive Medicare Part A and Part B directly from the government, you have Original Medicare. If you receive your benefits from a private company approved by Medicare, you have a Medicare Advantage Plan. Medicare Advantage Plans typically provide extra coverage and can lower your out-of-pocket costs.
Original Medicare covers:
- Inpatient hospital care
- Skilled nursing facility care
- Behavior and mental health care
- Hospice care
- Home health services
- Nursing home care
- Medically necessary services and supplies to diagnose or treat your medical condition
- Preventive services like bone mass measurements, various cancer and disease screenings, a yearly wellness visit, immunizations for COVID-19, flu, hepatitis B, and pneumonia
Original Medicare doesn’t cover things like long-term care, routine physical exams, hearing aids and exams, eye exams or most dental care.
To fill these gaps in coverage, you may want to seek out a plan like MetroPlusHealth’s Medicaid Managed Care plan, which does cover dental care, regular check-ups, vision and hearing exams, specialist care and more.
Learn about your Medicare options
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