How Do I Qualify for Medicare
and When am I Eligible?
Qualifying for Medicare is a simple procedure. As a federally funded program, Medicare is available as health insurance for all people 65 or older and those with disabilities or permanent kidney failure. Medicare has four Parts – A, B, C and D. Generally, Part A is provided at no cost, while the other benefits are available with premium payments.
If you are over the age of 65 and you or your spouse paid Medicare taxes for at least ten years, then you are eligible to receive Medicare Part A without having to pay a premium. Part A is essentially hospital insurance. Basically, this includes inpatient care in hospitals, skilled nursing facilities, hospice and home health care. You may also receive Part A without paying a premium if you are receiving retirement benefits from Social Security or the Railroad Retirement Board, are eligible to receive benefits but have not filed yet or you or your spouse were employed by a Medicare-covered government employer.
If you are under the age of 65, you may still be able to receive Medicare benefits without having to pay a premium if you have been entitled to get Social Security benefits or Railroad benefits for 2 years, or you are a kidney transplant patient or currently receiving dialysis treatments. In addition, in most cases, if you or your spouse did not pay Medicare taxes while you were employed, you can still purchase benefits. However, the same age restrictions apply and you must be a United States citizen or permanent resident.
When Should I Apply?
Typically, if you are receiving benefits either from Social Security, disability or Railroad, you should receive information in the mail three months prior to turning 65. In fact, enrollment in Medicare Parts A and B is automatic if you live in one of the fifty states or Washington D.C. However, because the premium for Part B is deducted from your Social Security benefits, you have the right to refuse.
If you are currently not receiving benefits either from Social Security, disability or Railroad, keep in mind you are automatically signed up for Part A, but not for Part B. You have a 7-month period – your initial enrollment period – to sign up for Part B, and this period begins three months before the month of your 65th birthday. If you are not receiving benefits currently, it is you responsibility to contact Social Security three months prior to turning 65. Even if you do not plan on retiring at age 65, you can still sign up.
Medicare is available to everyone over the age of 65 and those under 65 with a disability or kidney failure. You will automatically be enrolled in Medicare Part A (hospital insurance) but you must take steps to enroll in Part B (medical insurance) as this is not automatic. In addition, look into Medigap coverage if you are not already enrolled or considering a Medicare Advantage plan.
Contact Healthcare Services of Illinois to answer any questions you may have.