Additional Information For Those With End
To get the full benefits available under Medicare to cover certain dialysis and kidney transplant services, youll need both Medicare Part A and Part B. .
Your Medicare coverage will generally end:
- 12 months after the month dialysis treatments stop, or
- 36 months after the month of a kidney transplant.
If your condition deteriorates and you require dialysis or a transplant before one of the above periods end, your Medicare benefits may be reinstated.
Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency . Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.
How Medicare Works If Your Age 62 Spouse Is Still Working And Youre On Medicare
To qualify for Medicare, your spouse must be age 65 or older. If your spouse is age 62 , he or she could only qualify for Medicare by disability.
Heres an example of when a younger spouse whos not yet on Medicare might help you save money.
- Suppose you reach age 65 and qualify for Medicare, but you havent worked long enough to qualify for premium-free Medicare Part A.
- And suppose your younger spouse has worked at least 10 years while paying Medicare taxes. When your spouse turns 62, youll qualify for premium-free Part A. Your spouse wont qualify for Medicare until they turn 65, but their work record will help you save money by getting Part A with no monthly premium.
NEW TO MEDICARE?
Your First Chance To Sign Up
Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.
Avoid the penaltyIf you miss your 7-month Initial Enrollment Period, you may have to wait to sign up and pay a monthly late enrollment penalty for as long as you have Part B coverage. The penalty goes up the longer you wait. You may also have to pay a penalty if you have to pay a Part A premium, also called Premium-Part A.
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Contact Social Security To Sign Up For Medicare
You can either:
Know when to sign up for Part BYou can only sign up for Part B at certain times. If you dont sign up for Part B when you turn 65, you might have to wait to sign up and pay a monthly late enrollment penalty. Find out when you can sign up. How much is the Part B late enrollment penalty?
Things You Should Know
How to find out whether or not you are eligible for Medicare Part A and Part B benefits if you are retired and under age 65 and your spouse or you are disabled
If you or your spouse is disabled and receiving Social Security disability benefits, contact Social Security about Medicare-eligibility. If eligible, contact the GIC at 617.727.2310 to request a Medicare Plan enrollment form.
If you have been a state employee and have never contributed to Social Security
You may still be eligible for Medicare benefits through your spouse. When you turn age 65, visit Social Securitys website or call Social Security to apply to see if you are eligible.
What happens to your spouse’s coverage if you enroll in a GIC Medicare Supplemental Plan
Your spouse will continue to be covered under in a GIC non-Medicare plan if he/she is under age 65 until he or she becomes eligible for Medicare. See the Benefit Decision Guide for under and over age 65 health insurance products. If your spouse is over age 65, he/she must enroll in the same Medicare supplemental plan that you have joined.
What you need to do at age 65 if your spouse or yourself was not eligible for Medicare Part A for free, but now, you and your spouse have subsequently become eligible for Medicare Part A for free
You or your spouse must notify the GIC in writing when you become eligible for Medicare Part A. The GIC will notify you of your coverage options. Failure to do this may result in loss of GIC coverage.
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What Is Extra Help
Extra Help is a Social Security program that provides additional financial assistance for people of limited means who need prescription drug coverage through Medicare.
To qualify for Extra Help, an individual must have less than $14,610 in resources. Married couples who live together must have less than $29,160 in combined resources.
The SSA defines resources to include the following:
- bank accounts
Eligibility For People With Als
People with ALS, or Lou Gehrigs disease, can qualify for Medicare when they are under 65 years of age.
ALS is a progressive, neurodegenerative disorder that disrupts a persons ability to speak, move, eat, and ultimately breathe. The condition has no cure and is eventually fatal.
According to the ALS Association, an estimated 16,000 people in the United States have the disorder. A doctor usually diagnoses ALS between the ages of 4070 years.
Unlike ESRD, those with ALS can receive Medicare Part A benefits in their first month of receiving Social Security or RRB benefits.
The SSA automatically enrolls a person with ALS in a Medicare plan when they start paying Social Security benefits.
According to a 2017 review in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, a persons monthly costs with ALS under Medicare can total $10,398 during the month of their diagnosis.
ALS often progresses rapidly and leads to high healthcare costs. This is why a persons Medicare benefits will usually begin as soon as possible.
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When Do I Have To Sign Up For Medicare
If youre collecting Social Security, youll automatically be enrolled in both Part A and Part B. If youre not receiving Social Security, then youll want to sign up manually during your Initial Enrollment Period.
Three months before your 65th birthday, your Initial Enrollment Period window will start. Your IEP is a once-in-a-lifetime enrollment window that you dont want to miss.
If you do happen to miss it, youll have another opportunity to enroll during another enrollment period. However, you could get a penalty for not signing up when you first become eligible. The only way around the penalty is if you have creditable coverage.
How Do I Get Full Medicare Benefits
If youve worked at least 10 years while paying Medicare taxes, there is no monthly premium for your Medicare Part A benefits. But if you havent worked, or worked less than 10 years, you may qualify for premium-free Part A when your spouse turns 62, if she or he has worked at least 10 years while paying Medicare taxes. However, to be eligible for Medicare, you need to be 65 years old. You also need to be an American citizen or legal permanent resident of at least five continuous years.
So, to summarize with an example:
- Bob is 65 years old. Hes on Medicare, but he pays a monthly premium for his Medicare Part A benefits. He only worked for seven years and no longer works.
- His wife, Mary, has worked for over 30 years.
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What Happens When You Turn 65
When you turn 65, you essentially lose your entitlement to Medicare based on disability and become entitled based on age. In short, you get another chance to enroll, a second Initial Enrollment Period if you will.6
If you decided not to take Part B when you were eligible for disability under 65, when you do turn 65, youll now be automatically enrolled in Part B. Your Medicare card will then be mailed to you about 3 months before your 65th birthday.
You can also decide during this time to enroll in a Medicare Advantage or Part D prescription drug plan. Additionally, once you have Part B, you can enroll in a Medigap plan if you so wish.
Can You Get Private Insurance Instead Of Medicare
If you have Medicare Part A or Part B, insurers generally arent allowed to sell you a traditional individual health insurance plan .
You can purchase individual health insurance if youve never enrolled in Medicare because you think the overall costs are too high. If youre in the unusual situation of paying for Part A premiums, you can also switch to individual health insurance.
If you develop a medical condition before turning 65 that would qualify you for Medicare, such as ESRD, you can decline to purchase Medicare.
If you decide to purchase private insurance once youre eligible for Medicare unless youre continuing the employer-sponsored insurance that qualifies you for a Special Enrollment Period then youll have to pay the costly late enrollment penalty once you do apply.
If youre nearing the age of 65, then its important you start considering your Medicare coverage.
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Documents You Need To Apply For Medicare
To begin the application process, youll need to ensure you have the following documentation to prove identity:
- A copy of your birth certificate
- Your drivers license or state I.D. card
- Proof of U.S. citizenship or proof of legal residency
You may need additional documents as well. Make sure to have on hand:
- Your Social Security card
- W-2 forms if still active in employment
- Military discharge documents if you previously served in the U.S. military before 1968
- Information about current health insurance types and coverage dates
If you are already enrolled in Part A and have chosen to delay enrollment in Part B, you will need to complete additional forms .
What Should You Do Once You Get Medicare
Although you can rely on Original Medicare alone, 86% of Medicare enrollees also have some type of additional coverage.2 It can be from an employer, a privately-purchased plan or from a government-run program like Medicaid. Original Medicare pays for a great deal of healthcare, but still leaves you with potentially costly gaps in healthcare coverage. Supplementary plans can cover these gaps including deductibles and copayments at a fraction of the out-of-pocket rate.
MedicareGuide.coms plan selector is designed to intelligently bring you the best Medicare Supplement plans. These plans, also known as Medigap policies, fill the gaps in coverage that you would otherwise be charged by Original Medicare.
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How To Enroll Early
A person should contact the SSA with any questions about their work history and eligibility for Medicare by visiting the Contact Us section of their site or calling 1-800-772-1213 .
If a person receives benefits from the RRB, they can call 1-877-772-5772 to find out more about qualifying for Medicare.
Medicare Eligibility For People Under 62
There are a few exceptions for Medicare age limits that can allow people younger than 65 and under age 62 to enroll in Medicare.
- If you have ALS , you are immediately eligible for Medicare regardless of your age as soon as your Social Security or Railroad Retirement Board disability benefits begin.
- You may also qualify for Medicare if you have kidney failure that requires dialysis or a kidney transplant, which is known as end-stage renal disease .
- You may also qualify for Medicare at age 62 or any age before 65 if you receive disability benefits from either Social Security or the Railroad Retirement Board for at least 24 months.
If you qualify for Medicare under the age of 65 because of a disability, you might also qualify for a Medicare Advantage Special Needs Plan.
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Q: What Should You Do To Prepare For Medicare At Age 64
A: If you take Social Security at age 65, you automatically get put into Medicare. Unfortunately the retirement age is now 66 and if you wait until then to take Social Security, youll likely need to prepare for Medicare at age 64 on your own, and a lot of people dont realize that.
You enroll in Medicare through the Social Security Office. You can either enroll online, on the Social Security website it takes about 10 minutes or you can go to a Social Security office. They recommend calling first to make an appointment, so you wont be waiting there all day. Or, you can enroll over the phone, by calling Social Security. You usually wait on hold for a while, but its another option.
Corinne Lofchie, LICSW, is an Elder Care Advisor at Somerville-Cambridge Elder Services
You can start the process three months before your 65th birthday. That way, your coverage will start the month that you turn 65. Lets say your birthday is January 15. If you enroll in the three-month period before January, your Medicare coverage will begin on January 1. After your birthday month, you have 3 more months to enroll. If you wait, say until January, your coverage will begin on February 1. It always starts the next month, unless you enroll before your birthday month.
Getting Medicare Under The Age Of 65
Many people think of Medicare as a government health-care program for Americans and legal permanent residents who are at least 65 years old. But some people qualify for Medicare before age 65.
Here are the most common ways you may be eligible for Medicare if youre under age 65:
- You receive disability benefits from the Social Security Administration or from the Railroad Retirement Board . Youre automatically enrolled in Original Medicare, Part A and Part B, after 24 continuous months of receiving disability benefits.
- You have Lou Gehrigs disease . Youre automatically enrolled in Medicare the same month that your disability benefits start.
- You have end-stage renal disease . In this case, you may qualify for Medicare, but youre not automatically enrolled. To enroll, contact Social Security .
If you have questions about your eligibility for Medicare if youre under 65, or to enroll, you can contact Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. Representatives are available Monday through Friday, from 7AM to 7PM. Or, you can contact Medicare, or a licensed insurance agent at eHealth .
New To Medicare?
Becoming eligible for Medicare can be daunting. But dont worry, were here to help you understand Medicare in 15 minutes or less.
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Getting Medicare Enrollment Assistance
If you have questions about or need help with Medicare eligibility or enrollment due to disability, you will want to talk with Social Security office. You can also go to your local State Health Insurance Assistance Program office for Medicare counseling.
If you get approved for disability benefits but arent yet eligible for Medicare yet , you can reach out your local state human services agency to see if Medicaid may be an option for you.11
If Your Income Has Gone Down
If your income has gone down due to any of the following situations, and the change makes a difference in the income level we consider, contact us to explain that you have new information and may need a new decision about your income-related monthly adjustment amount:
- You married, divorced, or became widowed.
- You or your spouse stopped working or reduced your work hours.
- You or your spouse lost income-producing property because of a disaster or other event beyond your control.
- You or your spouse experienced a scheduled cessation, termination, or reorganization of an employers pension plan.
- You or your spouse received a settlement from an employer or former employer because of the employers closure, bankruptcy, or reorganization.
If any of the above applies to you, we need to see documentation verifying the event and the reduction in your income. The documentation you provide should relate to the event and may include a death certificate, a letter from your employer about your retirement, or something similar. If you filed a federal income tax return for the year in question, you need to show us your signed copy of the return. Use Form Medicare Income-Related Monthly Adjustment Amount Life-Changing Event to report a major life-changing event. If your income has gone down, you may also use Form SSA-44 to request a reduction in your income-related monthly adjustment amount.
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Reaching Age 62 Can Affect Your Spouse’s Medicare Premiums
Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.
When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they havent yet qualified based on their own work history.
- For example, Gerald is 65 years old, but he doesnt qualify for premium-free Part A because he did not work the minimum number of years required for eligibility. He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.
- Lets say Geralds wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.
In the above example, Jessica has not become eligible for Medicare by turning 62. Her husband Gerald, however, is now eligible to receive his Medicare Part A benefits without paying a monthly premium any longer.
