Who is eligible for Medicare?

The correct answer is that individuals aged 65 and older, some younger individuals with disabilities, and those with End-Stage Renal Disease are eligible for Medicare. This eligibility criterion is established by the Centers for Medicare & Medicaid Services (CMS) and is fundamental to understanding how the Medicare program operates.

Medicare is primarily designed to provide health coverage for individuals as they reach retirement age, typically starting at 65. In addition to this age-based eligibility, the program also accommodates younger individuals who have certain disabilities that qualify them for Social Security Disability Insurance (SSDI). These individuals can access Medicare after a waiting period of 24 months from the onset of their disability. Furthermore, individuals suffering from End-Stage Renal Disease (ESRD), which requires regular dialysis or a kidney transplant, are also eligible for Medicare regardless of their age.

This inclusive eligibility framework is crucial because it ensures that a larger segment of the population, particularly those with significant health challenges, can benefit from Medicare’s health services. Understanding these eligibility criteria is vital for anyone involved in advising or assisting clients with Medicare-related questions, as it impacts who can enroll in various Medicare plans, including Medicare Advantage and Medicare Supplement plans.