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Medicare Advantage Eligibility in 2021

Let’s start with the basics of Medicare Advantage eligibility requirements.

In order to enroll in Medicare Advantage, you must also be enrolled in Original Medicare (Part A and Part B). Additionally, you must either be a United States citizen or legal resident who has been in the U.S. for at least 5 consecutive years.

Who is eligible for a Medicare Advantage Plan?

Most people qualify for Medicare Advantage when they turn 65 and become eligible for Original Medicare. It is also possible to sign up for Medicare Advantage, also called Part C, if you are under the age of 65 and qualify for Medicare because you receive disability benefits.

Medicare Advantage Eligibility for Those 65 and Older

Once you turn 65 and become eligible for Medicare, you also qualify for a Medicare Advantage plan. However, there are a few caveats.

First off, you must be enrolled in both Medicare Part A and Medicare Part B if you want to enroll in a Medicare Advantage plan.

Another very important consideration when it comes to Medicare Advantage eligibility is where you live. To be eligible for any given plan, you must reside within the plan’s service area. Plus, you must sign up during a Medicare Advantage enrollment period.

Medicare Advantage Eligibility for Those Under 65

The same rules apply for those who are under the age of 65 and qualify for Medicare because of an illness or disability. You must be enrolled in Part A and Part B and reside within a plan’s service area to be able to sign up for a Part C policy. 

There are specialized Medicare Advantage plans called Special Needs Plans (SNPs) that are tailored to people who suffer from chronic diseases and/or disabilities. These plans include the providers and coverage necessary to treat and manage their enrollees’ conditions. 

In the past, beneficiaries who qualified for Medicare because they had permanent kidney failure and suffered from End-Stage Renal Disease (ESRD) weren’t allowed to enroll in Medicare Advantage. But starting in 2021, they have the option to join a Medicare Advantage plan if they would like.

If you are someone who qualifies for Medicare Advantage, reach out to a licensed insurance agent here at Medicare Plans Direct. We can help you understand which plans you are eligible for and work together to find the plan that’s right for you.

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