Medicare Eligibility: What To Know

There are many different components that go into Medicare eligibility and the type of coverage you can receive. If you’re confused or wondering about your medicare eligibility, don’t worry, you’re not alone. Below we’ve laid out the requirements to be eligible for medicare as well as some of the different services that Medicare covers.

Who is eligible for Medicare?

Many people think that Medicare only covers people that are 65 years of age or older. While this is true in most cases, this is not the only way that you can receive Medicare. You may be eligible for Medicare if:

• You are at least 65 years or older
• Have been on Social Security Disability for at least 24 months (regardless of age)

According to HHS.gov, Medicare is aimed at covering those who are 65 years of age or older, younger people with disabilities or people who have End Stage Renal Disease.

Even though these are the general requirements for eligibility, the different parts of Medicare have certain requirements for eligibility as well.

Part A:

Part A of Medicare generally covers: Hospital, Hospice, Home Health Care, Skilled Nursing Care and Nursing Home Care.

According to HHS.gov, to be eligible for Part A of Medicare, premium-free, you must be age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. It may be possible to receive Medicare Part A at age 65 without having to pay premiums if:

• You receive retirement benefits from Social Security or the Railroad Retirement Board
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them
• Your spouse or you had Medicare-covered government employment

If you are 65 or older and a citizen or permanent resident of the United States, but you and your spouse did not pay Medicare taxes while working, you may be able to buy Medicare Part A.

Part B:

Medicare Part B generally covers: Doctor and Specialist Visits, Lab Tests, Mental Health Care, Ambulance, Preventative Services, Wheelchairs, Walkers, Oxygen, and Outpatient Hospital.

Medicare Part B is not free for anyone. However, the monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.
If you do not fall into any of these categories, you will be billed every three months for your premium of Medicare Part B.

Part D:

Part D covers prescription drugs. You can get Part D prescription drugs coverage two ways:
1) Voluntary enrollment in a stand-alone Medicare Part D plan OR
2) Enrollment in Part C (Medicare Advantage) plan that offers Part D prescription drug coverage.

Overall, Medicare generally coverage about 80% of your Medical Cost. This leaves you with 20% of the costs to pay out of your pocket.

If you still aren’t sure whether or not you’re eligible for Medicare, you can check on the eligibility calculator that is provided by www.medicare.gov.

At Accurate Choice Insurance, we care about matching a health insurance plan that specifically fits your eligibility, needs and lifestyle. There is no “one size fits all” Health Insurance plan anymore. That’s why Accurate Choice Insurance is here to help. If you have questions or would like to learn more about coverage options, contact us at info@accuratechoiceins.com or 702-425-4100!