Which Parts Of Medicare Will I Be Enrolled In
There are four parts of Medicare, named A, B, C, and D. Parts A and B are overseen by the Centers for Medicare and Medicaid Services while the other two parts are privately organised. This means you will automatically be enrolled in parts A and B with Social Security.
Part A relates to hospital inpatient services, covering the cost of hospital, nursing facility and hospice services. This coverage will typically also include any supplies and pharmaceuticals required while the patient is in hospital. It can even cover physical and occupational therapy required for housebound patients, and counselling for the terminally ill.
Part B is for outpatient coverage, meaning it is utilised for services administered outside of the hospital. Home visits from a medical professional, testing services and some equipment costs can be covered, as can the use of an ambulance in emergencies.
However, Part B does not include long-term care, also known as custodial care. This is when patients need support for daily living, like bathing or dressing.
How Do I Become Eligible For Medicare If I Am Under Age 65 And Disabled
Before you can receive Medicare you must apply, be approved and have received Social Security Disability Insurance for a period of time. You can apply for disability benefits at your local Social Security office, apply online at www.socialsecurity.gov or call toll free 1-800-772-1213 or 1-800-325-0778 to make an appointment to file an application.
Americans Are Eligible To Sign Up For Medicare When They Turn 65 By Which Time They Are Likely Already A Recipient Of Social Security Benefits
If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. At the beginning of your initial enrollment period , three months before your 65th birthday, Social Security will send you instructions in the post.
When you turn 65, you will need to register for Medicare coverage if you began receiving Social Security Benefits or Railroad Retirement Benefits four months or less from your 65th birthday. Those who have been receiving federal benefits at least 4 months prior to their 65th birthday will be automatically enrolled in both Medicare Part A and Part B.
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Does Social Security Pay For Medicare
Social Security does not pay for Medicare, but if you receive Social Security payments, your Part B premiums can be deducted from your check. This means that instead of $1,500, for example, youll receive $1,386.40 and your Part B premium will be paid.
Now lets take a look at Medicare and Social Security to understand what these important benefit programs are, how you qualify, and what they mean for you.
Who Is Eligible For Medicare Advantage Plans
Youll automatically qualify for Medicare Advantage once you qualify for Part A and Part B coverage. Advantage plans are sold by private companies and are designed to cover some of the out-of-pocket costs Original Medicare does not cover.
4 Medicare Advantage Eligibility Requirements
While regular Medicare Advantage does not cover ESRD, you may qualify for a Medicare Special Needs Plan . SNPs are special types of Advantage plans specifically designed for a particular condition or financial situation.
You can keep your Medicare Advantage plan if you purchased it before developing ESRD. You can also buy an Advantage plan after being medically determined to no longer have ESRD usually from a successful kidney transplant.
Don’t Leave Your Health to Chance
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Your First Chance To Sign Up
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.
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.
When Do I Need To Sign Up For Medicare Part A
As stated above, if youre collecting Social Security benefits, youll automatically get Part A and Part B. If youre not automatically enrolled, the best time to enroll in Part A is during your Initial Enrollment Period.
As long as you worked a minimum of ten years, Part A will be premium-free. Even if youre still working, it makes sense to join Part A to help keep your out-of-pocket medical costs to a minimum.
Reaching Age 62 Can Affect Your Spouse’s Medicare Premiums
Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.
When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they havent yet qualified based on their own work history.
- For example, Gerald is 65 years old, but he doesnt qualify for premium-free Part A because he did not work the minimum number of years required for eligibility. He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.
- Lets say Geralds wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.
In the above example, Jessica has not become eligible for Medicare by turning 62. Her husband Gerald, however, is now eligible to receive his Medicare Part A benefits without paying a monthly premium any longer.
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Make Your Decisions Independently
Collecting Social Security is by no means a prerequisite to getting Medicare. In fact, its often advisable to sign up for Medicare as soon as youre eligible but wait on Social Security to avoid a reduction in benefits, or boost them as much as possible.
The only downside to signing up for Medicare alone is having to make your premium payments directly, as opposed to having them deducted from your Social Security benefits, but its a small price to pay for the upside of a higher lifetime income stream.
Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.
How Medicare Affects Your Coverage
Medicare is the federal health insurance program for people who are 65 or older, or otherwise receiving Social Security disability benefits.
Medicare is divided into four different parts, which cover specific services. You will only need to focus on these three if you enroll in a state-sponsored retiree insurance plan:
- Part A
- Part D
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Do I Receive A Notice About Medicare When I Turn 65
If you are already receiving Social Security benefits, you will get information about Medicare in the mail three months before you turn 65. If you do not receive Social Security benefits, you must actively enroll in Medicare yourself by contacting your local Social Security office. You will not receive a notification in the mail informing you that you qualify for Medicare
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Top 5 Things You Need To Know About Medicare Enrollment
1. People are eligible for Medicare for different reasons.
Some are eligible when they turn 65. People under 65 are eligible if they have received Social Security Disability Insurance or certain Railroad Retirement Board disability benefits for at least 24 months. If they have amyotrophic lateral sclerosis , theres no waiting period for Medicare. Some people with End Stage Renal Disease may be eligible for Medicare. Its important to know the different ways that people qualify for Medicare so you can help current and former employees and their dependents anticipate their eligibility for Medicare so they can make timely and appropriate decisions about their enrollment.
People living in the United States and U.S. Territories who are already collecting Social Securityeither disability or retirementare automatically enrolled into Part A and Part B when theyre first eligible. These people will get a packet of information a few months before they turn 65 or receive their 25th month of Social Security Disability or Railroad Retirement Board benefits. At that time, they can choose to keep or decline Part B, but cant decline Part A unless they withdraw their original application for Social Security and pay back all Social Security cash benefits.
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What Does Medicare Cover
Medicare helps pay for certain health care services and durable medical equipment. To have full Medicare coverage, Medicare beneficiaries must have Part A and Part B .
The following is a partial list of Medicare-covered services. The covered services listed below may require payment of deductibles and Co-Payments.
If you have questions about covered services, call Medicare at 1-800-633-4227.
Social Security Disability Insurance
When people discuss Social Security benefits, they are usually referring to retirement benefits. However, Social Security also administers disability benefits to qualified individuals.
A full discussion of this insurance program is outside of the scope of this article, but you can find some more details from the Social Security Administration page on disability insurance.
People who have received Social Security Disability Insurance benefits for 24 months are eligible for Medicare Part A and Part B, even if they arent yet 65 and dont receive Social Security retirement benefits.
Individuals who qualify for SSDI coverage and have Lou Gehrig’s disease qualify to receive Medicare benefits sooner, starting on the first month of their SSDI coverage.
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How Much Money Can I Make Before Social Security Will Reduce My Benefits
It depends on your age. If you have not yet reached full retirement age, then you can only earn $18,960. If you make more than that, then your benefits will be reduced. That limit increases to $50,520 the year in which you reach full retirement age. Suppose you reach normal retirement age in September. Then from January to September, the higher limit will apply. Upon actually reaching normal retirement age, the limit is removed altogether. This means that you can earn an unlimited income with no effect on your benefits. This age is anywhere from 65 to 67 depending on the year in which you were born.
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Special Enrollment Periods For Medicare
Medicare special enrollment periods can happen any time during the year due to changes to your personal circumstances.
Examples of Medicare Special Enrollment Qualifying Events
- Moving somewhere outside of the coverage area of your current Medicare Advantage plan
- Phasing out of your employers health insurance plan
- Your current Medicare Advantage provider ending its contract with Medicare
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Can I Get Medicare Early If I Retire Early
If you retire earlier than age 65, you will not be eligible for Medicare. Although Medicare is often thought of as insurance for retired people, the Medicare age requirement is still 65. Some people continue to work past age 65 and have insurance coverage through their employer. Many people retire before they turn 65 and must purchase health insurance or are covered on their spouses insurance plan. Although you may be eligible for social security retirement benefits if you retire early, it does not change your age requirement for Medicare health insurance coverage.
Medicare Eligibility If You Are Under 65
If you are under 65, you can qualify for full Medicare benefits if:
- You have been receiving Social Security disability benefits for at least 24 months. These do not need to be consecutive months.
- You have end-stage renal disease requiring dialysis or a kidney transplant. You qualify if you or your spouse has paid Social Security taxes for a specified period of time, based on your age.
- You have amyotrophic lateral sclerosis, also known as Lou Gehrigs disease. You qualify for Medicare immediately upon diagnosis.
- You receive a disability pension from the Railroad Retirement Board and meet certain other criteria.
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Why Waiting On Social Security Pays
Though you’re allowed to start collecting Social Security at age 62, you’re not entitled to your full monthly benefit based on your work record until you reach full retirement age. That age is a function of your year of birth, as follows:
Year of Birth
DATA SOURCE: SOCIAL SECURITY ADMINISTRATION.
If you file for Social Security before your 65th birthday so that you’re already getting benefits by the time Medicare eligibility kicks in, you’ll end up reducing those benefits in the process, and most likely for the rest of your life. That’s why it often pays to wait on Social Security, and enroll in Medicare once you’re able. Though your Medicare coverage won’t kick in until you turn 65, you actually get a seven-month initial enrollment window to sign up that begins three months before the month of your 65th birthday and ends three months after the month you turn 65.
It pays to sign up for Medicare when you’re supposed to, because if you don’t, you’ll risk getting hit with a surcharge on your Part B premiums for life. Therefore, if you’re not already collecting Social Security as age 65 nears, there’s no need to rush to sign up for it. What you should do, however, is make sure to enroll in Medicare, unless you’re already covered by a group health plan through a job, in which case the rules regarding enrollment and penalties differ.
Why Should I Wait
You can take your Social Security benefits early or when you reach retirement age. You can also delay benefits.5 Whether you’re still working or have budgeted enough to live without Social Security benefits, you may be on the plus side when it comes to your monthly payout.
If your full retirement age is 66 or older, check out this chart, opens new window to see how delaying retirementeven just by several monthscould affect your Social Security benefits to your advantage.
You can also use this retirement benefits planner, opens new window to determine the best time to access your Social Security benefits.
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What Are The Medicare Eligibility Rules
You can become eligible for Medicare in one of three ways:
You are age 65 or older and meet the citizenship and residency requirements.
You have a long-term disability.
You have permanent kidney failure or ALS.
If you become eligible for Medicare by age, you can 3 months before your 65th birthday, during your birth month, and in the following 3 months. But if you wait until after your birthday to enroll, your coverage may be delayed by 1 to 3 months, depending on how long you wait.
You can estimate when youll be eligible for Medicare by using its eligibility calculator.
If youve paid into Medicare for long enough at least 10 years of payroll tax deductions if you are eligible for Medicare by age you can receive Medicare Part A premium-free. Otherwise, you can pay a premium based on how many quarters you have paid taxes.
If youve received Social Security retirement or disability or Railroad Retirement Board benefits for at least 4 months prior to turning 65, you will be automatically enrolled in Part A and Part B. In that case, you dont have to fill out an application for Medicare.
You also can choose whether to delay Part B enrollment. If you want to put off Part B, you can call the Social Security Administration at or send back your Medicare card when it arrives to avoid being charged premiums.
You are eligible for Social Security or RRB.
Your spouse is eligible for Social Security or RRB.
Your or your spouse paid enough Medicare taxes through a government job.