What Are The Requirements To Apply For Medicare

Who Is Eligible To Receive Medicare Benefits

Two groups of people are eligible for Medicare benefits: adults aged 65 and older, and people under age 65 with certain disabilities. The program was created in the 1960s to provide health insurance for senior citizens. Older Americans had trouble finding affordable coverage, which spurred the government to create a program specifically for this portion of the population. Its an entitlement program in that the federal government finances it to some degree, but its also supported and financed directly by the very people who use it. Youre eligible for Medicare because you pay for it, in one way or another.

To receive Medicare benefits, you must first:

• Be a U.S. citizen or legal resident of at least five continuous years, and
• Be entitled to receive Social Security benefits.

That means that every U.S. citizen can enroll in Medicare starting at age 65 . When we say Medicare, were referring to original Medicare. This comprises Parts A and B. Part A covers hospital care while Part B covers medical care. There are four parts to the program Part C is a private portion known as Medicare Advantage, and Part D is drug coverage. Please note that throughout this article, we use Medicare as shorthand to refer to Parts A and B specifically.

To qualify for Medicare based on ESRD, you first need to meet the following qualifications:

When Do I Use My Medicare Cards

Everyone who enrolls in Medicare receives a red, white, and blue Medicare card. This card lists your name and the dates that your Original Medicare hospital insurance and medical insurance began. It will also show your Medicare number, which serves as an identification number in the Medicare system.

If you have Original Medicare, make sure you always bring this card with you when you visit doctors and hospitals so that they can submit bills to Medicare for payment. If you have a supplemental insurance plan, like a Medicare Supplement Plan, retiree, or union plan, make sure to show that plans card to your doctor or hospital, too, so that they can bill the plan for your out-of-pocket costs.

Note: Medicare has finished mailing new Medicare cards to all beneficiaries. You can still use your old card to get your care covered until January 1, 2020. However, if you have not received your new card, you should call 1-800-MEDICARE and speak to a representative.

If you are enrolled in a Part D plan , you will use the Part D plans card at the pharmacy.

Remember: Do not give your Medicare or Social Security numbers or personal data to strangers. Medicare will never ask for this information over the phone. If you believe you have been the target of Medicare marketing or billing fraud, contact your local Senior Medicare Patrol.

Get Started With Medicare

Medicare is health insurance for people 65 or older. Youre first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease , or ALS .

Follow these steps to learn about Medicare, how to sign up, and your coverage options. Learn about it at your own pace.

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Can I Decline Medicare Altogether

Medicare isnt exactly mandatory, but it can be complicated to decline. Late enrollment comes with penalties, and some parts of the program are optional to add, like Medicare parts C and D. Medicare parts A and B are the foundation of Medicare, though, and to decline these comes with consequences.

The Social Security Administration oversees the Medicare program and recommends signing up for Medicare when you are initially eligible, even if you dont plan to retire or use your benefits right away. The exception is when you are still participating in an employer-based health plan, in which case you can sign up for Medicare late, usually without penalty.

While you can decline Medicare altogether, Part A at the very least is premium-free for most people, and wont cost you anything if you elect not to use it. Declining your Medicare Part A and Part B benefits completely is possible, but you are required to withdraw from all of your monthly benefits to do so. This means you can no longer receive Social Security or RRB benefits and must repay anything you have already received when you withdraw from the program.

Should I Sign Up For Medical Insurance

With our online application, you can sign up for Medicare Part A and Part B. Because you must pay a premium for Part B coverage, you can turn it down.

If youre eligible at age 65, your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.

Note: Important Upcoming Change Rules for 2023 and later: If you accept the automatic enrollment in Medicare Part B or if you sign up during the first three months of your IEP, your coverage will start the month youre first eligible. Beginning January 1, 2023, if you sign up during the month you turn 65 or during the last three months of your IEP, your coverage starts the first day of the month after you sign up.

The following chart shows when your Medicare Part B becomes effective in 2022:

The following chart shows when your Medicare Part B becomes effective in 2023:

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What If I Cant Get Copies

You should submit your application even if you dont have copies of some of these documents. Social Security might be able to help you track them down.

In fact, Social Security can often request copies and verification from your states Bureau of Vital Statistics. If not, it can help you get the forms you need in order to get the documents yourself.

The way you enroll in Medicare depends on which parts of Medicare you choose. There are different methods for enrolling in original Medicare as opposed to Medicare Advantage , Medigap, and Part D plans.

Do I Need Other Documents If Im Enrolling In A Specific Part Of Medicare

Youll need to provide the documents listed above when you enroll in Medicare Part A and Medicare Part B . Together, parts A and B are known as original Medicare.

Youll need to enroll in original Medicare before you can enroll in any other Medicare parts. Other parts of Medicare include:

• Medicare Part D, which is prescription drug coverage
• Medicare supplement insurance, also called Medigap

You shouldnt need to submit any additional documentation when you enroll in these other parts.

Youll just be asked to provide your Medicare number and your Medicare Part A start date. You can find your Medicare number and Part A start date on your Medicare card.

You can get new copies of any documents you no longer have. Its a good idea to start gathering documents before you apply for Medicare.

If you need new copies of any documents, you can follow the steps below.

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Medicare Part A Premiums

Most people will pay nothing for Medicare Part A. Your Part A coverage is free as long as youre eligible for Social Security or Railroad Retirement Board benefits.

You can also get premium-free Part A coverage even if youre not ready to receive Social Security retirement benefits yet. So, if youre 65 years old and not ready to retire, you can still take advantage of Medicare coverage.

Part A does have a yearly deductible. In 2023, the deductible is $1,600. Youll need to spend this amount before your Part A coverage takes over.

Is There A Way To Get Medicare Benefits If You Dont Qualify For Free

If you dont have eligibility for premium-free Part A, you can buy Medicare Part A by paying premiums if you are 65 or older and a U.S. citizen/permanent resident.

Youll pay a premium of either $259 or up to $471 each month in 2021 depending on how long you or your spouse worked and paid Medicare taxes. If you or your spouse paid taxes for 30 to 39 quarters, your Part A monthly premium will be $259. If you or your spouse paid taxes for less than 30 quarters, your premium will be $471 per month.

If youre paying premiums for Medicare Part A, and if you continue to work and pay Medicare taxes, those quarters will count toward your total number of quarters worked. Your premiums for Part A will be free once you work 40 total quarters.

In most cases, if you choose to buy Part A coverage, you must also have Medicare Part B and pay monthly premiums for both. If you choose not to buy Part A, you can still buy Part B. Whether you pay Part A premiums or not, and regardless of whether or not you opt for Original Medicare Parts A and B, or a Medicare Advantage or Medigap plan, youll always pay a Part B premium.

You can get help paying for insurance premiums if you qualify for a Medicare Savings Program eligibility is based on if your income and resources are below a certain limit. To find out if youre eligible and your expected premium go to the Medicare eligibility premium calculator tool.

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How To Enroll In Medicare And When You Should Start Your Research Process

Getting older means making more decisions, from planning for your kids futures to mapping out your retirement years. One of the most important decisions that youll make as you prepare to retire or head into your 60s is what to do about health insurance. If youve been working, then you probably have a plan through your employer. Most people do. But once you turn 65, you become eligible for Medicare, a government-backed program designed specifically for seniors. There are also other reasons that you might be eligible for Medicare, which can muddy the waters when youre researching your options for coverage.

Medicare is administered by the Centers for Medicare and Medicaid Services , but technically speaking, youll enroll via Social Security. In this article, well outline eligibility guidelines so that you can sign up with confidence, and as always, if you have any questions about how to sign up, or what plan might be best for your needs, were always available toll free to answer any questions you might have. Well also highlight the importance of enrolling on time to avoid penalties and delays in coverage. Heres what you need to know about eligibility and Medicare.

Ways To Apply For Disability Benefits:

• If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

Once your disability benefits start, well mail you a welcome package with your Medicare card.

Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up for Part B and pay a monthly late enrollment penalty.

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How Do I Enroll In A Prescription Drug Plan

The Medicare Prescription Drug Plans are sold by private insurance companies approved by Medicare. All people new to Medicare have a seven-month window to enroll in a PDP three months before, the month of and three months after their Medicare becomes effective. The month you enroll affects the PDPs effective date. All people with Medicare are eligible to enroll in a PDP however, unless you are new to Medicare or are entitled to a Special Enrollment Period, you must enroll or change plans during the Open Enrollment Period for Medicare Advantage and Medicare Part D, Oct. 15 through Dec. 7. There is a monthly premium for these plans.

For assistance with Part D plan comparisons and enrollments, please call our team of Medicare specialists at 1-855-408-1212 or you may log onto MyMedicare.gov to shop for prescription drug plans available in your area.

If you have limited income and assets/resources, assistance is available to help pay premiums, deductibles and co-payments. You may be entitled to Extra Help through the Social Security Administration. To apply for this benefit contact SHIIP at 1-855-408-1212 or the Social Security Administration at 800-772-1213 or www.socialsecurity.gov.

Applying For Medicare Part A And Part B Online

Applying for Medicare Part A and Part B online is a quick and easy process on the Social Security website, taking approximately ten minutes. After you have applied for Medicare Part A and Part B online, you can check the status of your application and appeal, request a replacement card, and print a benefit verification letter.

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Sign Up: Within 8 Months After You Or Your Spouse Stop Working

• Most people dont have to pay a premium for Part A . So, you may want to sign up for Part A when you turn 65, even if you or your spouse are still working.
• Youll pay a monthly premium for Part B , so you may want to wait to sign up for Part B.

Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?

How Long Does It Take For Your Medicare Application To Be Approved

Your Medicare application can take as little as a few weeks to be approved, and you can check your online account to find out the status of your application. However, the timing of when your coverage begins depends on when you apply. Most people will have their Part A and B coverage start on the first day of the month they turn 65. But if you apply during your birthday month or the three months after, your Medicare Part B benefits could begin one to three months after your application.

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When To Sign Up And Apply For Medicare

Home / FAQs / General Medicare / When to Sign Up and Apply for Medicare

When you are new to Medicare, you probably have questions regarding when and how to apply for Medicare. Understanding when to sign up for Medicare and knowing the right way to enroll in Medicare coverage is important. Below, we tell you how and when to apply for Medicare.

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How Long Does It Take To Apply For Medicare

It only takes 10 to 30 minutes to apply for Medicare through the Social Security Administration, and you’ll only need to enter basic information like your name, address and birth date. Afterward, it can take longer to compare the coverage options in your area and choose the best plan. But again, the actual enrollment in Medicare Advantage, Medicare Supplement and Medicare Part D is very quick.

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Sign Up: Within 8 Months After You Or Your Spouse Stopped Working

Your current coverage might not pay for health services if you dont have both Part A and Part B .

Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?

Medicare Coverage And Eligibility

It is good to know as much as you can about Medicare eligibility, so that you can be prepared when the time comes to enroll. The following criteria are necessary for Medicare eligibility:

• Be age 65 or older and eligible for Social Security: You may be automatically enrolled in Medicare Part A when you reach age 65 and become eligible for Social Security. But, if youâre not receiving retirement benefits from Social Security or the Railroad Retirement Board , you must sign up for Medicare Part B when you meet the age requirement, as your enrollment isnât automatic.
• Be permanently disabled and receive disability benefits for at least two years: You automatically get Part A and Part B after you get disability benefits from Social Security for 24 months or certain disability benefits from the Railroad Retirement Board for 24 months.
• Have end-stage renal disease : You need to sign up for Medicare, as your enrollment isnât automatic.
• Have Lou Gehrigâs disease : You automatically get Part A and Part B the month your disability benefits begin.

Most Medicare members donât have to pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working for at least 10 years . If youâre not eligible for premium-free Part A, you will have to pay a monthly premium of up to $506 in 2023.

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