Medicare Eligibility in New York | Who is Eligible? | Empire Blue Skip To Main Content
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Knowing when you qualify for the different parts of Medicare is important since it lets you know when you can enroll. Let’s start with Original Medicare (Part A and Part B).

Who is Eligible for Original Medicare (Parts A and B)?

Generally, you’re eligible for Original Medicare (Parts A and B) if you’re a U.S. citizen or you’ve been a legal permanent resident for at least 5 continuous years, and one of the following applies to you:

  • You’re 65 or older and eligible for Social Security
  • You’re under 65, permanently disabled and you’re receiving disability benefits from Social Security or the Railroad Retirement Board
  • You have end-stage renal disease (ESRD)
  • You have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s Disease
 

What Do You Need to Know about Medicare Eligibility and Turning 65?

Most people qualify for Original Medicare (Parts A and B) when they turn 65. But the rules about Medicare eligibility and when you can enroll for Parts A and B are quite complex. They’re based on your age, whether you’re retired or still working, and whether or not you’re receiving Social Security benefits. To make it easier for you, you can use our Medicare Eligibility/Enrollment Calculator to find out exactly when you should enroll.

Are you eligible for Medicare benefits if you’re under 65 and receiving Social Security Disability Insurance?

If you’re permanently disabled and you’ve been receiving Social Security Disability Insurance (SSDI) benefits for 2 years, you’re eligible for Medicare and you’ll be automatically enrolled in Medicare Parts A and B.

If you have End-Stage Renal Disease (ESRD), you’ll qualify for Original Medicare (Parts A and B), no matter how old you are. You’ll need to sign up for Medicare when you first become eligible, as enrollment is not automatic. Contact Social Security or visit your local Social Security office for more information on signing up for Medicare if you have ESRD.

If you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, you’ll be automatically enrolled in Medicare Parts A and B the month your disability benefits begin –whatever your age is.

How do you become eligible for Medicare Part C, Part D and Medicare Supplement plans?

You’re eligible for Medicare Advantage (Part C), Prescription Drug (Part D) or Medicare Supplement plans after you’ve signed up for Original Medicare Part A and Part B. Make sure that the plan you wish to sign up for is available in your area.

If you’re ready to start shopping, we can help you find a plan in your area that’s based on doctors you’d like to see and other preferences.

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Y0114_18_37144_U CMS ACCEPTED 09/25/2018
68783MUSENMUB

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Empire HealthChoice HMO, Inc. (Empire) is the legal entity that has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer the HMO plan noted above or herein. Empire is the risk-bearing entity licensed under applicable state law to offer the HMO plan(s) noted. Empire has retained the services of its related companies and the authorized agents/brokers/producers to provide administrative services and/or to make the HMO plan(s) available in this region. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent or insurance company.

Once enrolled into your Medicare Supplement insurance plan, your coverage is guaranteed for the life of the plan with only two exceptions/restrictions: nonpayment of premiums and material misrepresentation.

This policy meets the minimum standards for MEDICARE SUPPLEMENT INSURANCE as defined by the New York State Department of Financial Services. The expected benefit ratio for this policy is 65%. This ratio is the portion of future premiums which the company expects to return as benefits, when averaged over all people with this policy.

Products offered are not connected with or endorsed by any division or agency of the state of New York, the United States government, or the Federal Medicare program. The policy form numbers are: APLANAM(17)-NY BCBS; APLANBM(17)-NY BCBS; APLANFM(17)-NY BCBS; APLANGM(17)-NY BCBS; and APLANNM(17)-NY BCBS.

A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc. licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. All external sites will open in a new browser window. Please view our website Privacy Policy for more information.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Call our Customer Service number, (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a nuestro número de Servicio de Atención al Cliente (TTY: 711). 注意:如果您使用非英語的其他語言,您可以免費獲得語言援助服務。請致電聯絡客戶服務部(聽語障用戶請致電:711)。

AADVWS032M(18)-NY