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Expand Section When do I qualify for Medicare under 65?

Expand Section What are my Medicare options
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Medicare Supplement:When Medicare standardized Medicare Supplement plans, it was left to the states to determine if that state was going to require the companies offering Medicare Supplement plans (also known as Medigap plans) to offer these plans to people under the age of 65. The Idaho Department of Insurance recently amended its rule regarding Medicare Supplement insurance to include coverage for Medicare-eligible individuals under age 65 with disabilities or end-stage renal disease. Previously these plans were only available to individuals age 65 and older. Eligible individuals can sign up for coverage effective January 1, 2018, including those who previously missed their six-month enrollment window. Companies will be permitted to charge up to 150% of the age 65 premiums. Additional information about this change can be found on the SHIBA FAQ page.

Medicare Advantage: When Congress enacted the Medicare Advantage (MA) plans, they excluded ESRD cases from those who would be covered under the MA plans. There is an exception that if the person was covered for health insurance by a company that offers MA plans until becoming eligible for Medicare, that company must offer the person a MA plan.

People under the age of 65 who are not ESRD patients at the time of coverage cannot be denied a MA plan offered in the county in which they live.

All persons with Medicare, whether Part A, Part B or both are eligible for a prescription drug plan, but can only be enrolled in one drug plan at a time. So if you have drug coverage through a retiree plan or some other option, excluding Veterans benefits, joining a Medicare drug plan may result in your being disenrolled from the other coverage.

See our brochure for more information.



Contact us for answers to your Medicare questions. Call SHIBA: 1-800-247-4422
SHIBA is a program provided by the Idaho Department of Insurance with financial assistance through a grant from the Administration for Community Living (ACL). SHIBA is Idaho’s State Health Insurance Assistance Programs (SHIP), a program that helps states enhance and support a network of local staff and volunteers to assist people with Medicare.
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