| Mon, Oct 11, 2010 @ 09:00 AM

Medicare Eligibility: Are You Eligible?

Posted by Medicare Made Clear

MedicareMany people are confused about Medicare, especially those who are preparing to enroll in Medicare for the first time. If you are nearing 65 or are eligible for Medicare due to certain disabilities, the following information is designed to help you to better understand Medicare eligibility and how it affects you.

Medicare Age Requirements

You’re eligible to join Medicare if you are an American citizen or have lived legally in the U.S. for a minimum 5 consecutive years and are at least 65 years old. You may also qualify on the basis of disability or other special situation.

If you are eligible based on age, you may begin the enrollment process at age 64 and 9 months; your Medicare coverage will begin the first day of the month in which you turn 65. Those collecting Social Security are automatically enrolled in Medicare Parts A and B and may decide to enroll in a Medicare Part D Prescription Drug Plan. Medigap, also known as Medicare Supplement Insurance, is an optional policy you may purchase to cover some of the costs that Medicare Part A and Part B do not cover.

There are many options regarding your Medicare coverage. Another alternative is to enroll in a Medicare Advantage or Part C Plan. A Medicare Advantage Plan is a single plan that combines help with hospital costs, doctor’s visits and other medical services, plus drug coverage if you choose.

Spouse Eligibility

Medicare benefits are granted based upon the age of the individual, not that of their spouse. In other words, you must wait for your 65th birthday regardless of when your spouse becomes eligible for Medicare.

Social Security and Medicare

Though Medicare is administered through the Social Security Administration, you may begin collecting Medicare even if you have not yet begun to collect Social Security.

Your Current Healthcare Coverage

When you become Medicare eligible, it is a good idea to review your current plan side-by-side with the plans available to you through Medicare. You may even have the option to select a Medicare plan and keep some of your current coverage. It is also important to keep in mind that you may have limited plan choices and be required to pay a higher premium if you decide to wait to enroll in Medicare.

Exceptions to Eligibility Requirements

There are several exceptions, often health related, that allow those under the age of 65 to enroll in Medicare. There are also exceptions to Medicare age limitations for certain low income individuals and families. If you believe you may be eligible for Medicare, contact your local Social Security Administration office.

Additional Resources




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