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Qualifying for Medicare


To qualify for Original Medicare, you need to be a U.S. citizen or resident with one of the following qualifiers:

  • Age 65 or older, or
  • Under age 65 and disabled (permanently disabled for 24 months or more), or
  • Living with end-stage renal disease (ESRD). You can't sign up for a Medicare Advantage plan with ESRD, but if you develop ESRD as a plan member, you can't be disenrolled for that reason.
Enroll in Original Medicare
Medicare can cover a lot of your healthcare expenses in retirement. Part A is free if you or your spouse paid into Social Security for at least 10 years through employment. Everyone shoudl enroll in Part A. You may want to wait to enroll in part B.
How to enroll
If you're already getting Social Security or Railroad Retirement benefits, you'll be automatically enrolled in Medicare Part A. If you're not, you'll need to sign up for Medicare yourself with the Social Security Administration. You can:
 
  • Enroll by phone at 1-800-772-1213 (TTY: 1-800-325-0778), 7 a.m. or 7 p.m., Monday through Friday
  • Enroll online at ssa.gov
  • Visit a Social Security office near you and enroll in person. Call for an appointment and a list of documents you'll need to bring with you

 

 

If you... Then...
Plan to retire at age 65 or are not working, and don't already receive Social Security You can enroll in Medicare benefits.
Already receive Social Security retirement, disability or railroad retirement benefits You'll automatically be enrolled in Medicare Part A.
Are currently covered by an employer-provided group health plan Talk to your human resources department before you enroll in Medicare.
Plan to continue working past age 65 You have the option to delay enrolling in Medicare Part B. Delaying may affect when you can enroll in a Medicare Supplement policy, a Medicare Advantage plan, or a Part D prescription drug plan.

Note: If you’re under 65 and eligible for Medicare due to disability or end stage renal (kidney) disease (ESRD), you’ll automatically get Part A and Part B after you get disability benefits from Social Security for 24 months, or certain disability benefits from the Railroad Retirement Board for 24 months.

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Good to know: Want extra coverage? Keep in mind that you must be enrolled in Medicare Part A and Part B BEFORE you can purchase additional coverage that helps pick up where Original Medicare leaves off. If you’re turning 65, the best time to enroll in Medicare Part A and Part B is during the 3 months before your 65th birthday. This helps to ensure that you can enroll in additional coverage options and that your coverage will start on the first day of the month you turn 65.

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Enrolling in Medicare

 When to enroll

Your initial enrollment period is a 7-month timeframe. It includes:

  • The 3 months before the month you turn 65,
  • Your birth month, and
  • The 3 months after your birth month.

 What you'll need
  • An original or certified copy of your birth certificate,
  • Any W-2 forms you have from the last 2 years, and
  • Your Social Security card or number.

 How to enroll
  • To request an application, visit the Social Security Administration office nearest you or
  • call 1-800-772-1213 weekdays, 7 a.m.-7 p.m.  (TTY: 1-800-325-0778)
  • Once completed, you’ll receive your Medicare card in the mail.

© 2019 Premera Blue Cross is an Independent Licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state, excluding Clark County. Premera Blue Cross is an HMO plan with a Medicare contract. Enrollment in Premera Blue Cross depends on contract renewal. ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 888-850-8526 (TTY: 711), April 1 - September 30, Monday - Friday, 8 a.m. - 8 p.m.; October 1 - March 31, 7 days a week, 8 a.m. to 8 p.m.To join a Premera Blue Cross Medicare Advantage Plan, you must have Medicare Part A and Part B and live in the Premera Blue Cross Medicare Advantage service area (Island, King, Pierce, Lewis, San Juan, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla, and Whatcom counties in Washington). Members must select a Primary Care Provider (PCP) from the Premera Blue Cross Medicare Advantage Plans provider network. For accommodation of persons with special needs at sales meetings, call 888-868-7767 (TTY/TDD: 711), April 1 - September 30, Monday - Friday, 8 a.m. - 8 p.m.; October 1 - March 31, 7 days a week, 8 a.m. to 8 p.m.

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Plan A 021190 (06-2010); 021194 (06-2010); Plan N 021191 (06-2010); 021195 (06-2010); Plan F 021192 (06-2010); 021196 (06-2010); High Deductible Plan F 021193 (06-2010); 021197 (06-2010); Plan G 042193 (01-2018); 042194 (01-2018); High Deductible Plan G 049578 (01-2020); 049579 (01-2020).