A Comprehensive Guide to Medicare Eligibility in Missouri

Medicare is a vital program for millions of Americans, and for Missouri residents, it’s an essential part of their healthcare coverage. If you or someone you know is approaching 65 or has a qualifying disability, it’s important to understand when and how to enroll in Medicare, as well as the eligibility requirements.

Eligibility Requirements for Medicare in Missouri

1. Age 65 and Older:

   • Medicare is available to U.S. citizens or legal residents who have lived in the country for at least five consecutive years. You must be 65 years old to qualify. For those who are already receiving Social Security benefits, enrollment in Medicare is automatic, and you’ll receive your Medicare card in the mail about three months before your 65th birthday.

   • If you aren't receiving Social Security benefits, you’ll need to apply for Medicare through the Social Security Administration (SSA) during your Initial Enrollment Period (IEP), which starts three months before your 65th birthday and ends three months after.

2. Under 65 and Disabled:

   • Individuals who are under 65 but have a qualifying disability can also become eligible for Medicare after receiving Social Security Disability Insurance (SSDI) benefits for 24 months. Upon reaching the 25th month of SSDI benefits, Medicare enrollment will be automatic.

   • If you have End-Stage Renal Disease (ESRD) or Lou Gehrig's disease (ALS), you may qualify for Medicare regardless of age, as long as you meet the necessary requirements.

How to Enroll in Medicare

1. Initial Enrollment Period (IEP):

   • The IEP is the first chance you have to enroll in Medicare. It begins three months before the month you turn 65, includes your birthday month, and ends three months after your 65th birthday. It’s important to enroll during this period to avoid any gaps in coverage or potential late enrollment penalties.

2. General Enrollment Period (GEP):

   • If you miss your IEP, you can enroll during the General Enrollment Period, which runs from January 1 to March 31 every year. However, if you enroll during this time, your coverage won’t begin until July 1, and you may face a penalty.

3. Special Enrollment Period (SEP):

   • If you are still working at age 65 and covered under an employer's health insurance plan, you can delay your Medicare enrollment without facing a penalty. You’ll qualify for a Special Enrollment Period to sign up once you retire or lose your employer health coverage. The SEP lasts for eight months after your employment ends.

4. Medicare Advantage Enrollment Period:

   • If you want to switch from Original Medicare to a Medicare Advantage plan, or vice versa, you can do so during the Annual Enrollment Period (AEP) from October 15 to December 7. During this time, you can also enroll in, switch, or drop Medicare Part D prescription drug coverage.

Contact Us

At Riverside Insurance Professionals, we’re here to guide you through the Medicare process in Missouri. Our licensed agents are ready to answer your questions and help you select the best plan. If you need assistance, feel free to reach out:

• Phone: (573) 535-6044

• Email: Jennifer@riversideinsuranceprofessionals.com

• Office Hours: Monday – Friday, 9:00 AM to 5:00 PM

For additional official Medicare resources, visit the Medicare Eligibility & Enrollment page on Medicare.gov.