Eligibility for Medicare in California


To qualify for Medicare, the federal government assisted health care coverage, you must meet certain specific requirements. Among other things, eligibility for Medicare in California will depend upon your age, state of health and legal residency status in the United States. This page will explain how to qualify for Medicare in California, so you can see if you are eligible and prepare for your Medicare application.

For comprehensive information about enrolling in California Medicare, check out our state guide.

Who is eligible for Medicare Part A in California?

You can qualify for Medicare coverage if you are a citizen of the U.S. or a permanent legal resident who has been living in the U.S. for at least five years. Residents reach Medicare eligibility upon turning 65 years of age, but may be able to enroll in California Medicare before their birthday. Medicare benefits eligibility is not exclusive to senior citizens, though the majority of participants are of retirement age.

California residents younger than 65 years of age qualify for Medicare Part A if they have been eligible for Social Security disability benefits for a minimum period of 24 months. People who suffer from illnesses such as Lou Gehrig’s disease or kidney failure, which requires regular dialysis, can sign up for Medicare insurance coverage. Residents also meet eligibility requirements for Medicare if receiving a disability pension from the Railroad Retirement Board.

Spouses, children and parents of Medicare eligible participants may also qualify for health insurance coverage. Learn what the requirements for family member to be eligible for Medicare as well in our in-depth California guide.

How to Qualify for Medicare Part A Premium-Free in California

There are Medicare qualifications to receive Part A free of charge, which most participants fit. Eligibility for Medicare at no cost applies to petitioners as well as their current or former spouse. If one spouse meets Medicare benefits eligibility for premium-free coverage, the other spouse is also eligible. If applicants have been in employment long enough to qualify for Social Security payments or railroad retirement benefits, they qualify for premium-free coverage. Younger California residents may be eligible for Medicare Part A free of premium cost if they collect certain disability benefits or have a qualifying affliction.

California applicants who do not qualify for Medicare Part A premium-free may still be able to enroll by paying monthly payments. The cost will depend on the amount of work credits the participant has. Once he or she has gained the full amount of work credits, enrollees are no longer required to pay premiums.

Who is eligible for Medicare Part B in California?

The Medicare qualifications for Part B are identical to Part A. However, even residents who qualify for MedicarePart A at no cost will have a monthly premium for Part B. The cost for Medicare benefits eligibility will depend upon income, as those who have higher earnings will pay more.

Who is eligible for Medicare Part C in California?

Participants eligible for Medicare Part A and B can opt for Part C, also known as Medicare Advantage. However, those with premium-free Medicare benefits eligibility may incur monthly fees for enrolling in Part C. Applicants who qualify for Medicare C can enroll during the initial enrollment period or choose to change coverage during annual Medicare enrollment timeframes or when special enrollment periods permit.

Who is eligible for Medicare Part D in California?

Residents who meets the Medicare benefits eligibility requirements for Part A or B, also have access to prescription drug coverage (Part D). Like the financial requirements for Medicare Part B and C, the prescription insurance has monthly premiums for which participants are responsible. A participate who is eligible for Medicare may choose to enroll in Part D solely or as part of any of the aforementioned sections of the Medicare program.

Other Requirements for California Medicare

Upon reaching the Medicare eligibility age, residents of California who currently collect benefits are automatically enrolled in Part A and B. Since Part B requires monthly premiums, a Medicare qualification letter is sent to participants who will then have the option to deny coverage. Residents who are eligible for Medicare Part B and D must enroll in when first entitled or risk paying a late enrollment penalty. However, exceptions to this requirement, such as having health insurance through an employer, will waive penalties.

California participants enrolled in a Medicare plan are not required to apply for health care through Covered California or any other health care plan. Medicare has sufficient coverage to meet the new health care laws of the Affordable Care Act.

Residents who are on a low income and meet certain Medicare qualifications may be eligible for a Medicare Savings Program (MSP). Several available programs can help to pay for Part A and B premiums including Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualified Disabled Working Individual (QDWI) and Qualified Individual (QI), which can help to pay for Part B premiums.

What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.

Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.