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How Previous to Get Medicare
Medicare eligibility age and choices:
- Age 65 or older
- Youthful with incapacity
- Finish-stage renal illness
- Lou Gehrig’s illness
- Particular circumstances
- Half A: free
- Half B: month-to-month premium
- Half D: prescription drug protection
To be taught extra, go to the Medicare web site or name 1-800-MEDICARE.
Age 65 or older
Most individuals turn out to be eligible for Medicare at age 65.
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Computerized enrollment:
In case you are already receiving Social Safety advantages, you can be mechanically enrolled in Medicare Elements A and B. In case you are not receiving Social Safety advantages, you will have to enroll in Medicare throughout the Preliminary Enrollment Interval (IEP). The IEP begins three months earlier than the month you flip 65 and ends three months after the month you flip 65. It’s also possible to enroll throughout the Common Enrollment Interval (GEP), which runs from January 1 to March 31 annually.
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Late enrollment penalty:
If you don’t enroll in Medicare Half B throughout your IEP or GEP, you could have to pay a late enrollment penalty. The penalty is 10% of the Half B premium for every 12-month interval that you simply had been eligible for Half B however didn’t enroll.
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Medicare Benefit:
You possibly can select to obtain your Medicare advantages by a Medicare Benefit plan, also referred to as Half C. Medicare Benefit plans are supplied by personal insurance coverage corporations and will provide extra advantages, resembling prescription drug protection.
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Additional Assist:
When you have restricted earnings and sources, you might be eligible for Additional Assist from Medicare. Additional Assist will help you pay to your Medicare Half D prescription drug protection.
To be taught extra about Medicare eligibility and enrollment, go to the Medicare web site or name 1-800-MEDICARE.
Youthful with incapacity
In case you are beneath age 65 and have a incapacity, you might be eligible for Medicare. To qualify, you should have a incapacity that’s anticipated to final a minimum of 12 months or end in dying. You could additionally meet one of many following standards:
You’re receiving Social Safety incapacity advantages.
You’re receiving Supplemental Safety Earnings (SSI) advantages.
You have got been recognized with end-stage renal illness (ESRD) and are receiving dialysis or a kidney transplant.
You have got Lou Gehrig’s illness (amyotrophic lateral sclerosis, or ALS).
In case you meet one among these standards, you’ll be able to apply for Medicare at any time. You do not need to attend for an Preliminary Enrollment Interval or Common Enrollment Interval.
As soon as you might be authorized for Medicare, you can be mechanically enrolled in Half A and Half B. It’s also possible to select to enroll in a Medicare Benefit plan or a Medicare Half D prescription drug plan.
To be taught extra about Medicare eligibility for folks with disabilities, go to the Medicare web site or name 1-800-MEDICARE.
Finish-stage renal illness
When you have end-stage renal illness (ESRD), you might be eligible for Medicare no matter your age.
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Medicare Half A:
Half A covers hospital care, expert nursing facility care, hospice care, and residential well being care.
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Medicare Half B:
Half B covers medically essential companies, resembling physician visits, outpatient hospital care, and sturdy medical tools.
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Medicare Half D:
Half D covers prescription drug protection.
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Medicare Benefit:
You possibly can select to obtain your Medicare advantages by a Medicare Benefit plan, also referred to as Half C. Medicare Benefit plans are supplied by personal insurance coverage corporations and will provide extra advantages, resembling prescription drug protection.
To be taught extra about Medicare protection for folks with ESRD, go to the Medicare web site or name 1-800-MEDICARE.
Lou Gehrig’s illness
When you have Lou Gehrig’s illness (amyotrophic lateral sclerosis, or ALS), you might be eligible for Medicare no matter your age.
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Medicare Half A:
Half A covers hospital care, expert nursing facility care, hospice care, and residential well being care.
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Medicare Half B:
Half B covers medically essential companies, resembling physician visits, outpatient hospital care, and sturdy medical tools.
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Medicare Half D:
Half D covers prescription drug protection.
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Medicare Benefit:
You possibly can select to obtain your Medicare advantages by a Medicare Benefit plan, also referred to as Half C. Medicare Benefit plans are supplied by personal insurance coverage corporations and will provide extra advantages, resembling prescription drug protection.
To be taught extra about Medicare protection for folks with ALS, go to the Medicare web site or name 1-800-MEDICARE.
Particular circumstances
In some particular circumstances, you might be eligible for Medicare even when you don’t meet the age or incapacity necessities.
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Working previous age 65:
In case you proceed to work previous age 65 and your employer doesn’t provide group medical insurance, you could possibly delay enrollment in Medicare Half B. Nonetheless, you should enroll in Half B inside eight months of shedding your employer-sponsored medical insurance.
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Dwelling overseas:
In case you are a U.S. citizen or everlasting resident dwelling overseas, you might be eligible for Medicare should you meet sure necessities. You could have paid Medicare taxes for a minimum of 10 years and also you have to be enrolled in a Medicare-approved well being plan within the nation the place you reside.
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American Indians and Alaska Natives:
American Indians and Alaska Natives are eligible for Medicare no matter their age or incapacity standing. They will enroll in Medicare at any time.
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Navy service:
In case you are a veteran, you might be eligible for Medicare advantages. It’s possible you’ll be eligible for Medicare Half A should you served within the navy for a minimum of 24 months. It’s possible you’ll be eligible for Medicare Half B if you’re receiving a navy pension or you probably have a service-connected incapacity.
To be taught extra about Medicare eligibility in particular circumstances, go to the Medicare web site or name 1-800-MEDICARE.
Half A: free
Medicare Half A is free for most individuals. You do not need to pay a month-to-month premium for Half A if you’re:
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Age 65 or older and receiving Social Safety advantages:
In case you are age 65 or older and receiving Social Safety advantages, you can be mechanically enrolled in Medicare Half A. You’ll not must pay a month-to-month premium for Half A.
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Age 65 or older and never receiving Social Safety advantages:
In case you are age 65 or older and never receiving Social Safety advantages, you’ll be able to nonetheless enroll in Medicare Half A. Nonetheless, you’ll have to pay a month-to-month premium for Half A. The premium quantity relies in your work historical past.
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Underneath age 65 and receiving incapacity advantages:
In case you are beneath age 65 and receiving Social Safety incapacity advantages, you can be mechanically enrolled in Medicare Half A. You’ll not must pay a month-to-month premium for Half A.
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Underneath age 65 and have end-stage renal illness (ESRD):
In case you are beneath age 65 and have ESRD, you can be mechanically enrolled in Medicare Half A. You’ll not must pay a month-to-month premium for Half A.
To be taught extra about Medicare Half A premiums, go to the Medicare web site or name 1-800-MEDICARE.
Half B: month-to-month premium
Medicare Half B has a month-to-month premium. The usual Half B premium for 2023 is $164.90. Nonetheless, your premium could also be larger you probably have the next earnings.
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Computerized enrollment:
In case you are mechanically enrolled in Medicare Half B, your premium might be deducted out of your Social Safety advantages.
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Voluntary enrollment:
In case you voluntarily enroll in Medicare Half B, you’ll obtain a invoice from Medicare every month. You possibly can pay your premium on-line, by mail, or by cellphone.
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Monetary help:
When you have restricted earnings and sources, you might be eligible for monetary help to assist pay your Medicare Half B premium. You possibly can apply for monetary help by the Social Safety Administration.
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Late enrollment penalty:
If you don’t enroll in Medicare Half B if you find yourself first eligible, you could have to pay a late enrollment penalty. The penalty is 10% of the Half B premium for every 12-month interval that you simply had been eligible for Half B however didn’t enroll.
To be taught extra about Medicare Half B premiums, go to the Medicare web site or name 1-800-MEDICARE.
Half D: prescription drug protection
Medicare Half D is prescription drug protection. It’s obtainable to individuals who have Medicare Half A and/or Half B. You possibly can select to get Half D protection from a stand-alone prescription drug plan (PDP) or a Medicare Benefit plan that features prescription drug protection (MAPD).
There are a lot of totally different PDPs and MAPDs to select from. Every plan has its personal formulary, which is an inventory of the medicine that the plan covers. The premiums, deductibles, and copays for every plan additionally differ. You possibly can examine PDPs and MAPDs on the Medicare web site or by calling 1-800-MEDICARE.
If you don’t enroll in a PDP or MAPD, you’ll have to pay full value to your pharmaceuticals. Nonetheless, you might be eligible for Additional Assist from Medicare, which will help you pay to your prescription drug prices.
To be taught extra about Medicare Half D prescription drug protection, go to the Medicare web site or name 1-800-MEDICARE.
FAQ
Have extra questions on Medicare eligibility and enrollment? Listed here are some often requested questions (FAQs):
Query 1: How do I do know if I am eligible for Medicare?
Reply: You’re eligible for Medicare if you’re:
- Age 65 or older
- Underneath age 65 and have a incapacity
- Underneath age 65 and have end-stage renal illness (ESRD)
- Underneath age 65 and have Lou Gehrig’s illness (ALS)
Query 2: How do I enroll in Medicare?
Reply: You possibly can enroll in Medicare on-line, by cellphone, or by mail. The best option to enroll is on-line on the Medicare web site. It’s also possible to name 1-800-MEDICARE (1-800-633-4227) or go to your native Social Safety workplace.
Query 3: What’s the Medicare Half B premium?
Reply: The usual Half B premium for 2023 is $164.90. Nonetheless, your premium could also be larger you probably have the next earnings.
Query 4: What’s Half D prescription drug protection?
Reply: Medicare Half D is prescription drug protection. It’s obtainable to individuals who have Medicare Half A and/or Half B. You possibly can select to get Half D protection from a stand-alone prescription drug plan (PDP) or a Medicare Benefit plan that features prescription drug protection (MAPD).
Query 5: How do I examine Medicare plans?
Reply: You possibly can examine Medicare plans on the Medicare web site or by calling 1-800-MEDICARE. You possibly can examine plans by premium, deductible, copay, and formulary (checklist of coated medicine).
Query 6: What’s the Medicare Additional Assist program?
Reply: The Medicare Additional Assist program is a federal program that helps folks with restricted earnings and sources pay for his or her Medicare prescription drug prices.
Query 7: How do I apply for the Medicare Additional Assist program?
Reply: You possibly can apply for the Medicare Additional Assist program on-line, by cellphone, or by mail. The best option to apply is on-line on the Social Safety web site.
Closing Paragraph for FAQ: These are just some of essentially the most often requested questions on Medicare eligibility and enrollment. For extra info, go to the Medicare web site or name 1-800-MEDICARE.
Ideas
Listed here are just a few ideas that will help you navigate the Medicare system:
Tip 1: Create a MyMedicare.gov account.
A MyMedicare.gov account is a safe on-line portal that means that you can handle your Medicare advantages and knowledge. You should utilize your MyMedicare.gov account to:
- View your Medicare protection and advantages
- Enroll in a Medicare plan
- Evaluate Medicare plans
- Get assist with Medicare prices
Tip 2: Store round for Medicare plans.
There are a lot of totally different Medicare plans to select from. It is very important store round and examine plans earlier than you enroll. You possibly can examine plans by premium, deductible, copay, and formulary (checklist of coated medicine).
Tip 3: Reap the benefits of Medicare’s free preventive companies.
Medicare covers a variety of preventive companies, resembling mammograms, colonoscopies, and flu pictures. These companies are free to you should you get them from a Medicare-approved supplier.
Tip 4: Ask for assist should you want it.
When you have questions on Medicare or need assistance enrolling in a plan, do not hesitate to ask for assist. You possibly can name 1-800-MEDICARE (1-800-633-4227) or go to your native Social Safety workplace.
Closing Paragraph for Ideas: By following the following tips, you’ll be able to take advantage of your Medicare advantages and get the care you want.
Conclusion
Medicare is a medical insurance program for folks age 65 and older, folks with disabilities, and other people with end-stage renal illness. Medicare is a posh program, however it is very important perceive your eligibility and enrollment choices to be able to get the protection you want.
The details to recollect about Medicare eligibility and enrollment are:
- You’re eligible for Medicare if you’re age 65 or older, have a incapacity, or have end-stage renal illness.
- You possibly can enroll in Medicare on-line, by cellphone, or by mail.
- There are two most important components of Medicare: Half A (hospital insurance coverage) and Half B (medical insurance coverage).
- You possibly can select to get your Medicare advantages by Unique Medicare or a Medicare Benefit plan.
- Medicare Half D is prescription drug protection. You may get Half D protection from a stand-alone prescription drug plan or a Medicare Benefit plan that features prescription drug protection.
Closing Message: When you have questions on Medicare, go to the Medicare web site or name 1-800-MEDICARE. It’s also possible to get assist from a Medicare counselor.
