Who is Eligible for Medicare Health Insurance?


Eligible for Medicare?

To qualify for Medicare, you must be a U.S. citizen or a permanent legal resident for at least 5 years. In addition, you would need to meet any one of the following to be eligible for Medicare:

Be age 65 or older and eligible for Social Security: You may be automatically enrolled into Medicare Part A (hospital insurance) when you turn 65 and become entitled to Social Security; but if you also want Medicare Part B (medical insurance), you have to enroll in it voluntarily. If you are already getting benefits from the Railroad Retirement Board (RRB) or from Social Security, you will automatically receive Part A and Part B starting the first day of the month you turn 65. We created a simple video explaining when Medicare starts for you, if you are not sure.  If you are not receiving Social Security or benefits from the Railroad Retirement board, you will need to enroll in Medicare when you approach age 65 as the enrollment will not be automatic.

Have End Stage Renal Disease (ESRD) (permanent kidney failure that requires kidney transplant or dialysis treatment): You need to sign up for Medicare parts A and B on your own, as the enrollment isn’t automatic.

Have Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis, or ALS): You can automatically get Part A and Part B the month your disability benefits begin.

Most won’t need to pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working for at least 10 years (or 40 quarters). If you don’t qualify for cost-free Part A, you will have to pay a monthly premium of up to $426 per month in 2014. This amount changes from year to year. Either way, you must also pay the Part B premium cost each month. Most people pay the standard premium amount, which is $104.90 in 2014; however, individuals with a higher income may have to pay more.

Be aware that if you don’t sign up for Medicare Part B when you first become eligible, you may have to pay penalty of 10% at the time you do enroll for each 12-month period you could have had it. This penalty amount doesn’t go away in normal circumstances so it is beneficial to sign up when you are first eligible.

Doctor Clipboard Eligible for Medicare Insurance

Medicare Part C Eligibility

Medicare Part C, also called Medicare Advantage is an alternative to Medicare Part A and Part B and is available through private insurers. These types of plans work as a replacement to your Part A and B of Medicare. To be eligible for Medicare Part C, you must already be enrolled in Medicare Part A and Part B, and you must reside within the service area of the Medicare Advantage plan you prefer.

Am I eligible for the Medicare drug benefit (Part D)?

If you are eligible for Medicare coverage, you are also eligible for the Medicare drug benefit (Part D). You must be enrolled in Medicare Part A and/or Part B to enroll in the Medicare drug benefit (Part D).

Medicare drug coverage is only available through private plans such as Blue Cross Blue Shield and others. If you have Medicare Part A and/or Part B but you don’t have other drug coverage (creditable coverage) then you should enroll into a Part D plan. You should enroll into a Part D plan even if you do not currently take any prescription drugs. The reason being that for every month that you were eligible for a Part D Prescription Drug Plan and did not enroll, a penalty percentage is added on. The longer you delay in enrolling past your initial eligibility, the more the plans will cost. Similar to Part B of Medicare, Medicare Part D plans can also cost more if your income is over a certain threshold.

If you want to know more about Medicare eligibility, qualifying for Medicare, Medicare Advantage Plans, or Part D (prescription drug plans) please give us a call at (888) 922-2789 or request your Free Medicare Information Kit by Clicking Here.