1. Age-Based Eligibility
- Must be 65+
- U.S. Citizen or Lawful Permanent Resident continuously for at least 5 years
2. Work History or Spousal Coverage
- At least 10 years (40 credits) of Medicare-covered employment by you or your spouse
3. Early Enrollment Options
- Disability (SSDI) recipients: Medicare begins in month 25 of disability benefits.
- End‑Stage Renal Disease (ESRD): Eligible at diagnosis, regardless of age.
- Amyotrophic Lateral Sclerosis (ALS): Starts immediately upon SSDI eligibility.
4. Medicare Parts & Enrollment Essentials
| Part | Overview | Eligibility / Timing |
|---|---|---|
| Part A | Hospital Insurance | Free with 40 credits; otherwise paid |
| Part B | Medical (Doctors, Outpatient) | Enrollment typically at 65; late penalties if delayed |
| Part C | Medicare Advantage (via private insurers) | Must be enrolled in Part A & B; availability varies locally |
| Part D | Prescription Drug Coverage | Must be enrolled in Part A/B; delay incurs penalty and drug gap risk |
5. Key Enrollment Periods
- Initial Enrollment Window: 3 months before until 3 months after 65th birthday
- General Enrollment: Jan 1 – Mar 31, with Part B effective July
- Special Periods: For people with Work-based or other coverage
6. Important Notes
- Dual-status beneficiaries (e.g., ESRD + age) follow standard enrollment periods
- People with prior Big Group insurance must carefully plan to avoid late enrollment penalties
- Lifetime benefits are lost if penalties apply and maintained consistently upon future enrollment
Visual Design Tips
- Use bold headers, clean bullet points, and color-coded sections
- Incorporate icons:
- 🎂 for age
- 🏥 for coverage types
- ⏰ for enrollment windows
- Maintain an easy-to-read flowchart style, starting with the age box at top and branching to pathways (work history, disability, specific diseases)