Medicare eligibility FAQ

To enroll in Medicare, you must meet certain rules. You may qualify if:
 

• You are age 65 or older
• You have a qualifying disability and have had Social Security Disability Insurance (SSDI) for at least 24 months
• You have end-stage kidney failure and need dialysis or a transplant
• You have ALS (Lou Gehrig's disease)

That depends on when you started getting benefits. Some people get Medicare automatically. Others need to sign up for Medicare.
 

• Did you start getting Social Security or Railroad Retirement benefits at least 4 months before you turned 65? If so, you’ll be enrolled automatically in Medicare.
• Didn’t get those benefits? You’ll need to sign up for Medicare on your own.

Medicare Part C (Medicare Advantage) is also called Medicare Part C. This is a type of plan that builds on the Medicare benefits of Parts A and B. A Medicare Part C plan joins your current benefits and adds new ones.

You can join Medicare Advantage if you:
 

• Have Original Medicare (Medicare Parts A and B)
• Live in the plan’s service area

Do you qualify? If you do, Aetna® or another company can help you with your benefits after you enroll in Medicare.

Learn about the Medicare Advantage Open Enrollment Period

You are eligible for Medicare Part D if you have Medicare Part A or Part B.

You may want to sign up for a Medicare prescription drug plan unless you have other drug coverage. Medicare may add a Part D late enrollment penalty to your monthly Part D premium if:

• You don’t enroll during your Initial Enrollment Period
• Don’t have prescription drug coverage

Do you have limited income and resources? You may qualify for the Extra Help program. If you qualify for Extra Help, you won’t have to pay the late enrollment fee.

Medigap eligibility depends on your age and current plan enrollment.

You may qualify for Medigap if:
 

• You’re 65 or older and have Medicare Part B

You may also qualify for a Medicare Supplement plan if:
 

• You’re under 65 and have a disability

Your first chance to sign up is called Medicare’s Initial Enrollment Period (IEP).

It lasts 7 months. Here’s how it works:
 

• It starts 3 months before the month you turn 65
• It includes the month you turn 65
• It ends 3 months after the month you turn 65

Example:
 

If you turn 65 in July, you can sign up from April through October.

When coverage starts:
 

Did you sign up during the first three months of your Medicare Initial Enrollment Period? Then your Medicare coverage usually starts on the first day of your birthday month. 

Is your birthday on the first? Then your coverage will begin the month before.

Yes, you can enroll in Medicare while still working.

Here’s how it works:
 

• You can keep your job’s health plan after age 65.
• You can sign up for Medicare Part A as soon as you’re eligible. (This helps you avoid paying a monthly premium.)

You should also sign up for Medicare Part B when you turn 65. (This helps you avoid a late fee later on.)

Medicare’s Annual Enrollment Period (AEP) runs from October 15 through December 7 each year. The choices you make during this time usually start January 1.

During AEP, you can:
 

• Switch Medicare plans
• Join a new Medicare plan
• Cancel your Medicare plan

When you are in an enrollment period, you have a few ways to sign up.

You can choose one of these options:
 

• Enroll online
• Use the plan’s paper enrollment form
• Call a licensed Aetna agent at 1-844-514-4096 ${tty} ${hours}

To be eligible to join a Medicare Advantage plan with drug coverage, you must have Medicare Part A and Part B and live in the plan’s service area. You also need to enroll during an enrollment period.

There isn’t one plan that’s best for everyone. A good choice is one that covers your prescriptions, includes your doctors and fits your budget.

Compare Aetna Medicare Advantage plans

If you’re eligible to switch, you can make a change during certain enrollment periods, like the Annual Enrollment Period. When you join a new plan, it will replace your current one. 

Before you switch, check that your prescriptions are covered and that your doctors are in the plan’s network.

If you are an Aetna Medicare member, log in and review your plan details.

If you’re eligible and have ongoing health needs, look for a plan that covers your prescriptions and includes your care team. Some plans offer extra support for certain conditions.

Review Aetna Medicare Chronic Condition Special Needs Plans (C-SNPs)

If you’re newly eligible, you can choose a Medicare Advantage plan that includes prescription drug coverage. Start by checking which plans are available where you live.

A good plan is one that covers your medicines, includes your doctors and keeps your costs manageable.

Compare Aetna Medicare Advantage plans