Medicare is our country’s government administered health care program. At the ripe age of 33, I have many years before I have to worry about signing up. I do, however, have several clients that depending when they qualify for Medicare is a big determent on when they retire. It’s huge for many retirees.
There are essentially two groups of people who qualify for Medicare health insurance coverage – those who have reached age 65 and those with disabilities.
Adults Over 65
Most adults in the United States are eligible for Medicare when they turn 65. Individuals must be US citizens or permanent residents and enroll in the Medicare program to qualify.
Individuals who are already receiving Social Security benefits will be automatically enrolled in the Medicare program. Approximately three months before their 65th birthday, an enrollment package will be sent and must be completed to activate coverage. Medicare part A, which covers hospitalizations, requires no payment. However, adding part B – which is for doctors visits and outpatient procedures – or additional coverages, such as prescription drug coverage does cost money. The premium is determined based on income level. So individuals must decide what plan is best for them when enrolling and what they can afford to have.
Who Does NOT Qualify for Medicare
People who are not already receiving Social Security benefits will need to contact their local social security office to apply for Medicare coverage. This should be done three months before the individuals 65th birthday. The enrollment period begins in the three months before the month of the 65th birthday and ends three months after. If one enrolls during this time frame there is no cost for enrollment and coverage should begin at the start of the 65th birthday month or shortly thereafter (if one applies after their birth date). If, however, one does not apply during that enrollment period then fees apply. So it is important to apply on time, and as close to the three month prior date as possible. This will ensure everything is done correctly and coverage starts at the beginning of the individuals birth month.
Individuals with Disabilities
Medicare coverage is also available to individuals with disabilities regardless of their age. Once an individual has been collecting social security disability payments for twenty four months, they become eligible for Medicare during the 25th month. An enrollment package will be sent a few months before a person becomes eligible for Medicare coverage. If a person with social security disability does not receive the enrollment package, they should contact their local social security office to request a packet.
Like an individual who is over age 65, disabled persons who have been getting SSI disability payments are automatically eligible for Medicare. There is no reason to decline coverage as Medicare part A costs nothing and covers hospital care and nursing facility care. However, if a disabled individual would like, they can decline Medicare Part B coverage which would require premium payments. There is a card that comes with the enrollment package that the individual can mail back declining part B coverage.
With the high costs of health care it makes sense for those eligible for Medicare to take advantage of this government administered health care program.