HomeMedicareWho Can Get Medicare...

Who Can Get Medicare Benefits

Should I Take Medicare Part B

Medicare and Your CalPERS Health Benefits

You should take Medicare Part A when you are eligible. However, some people may not want to apply for Medicare Part B when they become eligible.

You can delay enrollment in Medicare Part B without penalty if you fit one of the following categories.

Employer group health plans may cover items normally not covered by Medicare Part B. If so, and you meet one of the categories above or below, then you may not need to enroll in Medicare Part B and pay the monthly premium.

If you are:

  • a spouse of an active worker
  • a disabled, active worker
  • a disabled spouse of an active worker

and choose coverage under the employer group health plan, you can refuse Medicare Part B during the automatic or initial enrollment period. You wait to sign up for Medicare Part B during the special enrollment period, an eight month period that begins the month the group health coverage ends or the month employment ends, whichever comes first.

You will not be enrolling late, so you will not have any penalty.

If you choose coverage under the employer group health plan and are still working, Medicare will be the “secondary payer,” which means the employer plan pays first.

If the employer group health plan does not pay all the patient’s expenses, Medicare may pay the entire balance, a portion, or nothing. An employer group health plan must be primary or nothing.

To Qualify For Medicare You Need To Get Disability Benefits From:

  • Social Security
  • Railroad Retirement Board

Youll automatically get Part A and Part B after you get disability benefits for 24 months. Well mail you a welcome package with your Medicare card.

If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

If you live in Puerto Rico or outside the U.S.

Enrolling In Medicare With A Disability

Just like when you become eligible for Medicare at age 65, when you are eligible with disability, you have an Initial Enrollment Period of 7 months.

Your Initial Enrollment Period will begin after you have received either disability benefits from Social Security for 24 months or certain disability benefits from the Rail Road Retirement Board for 24 months.1 In other words, your IEP starts on the 25th month of disability benefits.

You will be automatically enrolled in Medicare Part A and Part B, but if you decide you want to get a Medicare Advantage or Part D prescription drug plan, you will need to enroll yourself directly with the private plan provider. You will need to enroll during your IEP to avoid late enrollment penalties.

NOTE: If you become eligible for Medicare because of ALS or ESRD, your situation is different. See the below special sections for eligibility and enrollment for ALS and ESRD.

Recommended Reading: What Zip Codes Get Extra Social Security Benefits

What Is The Maximum Income To Qualify For Medicare

Income is not a factor in Medicare eligibility. You are entitled to coverage if you meet the basic Medicare eligibility requirements.

However, your income will affect how much you pay for coverage. If you are a high earner with an annual income over a specific limit, you will be responsible for additional premiums due to IRMAA. This amount applies to Medicare Part B and Medicare Part D prescription drug plans.

You may become eligible for low-income subsidies, Medicaid, and Medicare Savings Programs if your monthly income is below a certain threshold. These programs offer financial assistance to those on Medicare with low incomes to ensure coverage.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

Monthly Medicare Premiums For 2022

Are You Taking Full Advantage of Your Medicare Plan?Social Security Matters

The standard Part B premium for 2022 is $170.10. If youre single and filed an individual tax return, or married and filed a joint tax return, the following chart applies to you:

Modified Adjusted Gross Income Part B monthly premium amount Prescription drug coverage monthly premium amount
Individuals with a MAGI of less than or equal to $91,000 Married couples with a MAGI of $182,000 or less 2022 standard premium = $170.10
Your plan premium + $77.90

Don’t Miss: Social Security Disability Widow Benefits

Special Circumstances: Medicare With Als Or End

Medicare eligibility rules for people with ALS or end-stage renal disease are different. Individuals who qualify for Medicare with ALS or ESRD do not have to wait for your 25th month of disability to be eligible for Medicare.

If you qualify with ALS: You will automatically get Medicare Part A and Part B the month your disability benefits begin.7

If you qualify with ESRD:8

  • For most people, Medicare coverage will start on the 1st day of the 4th month of dialysis treatment.
  • If you have an employer group health plan, Medicare will begin on the fourth month of dialysis.
  • Treatments if you have employer coverage.
  • If you participate in an at-home dialysis training program, your coverage may begin the first month of a regular course of dialysis provided the following are true:
  • You participated in training from a Medicare-approved training facility for the first three months of your regular dialysis
  • Your doctor expects you to finish training and be able to do your dialysis treatments yourself

Note, according to Medicare in order to qualify with ESRD all of the below must apply:9

For further information related to ALS and Medicare, visit www.alsa.org.

For further information related to ESRD and Medicare, visit www.medicare.gov.

How Much Can You Earn While Collecting Widows Benefits In 2020

The Social Security earnings limits are established each year by the SSA. For 2020, those who are younger than full retirement age throughout the year can earn up to $18,240 per year without losing any of their benefits. After that, youll lose $1 of annual benefits for every $2 you make above the threshold.

Don’t Miss: When To Apply For Social Security Benefits At Age 62

Do You Have To Get Medicare If You Are Still Working

Whether you are working or not when you turn age 65, youll still be eligible for Medicare coverage. It is not mandatory to sign up for Medicare. In fact, you may prefer the healthcare coverage offered by your employer. However, if you defer or decline Medicare coverage, you could pay some form of penalty.

Well go over some of the things you might consider before deciding to enroll in Medicare while still being employed.

Understanding Medicare And Medicaid

How Oregonians can get the most out of Medicare coverage

Medicare is health and hospitalization insurance for people age 65 and older and those under 65 with certain disabilities or end-stage renal disease. Some portions of Medicare are free and others cost money, with premiums typically deducted from your Social Security benefit checks.

Even if you have private insurance you should apply for Medicare. If you wait until after your 65th birthday to apply, you may end up paying a late penalty or higher premiums. For most people, the initial enrollment period is the seven-month period that begins three months before the month in which they turn 65. If you miss that window, you may enroll between January 1 and March 31 each year, although your coverage won’t begin until July 1.

There are four types of Medicare coverage available.

Recommended Reading: Tax Benefits Of Leasing Car

What If You Still Work

There’s a limited period of time during which you can receive SSDI benefits and work, but you can continue to receive Medicare benefits even once disability payments have stopped. This is known as the extended period of Medicare coverage, and it allows you to keep your Medicare coverage for at least 93 months after you have completed your trial work period.

Trial Work Period

There are three timeframes to understand. The first, the trial work period, is a nine-month period during which you can test your ability to work and still receive full SSDI and Medicare benefits. The nine months don’t have to be consecutive, and a qualifying month is one during which you earned at least $1,050 in 2023. The trial period continues until you have worked for nine months within a 60-month long period.

Extended Period of Eligibility

Once those nine months are up, you move into the next time framethe extended period of eligibility. For the next 36 months, you can still receive SSDI in any month you aren’t earning substantial gainful activity income. Plus, you receive a 3-month grace period the first time you earn SGA-level income, during which you’re still paid SSDI benefits. The 2023 monthly SGA amount is $1,470 if you aren’t blind $2,460 if you are. You’ll continue to receive Medicare benefits regardless of income.

Extended Period of Medicare Coverage

Eligibility For Medicare Disability Benefits

If You Are Under Age 65 Social Security Disability Insurance

If you are age 18 to 64, your eligibility for Medicare is tied to your eligibility for Social Security Disability Income benefits. One exception is for people with end-stage renal disease , who are automatically eligible for Medicare solely on the basis of having ESRD.

You must qualify for and receive SSDI monthly income benefits to be eligible for Medicare. SSDI benefits are based on work credits earned through Social Security, Railroad Retirement or Medicare-covered government employment. Note: If you dont have work credits and dont qualify for SSDI, you may qualify for other income benefit programs such as Supplemental Security Income . For more information, see If You Dont Qualify for SSDI.

To qualify for SSDI, you must be unable to work for a least one year because of a qualifying physical or mental impairment, a combination of impairments or a terminal condition resulting from an impairment. You can apply for SSDI at your local Social Security Administration office. Once you are approved for SSDI, you must wait 5 months for your income benefits to begin, and an additional 24 months before Medicare benefits begin.

However, there are 2 exceptions:

  • Amyotrophic Lateral Sclerosis

    If you have Amyotrophic Lateral Sclerosis , you can get Medicare the first month you get SSDI monthly income benefits.

  • Ongoing Eligibility for Medicare and SSDI

    If You Dont Qualify for SSDI

    Also Check: List Of Employee Benefits And Perks

    Does Medicare Cover The Costs Of Diabetic Supplies

    Yes, Medicare does cover certain supplies if you have diabetes. Part B covered supplies include blood sugar self-testing equipment and supplies, insulin pumps, and therapeutic shoes or inserts. To get Medicare drug coverage, you must join a Medicare prescription drug plan. These plans typically cover insulin, anti-diabetic drugs, and certain diabetes supplies such as syringes and needles. The Medicare Coverage of Diabetes Supplies and Services booklet provides a comprehensive look what diabetes related services are covered.

    When Can I Get Medicare

    Guide to Medicare in Wisconsin â Wisconsin Medicare Plans

    When making a decision about which health insurance plan is right for you, keep in mind that there is a waiting period to receive Medicare.

    Typically, it takes a minimum of 6 months to start receiving disability income from the time that you submit your application.

    You may be wondering, How long does it take for Medicare to go into effect one I apply?

    Once you receive a positive disability decision, there is a lengthy waiting period for Medicare coverage.

    After receiving approval, you will need to wait 24 months before your coverage starts.

    Know that there are a few options to cover your healthcare costs while you wait. You do not have to go uninsured during the 24-month waiting period. Here are the three options typically recommended:

  • You may be able to get Medicaid. If youre eligible for Medicaid, you may continue to be eligible even after you are enrolled in Medicare.
  • You can enroll in a private health plan through the Marketplace. You might qualify for lower cost premiums based on the size of your household and your income.
  • Note that if you enrolled in a Marketplace health insurance plan before getting Medicare, you can keep your original plan as supplemental insurance when you enroll for Medicare.

    However, if this is what you decide to do, know that you will lose your premium tax credits and other savings for your Marketplace plan.

    Also Check: Employee Benefits Account Manager Salary

    Can You Qualify For Medicare If Youre Under 65 Years Old

    Most Americans become eligible for Medicare on their 65th birthday.

    You may be able to receive Medicare coverage if youre under age 65 and:

    • received disability benefits for 24 months

    If youre eligible for premium-free Medicare Part A, theres often very little downside to enrolling. You may be eligible for premium-free Part A if you paid into Medicare through payroll taxes for at least 10 years of employment.

    If you work for a large company with more than 20 employees, a Medicare policy can act as a secondary payer and can help to fill in gaps in your existing coverage without any additional cost on your end.

    If you work for a small company or have a health insurance plan through your employer with minimal coverage, enrolling in Medicare may help reduce your medical expenses.

    Medicare will often become the primary payer in these cases and may provide better coverage than you currently receive. In fact, your small employers insurance may not cover you if they discover youre eligible for Medicare benefits and havent enrolled.

    In many cases, its best to apply for Medicare Part A when you become eligible, even if youre covered by a group health plan. Delaying enrollment in Part A may lead to a penalty if you sign up later.

    Lesson Four: Higher Quality Leads Yield Persistency

    As some of the larger, publicly traded Medicare companies downsized ahead of this years AEP, weve seen a more favorable cost per lead . This benefits us as agents and marketers by contributing to a lower cost per acquisition .

    Taking it one step further, our office has put a strong focus on qualified sales. In order to find the highest-quality leads, its important to do your research to find prospective customers who will increase persistence of the policy. Weve done this by qualifying our leads with a complete needs analysis and health risk assessment .

    Now, HRAs are nothing new, but theyre more accessible than ever as more carriers are added to our enrollment platform. An HRA can help the client get more out of their plan because it helps the carrier identify what benefits the customer should use. Its good for the agency because it helps keep the client around longer, allowing us to generate increased revenue with plan persistence.

    Read Also: What Age Do I Get Medicare Benefits

    Medicare Coverage And Eligibility

    It is good to know as much as you can about Medicare eligibility, so that you can be prepared when the time comes to enroll. The following criteria are necessary for Medicare eligibility:

    • Be age 65 or older and eligible for Social Security: You may be automatically enrolled in Medicare Part A when you reach age 65 and become eligible for Social Security. But, if youâre not receiving retirement benefits from Social Security or the Railroad Retirement Board , you must sign up for Medicare Part B when you meet the age requirement, as your enrollment isnât automatic.
    • Be permanently disabled and receive disability benefits for at least two years: You automatically get Part A and Part B after you get disability benefits from Social Security for 24 months or certain disability benefits from the Railroad Retirement Board for 24 months.
    • Have end-stage renal disease : You need to sign up for Medicare, as your enrollment isnât automatic.
    • Have Lou Gehrigâs disease : You automatically get Part A and Part B the month your disability benefits begin.

    Most Medicare members donât have to pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working for at least 10 years . If youâre not eligible for premium-free Part A, you will have to pay a monthly premium of up to $506 in 2023.

    Your First Chance To Sign Up

    How to Enroll in Medicare Part A, Part B, Part C and Part D

    Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

    Avoid the penaltyIf you miss your 7-month Initial Enrollment Period, you may have to wait to sign up and pay a monthly late enrollment penalty for as long as you have Part B coverage. The penalty goes up the longer you wait. You may also have to pay a penalty if you have to pay a Part A premium, also called Premium-Part A.

    Don’t Miss: Social Security And Medicare Benefits

    Your New Social Security Payment Won’t Necessarily Be Exactly 87% More Than What You Currently Receive

    Out with the old, in with the new. Many Americans will be glad to move past 2022 and begin a new year. And they only have a week left before they’ll do so.

    Retirees, in particular, have an extra reason to celebrate the new year. There’s a huge Social Security increase coming in 2023. How much will your check be?

    Image source: Getty Images.

    Social Security Q& A: Can I Claim Widows Benefits At 60

    Welcome to Social Security Q& A. You ask a Social Security question, our guest expert provides the answer.

    You can learn how to ask a question of your own below. And if you would like a personalized report detailing your optimal Social Security claiming strategy, .

    Check it out: It doesnt cost much and could result in you receiving thousands of dollars more in benefits over your lifetime.

    Todays question comes from Debbie:

    I am currently 60 years old and working full time. My husband died in 2013, and I am wondering if I can collect on his benefits now?

    Read Also: What Does Medicare Supplement Plan N Cover

    You May Like: Part Time Employee Health Benefits

    Most Popular

    More from Author

    Read Now

    Social Security Benefits Sign Up

    Next Steps For Apply For Ssdi Or Ssi Benefits How To Sign Up For My Social Security Account Online Evidence required by DDS for case documentation ...

    How To Get Social Security Death Benefit

    How To Apply For The Social Security Death Benefit After A Family Member Passes Away Social Security Lump Sum Death Benefit You can apply for the $255 lump-sum payment...

    Medicare Additional Benefits By Zip Code

    Check Online For Free At Medicaregov Medicare Benefits and Questions Line Commercial 'Medicare Part C' Part 1 The Medicare website lists the general qualifications to get and verify Medicare...

    Social Security Disability Spousal Benefits Loophole

    How Do I Apply For Spousal Benefits Social Security Spousal Benefits Simplified (2022 Update) You can file for spousal benefits the same way you would earned benefits: on...

    Pre-tax Commuter Benefits 2022

    How Much Do You Save On Transit How to use OMNY with Pre-Tax Benefits On average, employees save $700 each year, or more when they set aside...

    How Much Tax On Social Security Benefits

    The Answer Is More Complicated Than You Might Think Here's How To Figure It Out Is Social Security Taxable? You probably know that Social Security tax is deducted from...

    Do You Pay Taxes On Social Security Benefits

    How To Calculate Social Security Tax Is Social Security Taxable? Its fairly easy to calculate your Social Security tax. You multiply your earningsup to $147,000by your Social Security tax...

    Do You Have To File Taxes For Unemployment Benefits

    Real Tax Experts On Demand With Turbotax Live Basic Tips for filing taxes with unemployment benefits Get unlimited advice and an expert final review. Done right, guaranteed. ...

    Filing Tax Return For Social Security Benefits

    Is My Social Security Taxable Is Social Security Taxable? For purposes of this discussion, we are talking about social security payments that get reported to you and the IRS...

    At What Age Can You Receive Medicare Benefits

    Benefits Received Before 65 Medicare and Your CalPERS Health Benefits For those who do qualify for benefits before age 65, there are restrictions. People in these categories qualify for...

    529 Plan Tax Benefits By State

    Looking For Something Specific Money Monday: Michigans 529 plan ranks among best 2 Account owners may deduct for Nebraska income tax purposes contributions they make to their own account...

    Social Security Spousal Benefit Rules

    Are Divorced Spouses Entitled To Social Security Spousal Benefits Rules for Drawing on a Spouse's Social Security Benefits Yes, divorced spouses are eligible if certain criteria are met. The...