Older Adults

Medicare for Older Adults and Caregivers

Insurance coverage becomes even more complex as people age.

Medicare age requirements

Medicare is the U.S. government health care program for adults ages 65 and older. It is also available to adults ages 18 to 64 who have certain disabilities.

There are many special circumstances that can affect Medicare enrollment. Regardless of the age when applying, everyone should consult the Medicare guide for beginning coverage.

The two most common times to enroll in Medicare are:

at age 65 (when many people retire). The enrollment period starts three months before the 65thbirthday, and ends three months after that.
after age 65, when employer insurance coverage ends. The current deadline is eight months after coverage ends, so it’s important to apply before that window closes.

Autistic people who did not qualify earlier in life (as well as their caregivers) are eligible for Medicare once they turn 65. Learn how Social Security benefits are linked to Medicare.

What happens when a younger disabled adult becomes eligible for Medicare? See the Insurance Resource Center for Autism and Behavioral Health’s fact sheet (the sheet says Massachusetts, but most of the information applies to people who live outside of Massachusetts).

Important: For caregivers whose autistic adults already have Medicare or Medicaid, any change in insurance must be reported to Medicare as soon as possible — even if it is simply changing from one employer’s insurance to another. Medicare requires current information for all guardians of adults on Medicare or Medicaid.

Find the date you can sign up for Medicare. Learn the basics of Medicare.

What does Medicare pay for?

Medicare covers specific health care expenses. The parts of Medicare include:

Medicare Part A – Everyone who signs up for Medicare receives Part A, which covers hospital care, nursing care, and hospice.

Medicare Part B – Everyone who signs up for Medicare also receives Part B, which covers medical expenses such as seeing a clinician or other health care provider.

Medicare Part C – Additional insurance to cover what Medicare Part A and Medicare Part B do not cover. You can choose a Medicare Advantage plan from a private insurance company. It is still Medicare, but a private insurance company oversees it.

Medicare Part D – Optional insurance to help pay the cost of prescription drugs. Medicare Advantage plans usually include a drug coverage plan.

The Medicare site has a page that explains how it works with private insurance and who pays for what.