Heres A Chart On How Medicare Enrollment Works Under Different Scenarios
|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|
Retirees And Those Still Working
If you paid into a retirement system that didnt withhold Social Security or Medicare premiums, youre probably still eligible for Medicareeither through your retirement system or through your spouse. To receive full Medicare coverage at 65, you must have earned enough credits to be eligible for Social Security.
Each $1,470 you earn annually equals one credit, but you can only earn a maximum of four credits each year. You will receive Social Security benefits at retirement if you have earned 40 credits10 years of work if you earned at least $5,880 in each of those years. If you continue to work beyond age 65, things get a bit more complicated. You will have to file for Medicare, but you may be able to keep your companys health insurance policy as your primary insurer. Or, your company-sponsored insurance plan might force you to make Medicare primary, or other conditions may apply to you.
Theres a lot to consider that makes it prudent to talk to a person knowledgeable in Medicare about your specific choices. This could be your Human Resources department or a Medicare representative.
If you continue to work beyond 65, theres a lot to consider that makes it prudent to talk to a Medicare expert about your choices.
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.
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.
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The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with TZ Insurance Solutions LLC, TruBridge, Inc. and/or a third-party partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier. TZ Insurance Solutions LLC, TruBridge, Inc., and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.
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Turning 65 What You Need To Know About Signing Up For Medicare
The first of the 78 million baby boomers turned 65 on January 1, 2011, and some 10,000 boomers a day will reportedly reach that milestone between now and 2030. If you are about to turn 65, then it is time to think about Medicare. You become eligible for Medicare at age 65, and delaying your enrollment can result in penalties, so it is important to act right away.
There are a number of different options to consider when signing up for Medicare. Medicare consists of four major programs: Part A covers hospital stays, Part B covers physician fees, Part C permits Medicare beneficiaries to receive their medical care from among a number of delivery options, and Part D covers prescription medications. In addition, Medigap policies offer additional coverage to individuals enrolled in Parts A and B.
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Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don’t need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65. If you do not receive Social Security benefits, then you will need to sign up for Medicare by calling the Social Security Administration at 800-772-1213 or online at . It is best to do it as early as possible so your coverage begins as soon as you turn 65.
Have You Or Your Spouse Worked For At Least 10 Years At Jobs Where You Paid Medicare Taxes
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.
Avoid the penalty If you dont sign up when youre first eligible, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
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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.
Medicare Before The Medicare Eligibility Age
There are also ways an individual under the age of 65 can be eligible for Medicare. For one, you may qualify if you have been eligible for Social Security benefits for at least 24 months. If you have a Railroad Retirement board disability pension you can also qualify. Or, if you have end-stage renal disease or Lou Gehrigs disease, you may qualify for Medicare benefits below the eligibility age.
You can also still get full Medicare benefits even if you dont qualify based on your work record or your spouses. However, you still must be at least 65 and a U.S. citizen or a legal resident of the U.S. for at least five years. To qualify, you must pay premiums for hospital insurance and pay the same monthly premiums that other enrollees pay for doctor visits and prescription drug coverage .
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Tips For Retirement Planning
- When getting started with retirement planning, it pays to have someone who knows your financial situation. A financial advisor may be able to help. Finding a qualified financial advisor doesnt have to be hard. SmartAssets free tool matches you with up to three financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you. If youre ready to find an advisor who can help you achieve your financial goals, get started now.
- Retirement planning is easier when you have resources at your disposal to help. SmartAsset has a number of these resources, and theyre free to access on our website. Try using our free retirement calculator and get started saving today.
Tips For Getting Retirement Ready
- A financial advisor can be a big help in figuring out how medical expenses will affect your retirement. Finding a qualified financial advisor doesnt have to be hard. SmartAssets free tool matches you with up to three financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you. If youre ready to find an advisor who can help you achieve your financial goals, get started now.
- SmartAssets free financial advisor matching tool matches you with financial advisors in your area in five minutes. If youre ready to be matched with local advisors that will help you achieve your financial goals, get started now.
- Medical costs arent the only expenses youll need to grapple with in retirement. Think about where youll want to retire to see how cost of living could impact your lifestyle. SmartAssets cost-of-living calculator can help you figure out your costs so youll know how much youll need to save. And our retirement calculator can help you see if youre on track with those savings.
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In What Month Does Medicare Coverage Begin
Medicare coverage begins the first day of the month in which you turn 65 if you sign up during your initial enrollment period. If your birthday is on the first day of the month, it starts the first day of the previous month.
If you sign up during your initial enrollment period but after your 65th birthday, your Medicare coverage will typically start up to three months after you sign up. As mentioned above, if you sign up for Medicare Part A and/or Part B during the Jan. 1 March 31 general enrollment period, your coverage will start July 1.
Do I Need Medicare Part B
We always advise our clients to contact their employer or union benefits administrator before delaying Part A and Part B to learn more about how their insurance works with Medicare. Employer coverage may require that you enroll in both Part A and Part B to receive full coverage.
Common reasons beneficiaries delay Part B include:
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Medicare & Social Security Disability Benefits
We have mostly discussed thebasics of Medicare as it relates to retirees and Social Security retirement benefits. However, you can also qualify for Medicare when you receive Social Security disability insurance benefits from the Social Security Administration . When receiving disability benefits, you will be automatically enrolled in Medicare once you have received disability benefits for a 24-month period. There is a 24-month waiting period before your Medicare benefits begin. However, that waiting period does not apply to some individuals with certain conditions.
If you have been diagnosed with end-stage renal disease , you will qualify for Medicare benefits right away. Similarly, those with amyotrophic lateral sclerosis or Lou Gehrigs disease will be eligible for immediate Medicare benefits. These diagnoses will qualify you for immediate benefits, but you must still apply for the benefits. You will not be automatically enrolled in coverage. You can contact your local Social Security office or Centers for Medicare & Medicaid Services office to apply for coverage. You can alsoapply for Medicare online through Medicare.gov, or you can call Social Security at 1-800-772-1213.
Medicare Part D Prescription Drug Coverage Eligibility
Like Medicare Advantage and Medicare Supplement, Part D prescription drug coverage is provided by Medicare-approved private insurance companies. These plans accompany Original Medicare. Generally, you cant have a standalone Part D plan if you have a Medicare Advantage plan.
To qualify for a Part D plan, you must meet the following requirements:
- You must have both Part A and B .
- You must live where plans are available.
- You must pay Part A, Part B, and Part D premiums, if applicable.
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What Are My Insurance Options If I Cannot Get Medicare At Age 62
If you dont qualify for Medicare, you may be able to get health insurance coverage through other options:
- Employer-provided insurance
LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.
Moore holds a bachelors degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.
Hes passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.
Medicare Eligibility Due To Specific Illnesses
In addition to the above ways to qualify for Medicare health insurance, you may also be eligible if you have one of the following diseases:
- End-stage renal disease. To qualify, you must need regular dialysis or a kidney transplant, and your coverage can begin shortly after your first dialysis treatment. If you receive a transplant and no longer require dialysis, youll lose Medicare eligibility.
- Amyotrophic lateral sclerosis. Also known as Lou Gehrigs Disease, patients diagnosed with this terminal disease gain immediate Medicare eligibility.
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What Insurance Do You Get With Social Security Disability
In most cases, people receiving Social Security Disability Income are automatically enrolled in Original Medicare after serving a 24-month waiting period.
The CMS waives this waiting period for people with ALS or end-stage renal disease. People with these conditions receive Medicare coverage as soon as they collect SSDI.
Who Is Eligible For Medicare
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
- You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.
If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
- You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
- You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
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