Who Qualifies for Medicare?
- Age 65+: US citizens or permanent residents with 5+ years residency
- Disability: People under 65 who have received Social Security Disability (SSDI) for 24+ months
- ESRD: End-Stage Renal Disease (kidney failure requiring dialysis or transplant)
- ALS: Amyotrophic Lateral Sclerosis (Lou Gehrig's disease) — eligible immediately
The Four Parts of Medicare
| Part | Covers | 2024 Cost |
|---|---|---|
| Part A (Hospital) | Inpatient hospital, skilled nursing facility, hospice, some home health | $0 premium if 40+ work quarters; $278–$505/mo otherwise |
| Part B (Medical) | Doctor visits, outpatient care, preventive services, durable medical equipment | $174.70/month standard premium + $240 annual deductible |
| Part C (Medicare Advantage) | All Part A & B benefits through private insurer; often includes dental, vision, hearing | Varies by plan; often $0 premium plans available |
| Part D (Prescription Drugs) | Prescription medications through private plans | Varies; average ~$55.50/month in 2024 |
Part A: Hospital Coverage Costs
Most people pay $0 for Part A if they (or their spouse) worked and paid Medicare taxes for at least 40 quarters (10 years). Part A covers inpatient hospital stays, but you pay:
- $1,632 deductible per benefit period (2024)
- $0/day for days 1–60
- $408/day for days 61–90
- $816/day for days 91+ (lifetime reserve days)
Part B: Medical Coverage Costs
Part B covers outpatient services. After meeting the $240 annual deductible, Medicare pays 80% and you pay 20% coinsurance with no out-of-pocket maximum (unless you have supplemental coverage).
Enrollment Windows
If you don't sign up for Part B when first eligible, your premium increases 10% for each 12-month period you delay — and this penalty is permanent for as long as you have Medicare. The same applies to Part D drug coverage.
Your Initial Enrollment Period is a 7-month window: 3 months before your 65th birthday month, your birthday month, and 3 months after. Sign up early to avoid delayed coverage.
Part D: Prescription Drug Coverage
Part D has changed significantly in 2024. Key thresholds:
- Deductible phase: Pay up to $545 before coverage kicks in
- Initial coverage: You and your plan share costs until total drug spending reaches $8,000
- Catastrophic coverage: After $8,000, you pay $0 for covered drugs for the rest of the year (new in 2024)