Medicare Part B Requirements

Medicare is a federal program designed to offer the disabled and elderly citizens of the United States comprehensive, quality health insurance. Medicare includes hospital, medical and drug coverage that is classified in parts. Part B is the medical insurance, which covers doctors' visits and other outpatient services. To access Part B, individuals must meet citizenship and enrollment requirements, as well as other criteria.


To enroll in Part B, the beneficiary must be in an enrollment period. This includes the initial enrollment period if the beneficiary is new to Medicare. It also includes the annual coordinated election period (November 15 to December 31 with coverage effective on January 1) and the open enrollment period (January 1 to March 31 with coverage effective July 1). If a beneficiary is joining Part B after losing qualified employer insurance, then he may qualify for a special enrollment period even if he is not in an enrollment period.


All Medicare enrollees must be United States citizens to join any part of Medicare, including Part B. While there is a work requirement to receive premium-free Part A, there is no work requirement for Part B, since Part B charges all beneficiaries a monthly premium.


For a beneficiary to continue receiving Part B benefits after signing up, he will have to continue to pay the monthly Part B premium. The premium varies depending on income, but the majority of people paid about $96.40 in 2010. Beneficiaries also must pay a deductible and a coinsurance for covered services.

Age Requirement

To qualify for Medicare by age, an individual must be 65 years of age or older. If they are older than 65 and have not signed up for Part B yet, they may have to pay a premium-penalty. If an individual is signed up for Social Security retirement or railroad retirement programs, then he is automatically enrolled into Part B once he reaches 65.

Disability Requirement

Those who are disabled become Medicare-eligible after 24 month on Social Security Disability Insurance or railroad disability. Once they are in the program for at least 24 months, they are automatically enrolled into Part B, effective the 25th month of receiving disability benefits.

Lou Gehrig's Disease Requirements

The exception to the disability rule are those who have been diagnosed with amyotrophic lateral sclerosis (ALS) which is more commonly known as Lou Gehrig's disease. They are immediately qualified once they receive their first check from Social Security Disability and are automatically enrolled into Part B.

End-Stage Renal Disease Requirements

End-stage renal disease patients become Medicare-eligible depending on how their disease is treated. If the beneficiary is treated with dialysis received either on an outpatient or inpatient basis, then the beneficiary is Medicare-eligible after four months of treatment. If the beneficiary opts for a self-dialysis program, then Medicare will begin coverage immediately. If the beneficiary requires a kidney transplant, then he will receive Part B and all other original Medicare benefits as soon as he becomes hospitalized for the transplant.