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Home > Glossary > beneficiary

beneficiary

What is a beneficiary?

beneficiary infographic

What is a beneficiary?

A beneficiary, in terms of Medicare, simply refers to a person who is enrolled in Medicare Part A and/or Part B.1 The term “Medicare enrollee” means the same thing as Medicare beneficiary.

There is sometimes confusion around the word “entitled” when it comes to Medicare. Specifically, if a person is “entitled to Medicare,” that means they’re both eligible for and enrolled in at least Medicare Part A. If they are eligible but have not enrolled, they are not considered “entitled” to Medicare.2

Medicare Part B is different, as it requires a monthly premium, and people who are eligible for Part B can reject it without having to also reject their Social Security benefits (as would be the case if they rejected Part A). This is why you’ll see references to someone being “entitled to Medicare Part A” but “enrolled in Medicare Part B.”3 But both of those terms describe a person who has Medicare coverage.

So the federal definition of Medicare beneficiary as “an individual who is entitled to benefits under part A… or enrolled under part B…”4 simply means a person who has coverage under Medicare Part A and/or Medicare Part B.

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2026 coverage: Medicare enrollment dates at a glance

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Beyond your initial opportunity to enroll in Medicare plans, the federal government provides other windows for enrollment and plan changes each year.

Medicare eligibility: how and when you qualify

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Eligibility for Medicare coverage depends on factors that include your work history, health status, and residency status. Check your eligibility today.

Footnotes

  1. ”Title 42 § 400.200 General definitions — Beneficiary” Code of Federal Regulations. Accessed June 5, 2025 ⤶
  2. ”When Is a Qualified Beneficiary Considered “Entitled to Medicare” for Purposes of Terminating COBRA Coverage Early?” NueSynergy. Accessed June 5, 2025 ⤶
  3. ”Frequently Asked Questions about Medicare Part A and B “Buy-in”” Centers for Medicare & Medicaid Services. June 2021 ⤶
  4. ”Title 42 Subchapter XVIII—Health Insurance for Aged and Disabled; (5) Definitions, (A) Medicare beneficiary” GovInfo.gov. Accessed June 5, 2025 ⤶