Am I Eligible for Medicare? What You Need to Know

Medicare is a federal health insurance program for those who are 65 years old or have a qualifying disability. If you retire before 65, you will need to obtain health insurance until you are eligible to enroll in Medicare. To enroll in Medicare, you must be a U.S. citizen or have permanent legal residency in the United States for at least five continuous years if you do not qualify for premium-free Part A. If you are looking to enroll in Medicare, this article is for you. Here, you will learn about what you need to know about Medicare eligibility.

What to Know about Medicare

There are two parts to Medicare: Part A and Part B. Part A covers inpatient hospital care, home health care, skilled nursing facility care, and hospice care. Part B covers outpatient care, preventive services, and some medical equipment and supplies. Part A is premium-free for most people, while Part B has a monthly premium. You can enroll in both at the same time, or you can enroll in Part A first and then add Part B later.

Those are the basics, but are there things you can do to become eligible?

1 – You’ll Need a Qualifying Disability (For Early Eligibility)

If you’re younger than 65, you must receive Social Security disability (SSDI) benefits for 24 months or have End Stage Renal Disease (ESRD), or ALS to be eligible for Medicare. Enrollment timelines will vary based on how you qualify for Medicare before age 65.

2 – You’ll Need to Be 65 or Older (For Regular Eligibility)

If you don’t have a qualifying disability, you can still enroll in Medicare when you turn 65. You’ll need to meet a few other requirements, too. For example, you must be a U.S. citizen or a legal permanent resident who’s lived in the United States for at least five continuous years. You can use this Medicare eligibility calculator to see if you are eligible.

3 – You May Need to Pay a Premium

While Part A is premium-free for most people, you may have to pay a premium for Part B. The standard Part B premium is $170.10 per month in 2022. However, your premium may be higher if your income is above a certain level.

4 – You May Need to Meet a Deductible

For both Part A and Part B, you’ll need to meet a deductible before your coverage kicks in. The Part A deductible is $1,556 in 2022. The Part B deductible is $233. Enrolling in either Medigap or Medicare Advantage plans can help with these out-of-pocket costs.

5 – You’ll Need to Enroll During a Specific Time Period

You can only enroll in Medicare during certain times of the year. If you’re 65 or older, you can enroll during your seven-month Initial Enrollment Period (IEP) which starts three months before the month you turn 65, includes the month you turn 65 and ends three months after the month you turn 65. After your IEP, if you want to enroll in Part B of Medicare after age 65, you will have to qualify for a Special Enrollment Period (SEP), or use the General Enrollment Period (GEP)

6 – You or Your Spouse Will Need 40 Work Credits

To be eligible for Part A at no cost, you or your spouse must have earned 40 credits from paying Medicare taxes while working. You earn one credit for each $1,220 of earnings, with a maximum of four credits per year. It is also important to know that if you use a spouse’s work history to qualify for premium-free Part A, your spouse will have to at least be 62 years old and eligible for Social Security benefits (although they do not have to actually be collecting their retirement benefits)

Conclusion

There are a number of things to consider when enrolling in Medicare. These six facts are just a few of the most important things you need to know to increase your chances of getting qualified. However, the best way to go about it is to talk to a specialist to ensure that you take all the right steps when signing up for your plan.

If you are looking for a medical insurance agency in Michigan, come to Giardini Medicare. We can help you to choose the best Medicare plan for you, get you signed up for that plan, and help you to avoid making costly mistakes.