Medicare Eligibility
Medicare is a federal insurance program that was started in the United States back in 1966. It was begun under the Social Security Administration and its currently being administered by the Centers for Medicare and Medicaid. It was started to help seniors who have attained the age of 65 to access healthcare with ease and manage their spending at a relatively low price.
There is also an exception for those people who have a disability even if they have not attained the age of 65. Other exemptions include having end-stage renal disease, and you are undergoing dialysis or awaiting a kidney transplant.
People who suffer from Amyotrophic lateral Sclerosis disease are also eligible to apply at least 24 months before you celebrate the 65th birthday.
It’s also worth noting that there is a difference between Medicare eligibility date and Social Security retirement age, which often brings confusion to many seniors. Medicare eligibility does not have a retirement date. Whether they are working or not, they still qualify for the program. So long as you are 65 and above and you have lived in the United States for five consecutive years, then you are eligible for Medicare.
But Social Security is based on the retirement period, where one is entitled to the retirements benefits at the age of 67.
Eligibility for Medicare Part A
Medicare Part A is a plan that covers inpatient care, including any care that you received while in the hospital, such as the skilled nursing facility.
To become eligible for part A, you or your spouse must have legally worked in the U.S. for at least ten years, and any taxes paid when you were working will be used to pay for part A premiums.
In case you have not worked for ten years, then the other option to be eligible is to buy the plan. You need to contact the Social Security fund to guide you on the amount to pay. The average payment for such enrollment is close to $400 per month, though there are some partial exemptions for people who have worked for over 30 quarters but less than 40.
If you are enrolled for Social Security income benefits, then you get automatically signed up for Medicare Part A and part B.
Eligibility for Medicare Part B
Apart from being 65 years of age, you must also pay for monthly premiums for Part B, which caters for outpatient benefits like the lab tests, surgery fees, doctors’ visits, and many more.
Some are still enrolled by their employer for healthcare coverage of choice. In such a case, you can delay signing up for Medicare part B and enroll later without paying for a penalty, though you need to have a prove that your employer was catering for such benefits. You can enroll then during the special enrollments period, which your insurance agent should advise you on the timings.
Eligibility for Medicare Part C
The other name for Medicare Part C is the Medicare Advantage Plan, which is an alternative plan to Original Medicare, and you can only be able to access it from private insurance companies.
This plan is guided by the network coverage available, which covers fewer networks than Original Medicare, but with additional benefits such as the Medicare Part D drug plan.
To qualify for Part C, you must have an active Medicare Part A and Part B, and they must remain active as long as you wish to retain the plan. Besides paying for the Part C monthly premium, you must also pay for Part B monthly Premiums.
Eligibility for Medicare Part D
Medicare Part D is a drug prescription plan that one qualifies for, so long as you have an active Medicare Part A and part B plan. This is a voluntary plan, but it’s worth considering having it. However, to access this plan, you must live in areas where it is accessible.
Many people argue about its importance, but it’s essential to know that without this plan, you stand to pay high costs on your medications. If you sign up for it, the copays on drugs are very low, and you can count on numerous benefits every year.
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Frequently Asked Questions
Is everyone eligible for Medicare?
Not everyone qualifies for Medicare. You must be a U.S. citizen who has lived in the US for five consecutive years to become eligible for the plan.
When do I qualify for Medicare?
You qualify for Medicare as soon as you turn 65.
Who is eligible for Medicare under age 65?
There are several exemptions to people who are less than 65 years, such as having a disability, having an end-stage –renal and undergoing dialysis, or a person dragonized with Lou Gehrig’s disease.
Although Medicare was initially for only people aged 65 and over, that has changed Lou Gehrig’s
How long do you have to work to be eligible for Medicare?
Eligibility for Medicare is not based on years of work. The only advantage that is there is if you have worked for ten years and have been paying for taxes, then you will be exempted from paying Medicare Part A expenses.
Is it mandatory to sign up for Medicare at age 65?
Enrolling for Medicare at 65 is not compulsory, though if you delay enrolling without a valid reason, you will be subjected to late enrolment penalties; any person who has enrolled in Social security benefits is, however, enrolled for Medicare automatically.
Seniors often get confused when it comes to Medicare eligibility. So many questions come up regarding how to qualify, the requirements, how to collect Medicare, and many more.
If you are not sure about the eligibility, do not worry; our team of experts is on the ground to support you get all the information you require to aid you in decision making.
As you approach 65, don’t struggle alone; we are here to offer the support as you journey through a peaceful healthcare plan of choice.
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