Medicare Part B Requirements

The requirements for enrolling in Medicare Part B:

  • Be a legal U.S. citizen or a legal permanent resident.
  • Be 65 years old or older.
  • Does not require work credits to enroll.
  • Permanently disabled people can enroll before the age of 65.
  • Have End Stage Renal Disease or ALS may get Part B before the age of 65.

Part B is a Premium Based Program

Part B is a premium-based program that requires participants to pay a monthly premium. For high wage earners, monthly premium amounts increase on a sliding scale according to the wages earned and reported on the tax return two years prior to turning 65.

As a premium-based program both Part D and Part B are available to non-citizens that can prove that they have been legally admitted to the country and have resided within the United States legally for at least five years. If a person meets both of these conditions and is 65 years or older they are allowed to purchase Part B. Part B is basic medical insurance but it does not cover hospital costs covered by Part A. Part A can not be purchased or given to a non-citizen in the same ways as Part B and Part D.

Part B Requirements for Disabled Individuals

Most permanently disabled individuals can receive Medicare Part B after receiving disability benefits for 24 months. Individuals who have ALS or End Stage Renal Disease also can qualify for Part B, Medical Coverage. In "compassionate" cases such as these the 24-month waiting period is usually waived.

Part B Requirements, Not Paying the Late Enrollment Penalty

People who opt out of Part B when they are 65 may be required to pay a Late Enrollment Penalty when they finally do enroll in Part B. This penalty is 10% a year. The penalty is then added onto the monthly premium for the duration of the plan. Certain special circumstances will allow you to delay Part B enrollment without incurring a penalty. Some of the most common special circumstances include:

  • Still employed and receiving creditable coverage through employment under a group health plan.
  • Have not enrolled due to the presence of creditable coverage from another source.
  • Did not enroll because of bad information received from a Medicare employee (documented).
  • Active Duty Military.

Auntie Lou says, "Special Enrollment is a judgment call so keep all documentation related to your interactions with Medicare. You want them to judge in your favor!"