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Medicare Eligibility Requirements

Wondering if you qualify for Medicare in Monterey County? This guide will help you check Medicare eligibility requirements based on age or other factors and determine which coverage and benefits options are available for you.  You can also find out whether you are eligible for Medicare using Medicare’s handy Medicare Eligibility and Enrollment Date Calculators.
  • Hospital Insurance: Medicare Part A Eligibility

    You are eligible to enroll if:

    You are age 65 or older and:

    • You receive or are eligible to receive Social Security benefits; or
    • You receive or are eligible to receive railroad retirement benefits; or
    • Your spouse receives or is eligible to receive Social Security or railroad retirement benefits; or
    • You or your spouse (living or deceased, including divorced spouses) worked long enough in a government job where Medicare taxes were paid; or
    • You are the dependent parent of a fully insured deceased child.

    You are under age 65 and:

    • You have been entitled to Social Security disability benefits for 24 consecutive months; or
    • You receive a disability pension from the railroad retirement board and meet certain conditions;  or
    • You receive Social Security disability benefits because you have Lou Gehrig’s disease (amyotrophic lateral sclerosis); or
    • You worked long enough in a government job where Medicare taxes were paid and you have been entitled to Social Security disability benefits for 24 months; or
    • You are the child or widow(er) age 50 or older, including a divorced widow(er), of someone who has worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program; or
    • You have permanent kidney failure (End-Stage Renal Disease (ESRD) and you receive maintenance dialysis or a kidney transplant and:
      • You are eligible for or receive monthly benefits under Social Security or the railroad retirement system; or
      • You have worked long enough in a Medicare-covered government job; or
      • You are the child or spouse (including a divorced spouse) of a worker (living or deceased) who has worked long enough under Social Security or in a Medicare-covered government job.
  • Medicare Medical Insurance: Medicare Part B Eligibility

    You are eligible to enroll if:

    You are eligible for free Medicare hospital insurance (Part A); and

    • Pay a monthly premium (based on your income)

    You are not eligible for free Medicare hospital insurance (Part A), but

    • You are age 65 or older and you are
      • A U.S. citizen; or
      • A lawfully admitted noncitizen who has lived in the United States for at least five years.
    • Pay a monthly premium (based on your income)
  • Medicare Advantage Plans: Medicare Part C Eligibility

    You are eligible to enroll if:

    • You are enrolled in Medicare Parts A and B
    • You live within the plan’s service area (depending on the type of Part C plan)
    • You pay additional premium (if applicable)
  • Prescription Drug Coverage: Medicare Part D Eligibility

    You are eligible to enroll if:

    • You are enrolled in Medicare Parts A and / or B; or
    • You are enrolled in a Medicare Advantage plan (Part C).
    • You pay an additional monthly premium for the coverage.
  • Medicare Supplement: Medigap Insurance Eligibility

    You are eligible to enroll if:

    • You are enrolled in Medicare Parts A and B.
    • You pay an additional monthly premium for coverage.

    For more information on Medicare eligibility, visit the Social Security Website.

    Interested in learning more about switching from Medigap to Medicare Advantage? Visit the Medicare website to understand your rights.