Signing Up Late: General Enrollment Period
Part A. If you didnt sign up for Medicare Part A when you were first eligible, you can sign up for Part A anytime, without penalty.
When coverage begins. Your Part A coverage will go back to six months before the date you signed up .
Part B, C and D. If you didnt sign up for Medicare Part B when you were first eligible, you can sign up for Part B during a General Enrollment Period, which happens between January 1 through March 31 each year. You will also have from April 1 through June 30 of that year to add a Medicare Advantage plan or Medicare Part D plan.
When coverage begins. When you sign up for Part B, C, or D during a General Enrollment Period, your coverage will start July 1.
Late sign-up penalty. Individuals who did not sign up for Medicare Part B when they turned 65 might face a penalty of higher lifetime premiums when they do sign up. However, most individuals who were covered by a group health plan through an employer are not subject to the penalty. If you didnt sign up for Part B because you had group health benefits through work, you should be able to sign up during your Special Enrollment Period.
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.
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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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 spouses 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 spouses, or divorced spouses 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 Gehrigs 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?
How Do Sources Of Supplemental Coverage And Prescription Drug Coverage Differ For Medicare Beneficiaries Under Age 65 With Disabilities And Older Beneficiaries
Most Medicare beneficiaries, including those under age 65 with disabilities, have public or private supplemental insurance to help cover Medicares cost-sharing requirements.9 A much larger share of beneficiaries under age 65 with disabilities than older beneficiaries rely on Medicaid to supplement Medicare because of their relatively low incomes .10 Medicaid helps with Medicare premiums and cost-sharing requirements, and covers services needed by many people with disabilities that are not covered by Medicare, particularly long-term services and supports.
Figure 3: Supplemental Coverage Among Medicare Beneficiaries Under Age 65 Compared to Those Age 65 or Older in 2012
Just over 1 in 5 beneficiaries under age 65 has no supplemental coverage, compared with 12% of those age 65 or older. Lack of supplemental coverage among Medicare beneficiaries is associated with higher rates of access problems, but rates of access problems are higher among younger beneficiaries with disabilities who lack supplemental coverage than among older beneficiaries, including not seeing a doctor for a health problem when they think they should and having trouble getting needed health care .12 Regardless of whether or not they have supplemental coverage, however, a larger share of younger beneficiaries with disabilities than older beneficiaries experience access and cost-related burdens .
Prescription drug coverage
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Can You Get A Medicare Supplement Plan On Disability
At the present time, there is no federal legislation that guarantees enrollment in Medigap for beneficiaries under age 65. It is left to the states to enact legislation that makes Medigap coverage a guaranteed issue.
Only 11 states require insurers to offer at least one Medigap plan to those under age 65 with an equal number making all plans guaranteed-issue, but under-65 premiums can be much higher. Twelve states make all plans guaranteed-issue and include restrictions on premiums. Also, 12 states and Washington, D.C., have no coverage requirement for insurers. Four states have not even addressed the issue of Medicare for those under 65.
Other Ways To Get Medicare Coverage At Age 65
If you dont qualify for premium-free Medicare Part A coverage, you may be eligible to buy coverage. However, you must still be a U.S. citizen or a permanent resident for at least five years to qualify.
Other Medicare Eligibility Options
- You can pay premiums for Medicare Part A hospital insurance. Premium costs vary based on how long you have worked and paid into Medicare.
- You can pay monthly premiums for Medicare Part B medical services insurance. Youll pay the same premiums as anyone else enrolled in Part B.
- You can pay monthly premiums for Medicare Part D prescription drug coverage. Your premium will be the standard rate and would depend upon the plan you choose.
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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 2023, the Medicare Part A premium can be as high as $499 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.
What Is A Quarter Of Coverage
To calculate a persons eligibility for premium-free Medicare Part A insurance, Medicare counts the number of employment quarters the individual worked.
A quarter of coverage is a 3-month calendar quarter in which a person worked in a job and paid Medicare taxes. Every quarter of coverage earned counts as one credit toward qualifying for free Medicare Part A.
During a quarter of coverage, an employee pays Federal Insurance Contributions Act taxes, which combine withheld taxes for Medicare and Social Security.
On a paycheck, Medicare withholding tax appears as Fed Med/EE. Each year has four quarters. Roughly, 40 quarters equals 10 years of work.
The 40-quarters rule only applies to premium-free Medicare Part A. Other parts of Medicare, including Medicare Part B, involve a monthly premium regardless of how long a person has worked in their lifetime.
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How Old Do You Have To Be To Get Medicare
When you think about Medicare, the first thing that comes to mind is typically retirement. Those who have Medicare are often of an age old enough for retirement. However, this is not always the case. Medicare not only covers those who have retired from the workforce, but also those disabled or who meet other specific criteria.
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So, how old do you have to be to get Medicare?
Below, we review the age for you to get Medicare and how you may qualify for coverage and not even know yet.
Many People Would Switch To Medicare From Other Sources Of Coverage
Lowering the Medicare eligibility age to 60 would make 15.6 million additional people eligible for the program, and CBO estimates that 13.6 million would ultimately enroll. The vast majority of those new Medicare enrollees would come from other sources of insurance, such as Medicaid and employer-sponsored coverage. A relatively small number of new enrollees 900,000 would otherwise have been uninsured, but would become insured by Medicare as a result of this policy change.
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Medicare Part B Premiums And Deductibles
In 2021, the Medicare Part B monthly premium is $148.50 if you earn up to $88,000 as a single income tax filer or $176,000 as a married filer.
The Part B deductible is $203 for 2021. Please note that premiums increase in tiers at higher income levels.
For 2022, the Part B monthly premium is $170.10 if you earn up to $91,000 as a single income tax filer or $182,000 as a married filer. The 2022 deductible is $233 for the year.
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Find Out About Your Medicare Eligibility
Determining your Medicare eligibility is sometimes tricky. We get many questions about how to qualify when to enroll in Medicare, and how to set up Medicare supplement insurance. Though the process may seem overwhelming to you, our experts deal with these processes every day. We can guide you easily through the process.
You are not alone let a Florida Medicare Agency licensed agent to assist you in making this entire process easier.
Get Your Free Copy of the Ultimate Medicare Quick Reference Guide from Florida Medicare Agency!
This guide helps you learn about the different parts of the Medicare program, including Medicare Part A and Part B , Part C and Part D .
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What Are Employment Quarters For Social Security
The Social Security Administration calls employment quarters by several names, such as quarter of coverage and Social Security credits or simply credits.
How credits for Social Security retirement benefits have been calculated has changed over the years. Today, Social Security credits are based on your total income during the year, and the year is divided into four employment quarters.
The dollar amount needed to earn credits may go up slightly each year, according to the Social Security Administration, as average earnings increase. For more information on the current earnings needed to earn Social Security or Medicare work credit, visit the Social Security website.
There are special rules for certain types of jobs, such as domestic work, farm work, and work for a church or similar organization that does not collect Social Security and Medicare taxes. Employment of this sort may count towards your employment quarters for retirement and Medicare benefits, but you should contact the Social Security Administration to confirm. Conversely, some people may not qualify for Social Security retirement credits, such as federal employees hired before 1984, railroad employees with more than 10 years of service, and employees of some state and local governments. Other factors may be used to determine their eligibility for premium-free Medicare Part A.
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What Are The Typical Age Requirements For Medicare Coverage
The typical Medicare age requirement is 65, or younger if you qualify for disability benefits. In addition to meeting the age requirement of 65, you must also be a U.S. citizen or legal permanent resident before you are eligible for Medicare.
Most people who are 65 qualify for premium-free Medicare Part A because they have worked for at least ten years and have paid Medicare taxes. Medicare Part A helps cover hospitalization, skilled nursing facility, home health care, and hospice costs. If you are not eligible for premium-free Part A because you have not worked and paid Medicare taxes, but are a citizen with permanent residency and are 65, you can pay premiums to have Part A coverage. If your spouse has worked long enough to qualify for premium-free Part A, your Part A premiums will be free after your spouse turns 62.
When you meet the requirements for Part A, you also qualify for Medicare Part B which helps cover medical out patient costs such as doctors visits, urgent care, durable medical equipment , some preventive care, and more. If you have Part B, there is a monthly premium you pay, which is $148.50 for 2021, and an annual deductible of $203.
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Can I Get Medicare At Age 55
Like those who retire at 62, those who retire at age 55 are not eligible for Medicare. While you may be eligible for Social Security benefits, this is not the same as Medicare healthcare coverage.
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The only time you qualify for Medicare before age 65 is if you have been diagnosed with specific conditions or have been receiving Social Security disability benefits for 24 months.
What If Im Not Automatically Enrolled At 65
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 .
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