Tuesday, September 20, 2022

When Do People Become Eligible For Medicare

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How Do You Receive Your Medicare Benefits When You Meet Medicare Eligibility Requirements For People Younger Than Age 65

Do I Need Medicare If I’m On My Spouse’s Employer Health Plan?
  • If you receive Social Security benefits for 24 months, usually you will automatically be enrolled in Medicare Part A and Part B at the beginning of the 25th month.
  • If you have Lou Gehrigs disease, usually you will automatically be enrolled in Medicare Part A and Part B as soon as you receive the first month of Social Security disability benefits.
  • If you have ESRD, you might be eligible for Medicare but you must apply for Medicare benefits by visiting your local Social Security office or contacting Social Security from 7AM 7PM Monday Friday, all U.S. time zones. Medicare coverage usually starts on the first day of the fourth month of your dialysis treatments.

Are you unsure whether you meet Medicare eligibility requirements? Contact me. I will be happy to help you.

  • You can use the links below to reach me or have me send you customized information through an email.

If you wish to learn more about some of the Medicare plans where you live, use the Compare Plans button on this page.

New To Medicare?

Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.

When Can I Start Receiving Medicare Part A Benefits

You can start receiving Medicare Part A benefits with no premium once you are 65 or older if you or your spouse worked and paid Medicare taxes for a certain period of time. You can know you are eligible for premium-free Medicare A if one of the following applies to you:

  • You currently receive or are eligible for Social Security.
  • You currently receive or are eligible for Railroad Retirement Board benefits.
  • You or your spouse served in a Medicare-covered government job.

If you received Social Security or RRB benefits at least four months prior to turning 65, you will receive Medicare Part A automatically. If not, you need to file an application with the Social Security Administration.

Who Would Be Eligible For Medicare At 60

When someone with U.S. citizenship of at least five years reaches age 65, they become eligible for Medicare. Currently, it seems as though the age would be lowered to 60 without any additional requirements.

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Therefore, millions more Americans could obtain Medicare coverage. Additionally, it is unclear if the penalties people must pay for delaying enrollment would become effective when they turn 60 rather than 65.

Now, those who lack creditable coverage and do not enroll when they age in at 65 pay late penalties through increased premiums. With this potential change, the penalties may start at 60 or remain for those who wait until after 65 to enroll.

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Am I Eligible For Medicare

To receive Medicare, you must be eligible for Social Security benefits.

Part A Eligibility

Most people age 65 or older are eligible for Medicare Part A based on their own employment, or their spouse’s employment. Most people have enough Social Security credits to get Part A for free. Others must purchase it.

You are eligible for Medicare Part A if you meet one of the following criteria:

  • You are eligible for Social Security or Railroad Retirement benefits, even if you do not receive those benefits.
  • You are entitled to Social Security benefits based on a spouse’s, or divorced spouse’s work record, and that spouse is at least 62 years old.
  • You have worked long enough in a federal, state, or local government job to be eligible for Medicare.

If you are under 65, you are eligible for Medicare Part A if you meet one of the following criteria:

  • You have received Social Security disability benefits for 24 months.
  • You have received Social Security benefits as a disabled widow, divorced disabled widow, or a disabled child for 24 months.
  • You have worked long enough in a federal, state, or local government job and meet the requirements of the Social Security disability program.
  • You have permanent kidney failure that requires maintenance dialysis or a kidney transplant.
  • You are diagnosed with ALS or Lou Gehrig’s disease.

Part B Eligibility

If you are eligible for Part A, you can enroll in Medicare Part B which has a monthly premium.

Will I Need To Prove My Age?

Automatic Enrollment

If I Retire At Age 62 Will I Be Eligible For Medicare At That Time

How to Apply for Medicare 2020

Medicare is federal health insurance for people 65 or older, some younger people with disabilities, and people with end-stage kidney disease. Most commonly, you are eligible for Medicare when you turn 65, but there are other health insurance options if you are younger and do not have coverage through you or your spouses employer.

What you should know
1. The typical age requirement for Medicare is 65, unless you qualify because you have a disability. 2. If you retire before 65, you may be eligible for Social Security benefits starting at age 62, but you are not eligible for Medicare.
3. You have options for health insurance if you are too young for Medicare. You may obtain it through your employer, or you can purchase from private-sector insurance companies through the health insurance exchange. You may be eligible for Medicaid, which is based on income. 4. If you retire before you are 65, you may be eligible for employer-provided group health insurance under the Consolidated Omnibus Budget Reconciliation Act .

Medicare was established in 1965 in order to provide health coverage for seniors who would otherwise not be covered by employer-sponsored health insurance plans. If you retire at the age of 62, you may be eligible for retirement benefits through social security, but early retirement will not make you eligible for Medicare.

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Medicare Eligibility Age Chart

Most older adults are familiar with Medicare and its eligibility age of 65. You can qualify for Medicare Part A and Medicare Part B by:

  • Being age 65 or older
  • Living with a qualifying disability
  • Living with certain health conditions, like end-stage renal disease or amyotrophic lateral sclerosis

Individuals under 65 and already receiving Social Security or Railroad Retirement Board benefits for 24 months are eligible for Medicare. Still, most beneficiaries enroll at 65 when they become eligible 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:

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When Can I Enroll In Medicare Part D

To be eligible for Medicare Part D prescription drug coverage, you must have either Medicare Part A or Part B, or both. You can sign up for Medicare Part D at the same time that you enroll in Medicare Part A and B.

As mentioned above, most people who select Medicare Advantage must receive their Part D prescription benefits as part of that same Medicare Advantage plan . Medicare Savings Account plans do not include Part D coverage, nor do some Private Fee-for-Service Medicare plans. If you have an MSA or a PFFS and it doesnt have Part D coverage included, youre allowed to purchase a stand-alone Part D plan to supplement it.

As with Part B, you are still eligible for Part D prescription drug coverage if you dont enroll when youre first eligible, but you may pay higher premiums if you enroll later on, unless you had during the time that you delayed enrollment in Part D.

Important Things To Know About Social Security Benefits

Do I Get Medicare When My Spouse Retires?

Now before we dive into how this may impact Medicare decisions, there are three things to keep in mind.

  • You can start collecting benefits as early as age 62, but if you do, you will lose 6.67% of your full benefit amount for up to 3 years and then 5% per year thereafter.
  • You can delay collecting benefits after your full retirement age and actually raise your benefits by 8% each year up until age 70, at which point the incentive stops.
  • Whatever amount you start receiving is locked in for life.
  • Recommended Reading: What Does Aarp Medicare Supplement Cost

    Medicare Eligibility At Age 65

    Nearly all seniors in the U.S. will become eligible for Medicare at age 65.

    Additional rules can affect how much you pay and how you get your coverage. But at age 65, you’ll usually be eligible to start receiving health insurance benefits through the Medicare program.

    Most people will need to apply for Medicare through the Social Security Administration. But if you’ve been getting Social Security benefits for at least four months before you turn 65, you’ll automatically be enrolled in Medicare Parts A and B.

    When qualifying for Medicare by age, timing is important.

    Whether or not you want to start receiving Medicare benefits right away, it’s important to take action on Medicare when you turn 65 to avoid any late enrollment penalties.

    The Medicare initial enrollment period is the seven months around your 65th birthday. It starts three months before your 65th birthday, includes your birthday month and ends three months after your birthday month.

    Medicare Eligibility Calculator

    Your initial enrollment period based on your age is

    Note that your enrollment period may differ if you currently have a disability or have certain medical conditions.

    How Much Does Medicare Cost

    Original Medicare

    Original Medicare is divided into Part A and Part B .

    • Part A helps pay for inpatient hospital care, some skilled nursing care, home health care and hospice care.
    • Part B helps pay for doctor services, outpatient hospital care, durable medical equipment, home health care not covered by Part A, and other services. Medicare was never intended to pay 100% of medical bills. Its purpose is to help pay a portion of medical expenses. Medicare beneficiaries also pay a portion of their medical expenses, which includes deductibles, copayments, and services not covered by Medicare. The amounts of deductibles and copayments change at the beginning of each year.

    Part A – Monthly Premium

    If you are eligible, Part A is free because you or your spouse paid Medicare taxes while you were working. You earn Social Security “credits” as you work and pay taxes. For each year that you work, you earn 4 credits.

    $471 $499

    You are 65 or older, and you receive or are eligible to receive full benefits fr om Social Security or the Railroad Retirement Board

    You are under 65, and you have received Social Security disability benefits for 24 months You are under 65, and you have received Railroad Retirement disability benefits and you meet Social Security disability requirements You or your spouse had Medicare-covered government employment You are under 65 and have End-Stage Renal Disease

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    What If You Still Work

    You can work and receive Medicare disability benefits for a transition period under Social Security’s work incentives and Ticket to Work programs.

    There are three timeframes to understand. The first, the trial work period, is a nine-month period during which you can test your ability to work and still receive full benefits. The nine months don’t have to be consecutive. The trial period continues until you have worked for nine months within a 60-month period.

    Once those nine months are used up, you move into the next time framethe extended period of eligibility. For the next 36 months, you can still receive benefits in any month you aren’t earning “substantial gainful activity.”

    Finally, you can still receive free Medicare Part A benefits and pay the premium for Part B for at least 93 months after the nine-month trial periodif you still qualify as disabled. If you want to continue receiving Part B benefits, you have to request them in writing.

    If you’re disabled, you may incur extra expenses that those without disabilities do not. Expenses such as paid transportation to work, mental health counseling, prescription drugs, and other qualified expenses might be deducted from your monthly income before the determination of benefits, which mayallow you to earn more and still qualify for benefits.

    What If Im Not Automatically Enrolled At 65

    Medicare Information

    If your Medicare enrollment at 65 is not automatic, but you want to enroll, here are some more magic numbers.

    3 and 7.

    To start taking advantage of Medicare at 65, you need to sign up during the three months before the birthday month you turn 65. Those are the first three months of your seven-month Initial Enrollment Period.

    Unless your birthday is on the first day of the month, your Initial Enrollment Period includes the three full months before turning 65, the month you turn 65, and the three months after you turn 65. If you were born on the first day of the month, IEP is the four months before your birth month, along with your birthday month and the two months after.

    If you sign up during one of the months before your 65th birthday, your coverage will begin on the first day of the month you turn 65 .

    Are you eligible for cost-saving Medicare subsidies?

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    What Can I Do Next

    Generally, youre first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65.

    Because the company has less than 20 employees, your job-based coverage might not pay for health services if you dont have both Part A and Part B.

    How Do I Get Full Medicare Benefits

    Youâre entitled to full Medicare Part A and Part B benefits as soon as youâre eligible for Medicare. Part A and Part B make up Original Medicare.

    So how do you sign up for Medicare? In many cases, youâre automatically enrolled in Medicare Part A and Part B, as described above.

    What happens when youâre eligible for Medicare and youâre not yet receiving Social Security benefits? In that case, youâll need to sign up for Medicare yourself â it generally wonât happen automatically. You can typically apply for Medicare through the Social Security Administration . If you worked for a railroad, you can sign up through the Railroad Retirement Board .

    If youâre interested in benefits beyond Original Medicare coverage, you might want to check out:

    • Medicare Advantage . Medicare Advantage gives you another way to get your Medicare Part A and Part B coverage, but plans often include extra benefits, like prescription drug coverage.
    • Medicare Supplement insurance. This is available from private insurance companies. It works alongside your Medicare Part A and Part B coverage.
    • Stand-alone Medicare Part D prescription drug plans. These plans may help cover your prescription drugs.

    You can learn more about your Medicare coverage choices by entering your zip code on this page, or by calling eHealth to speak to a licensed insurance agent.

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    When Your Coverage Starts

    The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month.

    If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

    Part B : Coverage starts based on the month you sign up:

    If you sign up:

    1 month after you turn 65

    In 2022: 2 months after you sign up

    Starting January 1, 2023: the next month

    2 or 3 months after you turn 65

    In 2022: 3 months after you sign up

    Starting January 1, 2023: the next month

    Heres A Chart On How Medicare Enrollment Works Under Different Scenarios

    Who Is Eligible for Medicare?
    If you Then you And coverage will start
    Dont have a disability and wont be receiving Social Security or Railroad Retirement Board benefits for at least four months before you turn 65 Must sign up for Medicare benefits during your 7-month IEP On the first day of your birthday month as long as you enroll before your birthday month otherwise, you may face a delay of up to three months
    Will be receiving retirement benefits from Social Security or the Railroad Retirement Board at least four months before you turn 65 Will be enrolled automatically into Parts A and B The first day of your birthday month
    Are under 65 with a disability Will be enrolled automatically into Parts A and B On the 25th month that you receive Social Security disability benefits
    Have ALS Will be enrolled automatically into Parts A and B The same month that you start receiving disability benefits
    Have end-stage renal disease Must sign up for Medicare benefits once you meet the qualifications for this condition On the first day of the fourth month of dialysis treatments but situations can vary, so if you have ESRD, check with Social Security

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