The Basics

When you work, some of the money you earn automatically comes out of your paycheck and helps fund Medicare, a national public health insurance program which helps pay for the medical costs of people who qualify.

If you or your spouse works enough time while paying Medicare taxes, you qualify for Medicare:

  • When you turn 65
  • After you get Social Security Disability Insurance (SSDI) benefits for two years, or
  • If you have end-stage kidney disease (ESRD) or Lou Gehrig’s disease (ALS).

If you get Disabled Adult Child (DAC) benefits for two years based on a parent’s work record, you also qualify for Medicare.

If you have Medicare coverage, it’s important for you to understand:

If you have questions about Medicare and need to talk with somebody:

  • After you get SSDI for two years, Part A and Part B of Original Medicare coverage start automatically.
  • Each year, Medicare has open enrollment from October 15 - December 7. During this time, you can switch between Original Medicare and Medicare Advantage or change which Part D or Medicare Advantage plan you have. If you also get Medical Assistance (MA) benefits, you can change plans at any time.
  • You can have Medicare and other health coverage at the same time and they may work together to pay for your medical expenses.
  • If you have low income and low assets, MA, Medicare Savings Programs (MSPs), and the Low Income Subsidy (LIS) may help you pay for Medicare.
  • If you get SSDI benefits, but they stop because you make too much money at work, Medicare coverage may continue for 93 more months (seven years and nine months) or more.

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