Important Things To Know About Social Security Benefits
Now before we dive into how this may impact Medicare decisions, there are three things to keep in mind.
Eligibility For People With Als
People with ALS, or Lou Gehrigs disease, can qualify for Medicare when they are under 65 years of age.
ALS is a progressive, neurodegenerative disorder that disrupts a persons ability to speak, move, eat, and ultimately breathe. The condition has no cure and is eventually fatal.
According to the ALS Association, an estimated 16,000 people in the United States have the disorder. A doctor usually diagnoses ALS between the ages of 4070 years.
Unlike ESRD, those with ALS can receive Medicare Part A benefits in their first month of receiving Social Security or RRB benefits.
The SSA automatically enrolls a person with ALS in a Medicare plan when they start paying Social Security benefits.
According to a 2017 review in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, a persons monthly costs with ALS under Medicare can total $10,398 during the month of their diagnosis.
ALS often progresses rapidly and leads to high healthcare costs. This is why a persons Medicare benefits will usually begin as soon as possible.
Medicare Eligibility At Age 65
- You are at least 65 years old
- You are a U.S. citizen or a legal resident for at least five years
In order to receive premium-free Part A of Medicare, you must meet both of the above requirements and qualify for full Social Security or Railroad Retirement Board benefits, which requires working and paying Social Security taxes for at least 10 full years .
Learn more about Medicare eligibility at and before age 65 by referring to this helpful chart and reading more information below.
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What Is The Texas Health Information Counseling And Advocacy Program
If you are eligible for Medicare, the Texas’ Health Information, Counseling and Advocacy Program can help you enroll, find information and provide counseling about your options. This partnership between the Texas Health and Human Services system, Texas Legal Services Center and the Area Agencies on Aging trains and oversees certified benefits counselors across the state.
You Can Receive Medicare Without Taking Your Social Security Benefits
Medicare and Social Security aid older Americans and their spouses who paid into the programs through FICA taxes during their working years.
Medicare provides both free and cost-effective health insurance coverage for eligible older adults who are 65 years of age or older. Social Security retirement benefits act as a small pension, providing monthly income to those eligible as early as age 62.
Even if you are eligible to start receiving benefits, you do not have to start taking them. In some cases, it may be better to delay or to start taking benefits from one program but not the other.
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Do I Need To Be On Social Security To Get Medicare Coverage
Many seniors sign up for Social Security prior to securing Medicare coverage but doing so is by no means a requirement.
Q: Do I need to be on Social Security to get Medicare coverage?
A: Millions of seniors rely on Medicare for health benefits in retirement, and depend on Social Security as a key income source. But while the two programs are interrelated, participation in one doesnt necessarily hinge on being signed up for the other.
Adding Part B Benefits
When qualifying for benefits at the age of 65, a person will get the benefits of Part A, along with Part B. Part A and Part B combined are known as Original Medicare. Weve covered Part A, now well look at the two areas covered with Part B. Again, these are defined by Medicare.gov.
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventative services: Health care to prevent illness or detect it at an early stage, when treatment is most likely to work best.
Unlike Part A, there is a Part B premium that most people will have to pay. However, the standard premium is minimal, currently $135.50. Those with an income below $85,000 will pay the standard Medicare premiums.
The Proposal For Medicare At 60
Besides a proposal to offer a public health insurance option similar to Medicare, President Biden hopes to lower the Medicare eligibility age to 60. During the presidential race, this was part of his health care platform. Currently, the age at which one becomes Medicare-eligible is 65. Individuals under 65 can obtain Medicare if they collect SSDI for 24 months or are diagnosed with ALS or ESRD.
Lowering the eligibility age five years aims to provide health care to those who retired early, are unemployed, or lack health benefits through their employer. Additionally, qualifying U.S. citizens over 60 would have an extra health care option. As the market is more difficult for older job seekers, the President says its necessary to provide this safety net.
Medicare Other Insurance And How We Can Help
Did you know you can enroll in Medicare even if you have other kinds of insurance such as Medicaid, VA benefits, and employer-sponsored health insurance? That said, some of these types of insurance work better with Medicare than others. In some cases, they may affect your ability to enroll in Medicare.
To find out how to choose the right Medicare coverage and understand how it will interact with health insurance you may already have, call the number below. A licensed Medicare expert can answer your Medicare eligibility questionsand help you enroll.
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What Is The Medicare Eligibility Age
For just about everyone, the Medicare eligibility age is 65. At that point, youll have access to Medicare Part A and are able to purchase Medicare Part B. For some with disabilities or End Stage renal disease, though, eligibility may come at a younger age. Most people are eligible to receive part A without having to pay for it, but there are a few exceptions, which well note in further detail below. For help with healthcare planning and other questions about finances and retirement, consider working with a financial advisor.
Are There Plans To Reduce The Medicare Enrollment Age
Some legislators have proposed measures to lower the Medicare eligibility age. Senator Bernie Sanders wrote a bill that would make all Americans eligible for Medicare in 2019. Representative Pramila Jayapal wrote a similar bill in 2021. Neither bill passed.
When this article was published, no changes had been made to the Medicare eligibility age.
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Benefits Received Before 65
For those who do qualify for benefits before age 65, there are restrictions. People in these categories qualify for free Part A benefits. According to medicare.gov, this is what Part A covers:
- Inpatient care in a hospital
- Skilled nursing facility care
- Inpatient care in a skilled nursing facility
- Hospice care
- Home health care
Most people qualify to not pay a monthly premium for Part A. This is true for those who have worked and paid Medicare taxes for at least ten years.
Alternative Healthcare Options For Children
Most kids wont qualify for Medicare. If a child doesnt qualify, you have some other health insurance options. Some common ones include:
- Parents employer or other private health plans. Kids can stay on their parents health coverage until theyre 26 years old. Kids are eligible to stay even if theyre working, married, and not financially dependent on their parents, but coverage ends on their 26th birthday.
- Health Insurance Marketplace plans. Plans you purchase through the Health Insurance Marketplace or your states Health Insurance Exchange follow the same rules as insurance through your employer or other private groups. Youre able to add kids who are under age 26 to any plan you buy.
- Childrens Health Insurance Program . CHIP is a national program that works with each states Medicaid office to provide health insurance to kids. Generally, CHIP is intended for families with limited incomes who make too much money to qualify for Medicaid but not enough money to afford private insurance. Income eligibility requirements vary by state and are based on the federal poverty level.
- Medicaid. Families with limited incomes can qualify for health insurance through Medicaid. Every member of your household, including children, will be eligible if you qualify for Medicaid. Eligibility for Medicaid is based on your income and varies by state.
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How To Enroll Kids In Medicare
The path to enrolling a child in Medicare depends on the reason theyre eligible. Kids between ages 20 and 22 who are eligible through disability will be automatically enrolled in Medicare after receiving 24 months of SSDI payments. Theyll receive enrollment information and their Medicare card in the mail. At this time, they can also enroll in Medicare Advantage, Medicare Part D, or Medigap.
Children eligible through an ESRD diagnosis will need to enroll through Social Security. You can enroll a child by visiting a local Social Security office or by contacting Social Security online. Medicare coverage for kids with ESRD begins their fourth month of dialysis treatment. Depending on when you apply, coverage might backdate and cover treatments a child has already received.
If I Retire At Age 62 Will I Be Eligible For Medicare At That Time
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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Citizenship And Residency Requirements
In most cases, to be eligible for Medicare, you need to be a U.S. citizen living in the U.S.
You can also qualify for Medicare if you’re a permanent U.S. resident who has been living in the U.S. for five continuous years prior to the month you apply for Medicare.
Even though these two eligibility criteria are specifically for Medicare Part B, they also apply to most other parts of Medicare. That’s because Part B enrollment is required for enrollment in Medicare Part C, Medicare Part D, Medigap and the Medicare Part A paid plans.
However, if you qualify for the free Medicare Part A plan because of your work history, you can be enrolled in Part A plan without being enrolled in Part B.
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
2 months after you sign up
2 or 3 months after you turn 65
3 months after you sign up
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Before You Make Your Decision
There are advantages and disadvantages to taking your benefit before your full retirement age. The advantage is that you collect benefits for a longer period of time. The disadvantage is your benefit will be reduced. Each person’s situation is different. It is important to remember:
- If you delay your benefits until after full retirement age, you will be eligible for delayed retirement credits that would increase your monthly benefit.
- That there are other things to consider when making the decision about when to begin receiving your retirement benefits.
How Old Do You Have To Be To Get Medicare Part C Or Medicare Supplement
To get Medicare Part C or Medicare Supplement plans, you must be enrolled in Original Medicare. This means, you must be at least 65 years old or meet the Medicare criteria for enrolling under age 65. If you do not meet these criteria, you can get Medicare at age 65.
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Medicare Part C and Medicare Supplement plans both act as a supplemental coverage to Original Medicare. However, you cannot have both plans. You are only able to enroll in Medigap OR Part C. If you enroll in Medicare Part C, the plan becomes your primary coverage over Original Medicare. If you enroll in a Medicare Supplement plan, it will pay secondary to Original Medicare. Because they require you to have Original Medicare, you cannot enroll in a plan without Medicare Part A and Part B.
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Is It Mandatory To Sign Up For Medicare After Age 65
No, it isnt mandatory to join Medicare. People can opt to sign up, or not.
If you dont qualify for Social Security retirement benefits yet, you may need to manually enroll in Medicare at your local Social Security office, online or over the phone when you turn 65. You can also apply online for your Medicare coverage at www.medicare.gov.
Enrolling in Medicare as soon as youre eligible ensures you get the subsidized health care you deserve without waiting periods or financial penalties.
If you continue to work for a company employing 20 or more people after you turn 65, you could delay your Medicare enrollment. Your employee group plan provides enough medical coverage while youre working, meaning you may be able to wait to sign up for Medicare once you retire without incurring any late penalties.
How Old Do You Have To Be To Get Medicare Part D
To enroll in Medicare Part D, you must be enrolled in Medicare Part A. Thus, the age requirement for Medicare Part A will inherently become the age requirement for Medicare Part D.
This means, you will need to be at least age 65 or qualify for Medicare Part A based on disability status to enroll in Medicare Part D.
What Services Does The Partnership Provide
- Medicare and Medicaid information and education
- Help with original Medicare eligibility, enrollment, benefits, complaints, rights and appeals
- Explain Medicare Supplemental insurance policy benefits and comparisons
- Explain Medicare Advantage and provide comparisons and help with enrollment and disenrollment
- Explain Medicare Prescription Drug coverage, help compare plans and search for other prescription help
- Information about long-term care insurance
The partnership also helps with the following programs. Benefit Counselors are specially trained to help you understand all the fine print to find and apply to a plan that works for you. They advocate for you with these programs and help you get the services you need.
Cancellation Of Calpers Health Coverage
If your CalPERS Basic health plan coverage is canceled because you did not provide supporting documentation to meet the requirements to continue your CalPERS health coverage after age 65, you can request reinstatement of your health coverage within 90 days of your cancellation. In your request for reinstatement, you must provide supporting documentation from the SSA.
You may also request re-enrollment through an administrative review process after 90 days of the date the coverage is canceled.
Submit your request for reinstatement of health coverage to:
CalPERS Health Account Management DivisionAttention: Medicare AdministrationP.O. Box 942715Sacramento, CA 94229-2715
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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.