Eligibility

Medicare Insurance Eligibility

There are certain guidelines you must meet to qualify for Medicare Insurance eligibility. Becoming a Senior citizen can be a happy time, provided you have planned ahead.  Below are the guidelines for qualifying for Medicare and when to enroll.

Medicare Insurance EligibilityMedicare is a health insurance program run by the federal government which helps eligible persons with the costs associated with health care. Medicare consists four parts, Part A, B, C and D, and each part covers a separate area in the Medicare health care system. There are three main requirements you need to meet in order to qualify for Medicare benefits, they include the following:

  1. You must have paid taxes into the Medicare system for at least 10 years (usually automatically deducted from your paycheck)
  2. You must be 65 years or older
  3. You have a disability or permanent kidney failure

Medicare Part A

Medicare Part A covers hospital insurance which aids with the costs associated with inpatient care in a hospital, a skilled nursing facility (following a hospital stay), some home health care and hospice care. Most eligible individuals do not have to pay a premium for Part A due to the following circumstances:

  1. You receive or are eligible to receive Social Security benefits
  2. You receive or are eligible to receive railroad retirement benefits
  3. You contributed Medicare taxes when you were employed in a government job
  4. You are the dependent parent of someone who worked long enough in a government job where Medicare taxes were paid

Medicare Part B

Medicare Part B covers medical insurance which helps pay for doctor visits, outpatient hospital care and other medical services which Part A does not cover. Any individual eligible for Part A can enroll in Part B by paying a monthly premium.

Enrolling in Medicare

When to enroll: If you are applying for social security retirement at 65, you can opt in for medicare at the same time. It is important  to apply for medicare benefits three months before your 65th birthday, even if you are not retiring. You can apply for medicare online or at your local social security office.

Optional Plan: As outlined above the Federal Medicare program provides fr the basics in health care for Seniors. You may have preferences on how you want your health care administered, coverage levels, providers etc. In that case you should investigate the option of choosing a private medicare plan. There are three plan types to choose from.

  • Medicare Advantage Plans – These Medicare Part C plans are usually administered by an HMO or PPO and provide additional benefits, above and beyond what Medicare provides.
  • Supplement Medicare Insurance – Often called Medigap, these plans help to pay some or all of the costs that the Original Medicare program does not.
  • Prescription Drug Plans – These are add on Prescription Medicare Plans for those Seniors without prescription coverage.

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