0865.010.00 Eligibility Requirements

0865.010.05.10 Part A Eligibility and Enrollment Process

The following paragraphs explain who is eligible to receive Part A Medicare, and how it can be obtained. This information is for the use of the worker only and should not be used to determine eligibility.

  • Medicare Enrollment: Persons may enroll in Medicare when they become 65. Enrollment can occur in the 3 months prior to, the 3 months following, and the month of their 65th birthday. Beginning dates of coverage for this enrollment vary with date of enrollment. If claimants miss this enrollment period, they can enroll during the open enrollment period which is held each year from January 1 through March 31, with coverage beginning July 1 of that year.
  • Part A – Free and automatic coverage: For individuals who are 65 years of age and over and receive a cash benefit (SSA or RR), or persons receiving disability benefits for at least 25 months, Part A Medicare coverage is automatic and free.
  • Part A – Free, application required: Some individuals are eligible to receive free Part A Medicare, but must make an application to enroll. This includes anyone that is 65 and over, and insured but not receiving a benefit (SSA or RR), any insured government workers 65 and over, and SSA eligibles who are still working. Also included are disabled individuals under 65 who are insured government workers or widowed, and individuals of any age with end-stage renal disease, who are insured or receiving benefits (SSA or RR), or who are a dependent of such.
  • Part A – Premium payers: Some individuals age 65 and over, are eligible to receive Part A Medicare by enrolling and paying a premium for the coverage. This category includes individuals who are uninsured and are not receiving benefits (SSA or RR).