Not sure if you’re eligible for Medicare health insurance? The Social Security Administration (SSA) enrolls some people automatically. But don’t expect that or wait for your Medicare card to show up. Find out if you’re eligible now so you can enroll at the right time and avoid any Late Enrollment Penalties (LEPs). There’s more than one way to qualify for Medicare, and enrolling in the different parts of Medicare differ as well. Plus, how you qualify may determine how you can receive coverage and what your premiums might be. Who’s eligible for Medicare? The Centers for Medicare & Medicaid Services (CMS) runs the Medicare program, but it doesn’t determine who’s eligible. That job falls on the Social Security Administration (SSA). Newly eligible enrollees apply for benefits through the Social Security Administration. People qualify for Medicare health insurance in one of three ways:
If you already receive Social Security or Railroad Retirement Board (RRB) benefits when you gain eligibility for Medicare health insurance, Uncle Sam may automatically enroll you. Otherwise, you’ll likely use your Initial Enrollment Period (IEP), a seven-month window that begins three months before you become eligible for coverage. Medicare eligibility by age The majority of people first join the ranks of Medicare beneficiaries the month they turn 65. If you qualify for Medicare this way, your Initial Enrollment Period will begin three months before the month you turn 65. Medicare eligibility due to specific illnesses In addition to the above ways to qualify for Medicare health insurance, you may also be eligible if you have one of the following diseases:
Requalifying for Medicare at 65 If you become eligible for Medicare before you turn 65 due to disability or one of the above diagnoses, you’ll requalify again when you reach age 65. When you do, you’ll have another Initial Enrollment Period and all the benefits of a newly eligible Medicare recipient, such as a Medicare Supplement Enrollment Period. Eligibility requirements for Part C, Medigap, and Part D When you qualify for Medicare, you’ll be able to enroll in Medicare Part A and Part B right out of the gate. Combined, Medicare Parts A and B are known as Original Medicare. But there are three other parts of Medicare as well. If you want to enroll in Part C (Medicare Advantage), Part D (prescription drug coverage), or Medicare Supplement (Medigap), you’ll have to meet additional requirements. Qualifying for Medicare Advantage (Part C) Medicare Advantage is an alternative to Original Medicare. Private companies provide Medicare-approved plans that cover everything Original Medicare covers, as well as additional benefits that may include vision, dental, hearing, and prescription drug coverage. To be eligible for Medicare Advantage, you must meet the following requirements:
If you meet these requirements, learn why you might choose Original Medicare or Medicare Advantage. Qualifying for Medicare Supplement Also known as Medigap, Medicare Supplement plans are designed to accompany Original Medicare. They help cover additional Part A and Part B costs, such as deductibles and copayments. To be eligible for a Medicare Supplement plan, you’ll need to meet the following requirements:
Qualifying for Medicare Part D prescription drug coverage Like Medicare Advantage and Medicare Supplement, Part D prescription drug coverage is provided by Medicare-approved private insurance companies. These plans accompany Original Medicare. Generally, you can’t have a standalone Part D plan if you have a Medicare Advantage plan. To qualify for a Part D plan, you must meet the following requirements:
Additional requirements We’ve gone over the ways people become eligible for Medicare, as well as how to qualify for the various parts of Medicare. But you’ll need to meet additional requirements as well, including the following:
Requirements that affect Medicare costsWhile people who meet the previously mentioned requirements qualify for coverage, the Centers for Medicare & Medicaid Services have established other requirements for determining Medicare premiums. Those requirements vary for the different parts of Medicare. Part A Most people qualify for premium-free Part A. To do so, you must earn 40 work credits—one for every quarter you work and pay Medicare taxes, for at least 10 years. Part B Most people qualify for the Medicare Part B standard premium ($135.50 in 20191). They do so because their income is $85,000 ($170,000 for married couples) or less. The higher your income, the higher your Part B premiums, so read about Part B premiums and deductibles to find out what rate you’ll pay. Part D Like Part B, premiums for Medicare Part D depend on income. If you make more than $85,000 ($170,000 for married couples), your Part D premiums will be higher than their advertised price. Medicare Advantage If you choose Medicare Advantage instead of Original Medicare, you’ll pay a separate premium for this plan (although some plans have a $0 premium). In addition to your Medicare Advantage premium, you’ll still need to pay any premiums for Medicare Parts A and B if they apply to your situation. Medicare Supplement Medicare Supplement premiums depend on your age, health, and any preexisting conditions you may have—unless you enroll in a plan immediately after your Medicare Part B coverage begins. During your one-time Medicare Supplement Open Enrollment Period, insurers legally must approve your Medicare Supplement application. They can’t consider any preexisting conditions nor can they make you wait for coverage. If you miss this enrollment period, your Medicare Supplement premiums could increase significantly. Medicare, other insurance, and how we can help. Did you know you can enroll in Medicare even if you have other kinds of insurance such as Medicaid, VA benefits, and employer-sponsored health insurance? That said, some of these types of insurance work better with Medicare than others. In some cases, they may affect your ability to enroll in Medicare. To find out how to choose the right Medicare coverage and understand how it will interact with health insurance you may already have, call the number below. A licensed sales agent can answer your Medicare eligibility questions—and help you enroll. Explore health insurance plans harrisburg and get the best plans for your family, if you want to know more details then please send your queries in the comment section.
2 Comments
26/8/2019 02:29:41 am
A good medicare policy would usually cover expenses made towards doctor consultation fees, costs towards medical tests, ambulance charges, hospitalization costs and even post-hospitalization recovery costs to a certain extent.
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17/9/2019 11:20:05 pm
Informative post!! Thanks for sharing your valuable knowledge with us.
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