Who Is Eligible for Medicare?

Are you aged 65 years and above and are a recipient of social security benefits? Do you have a permanent disability? Are you looking to benefit from Medicare? If your answer is ‘yes’ to these questions, then you might be wondering how you can become eligible for this health plan.

Now, more than 18 percent of United States of America citizens depend on Medicare for health coverage. By 2018, the number of beneficiaries of this program had crossed the 60 million mark and continued to rise in 2019. This article will give you a basic understanding of what you need to become eligible for the health coverage program. You will also understand what you need to do to get the part A and part B benefits. Finally, if you are younger than 65 years, this article will explain the criteria for eligibility.

Medicare Eligibility for People Aged 65 Years and Above

When Do I Start Receiving Part A Benefits of This Program?

Essentially, you are eligible to start receiving your Part A benefits of the program without a premium when you reach 65 years. Typically, part A benefits are usually packaged in hospital insurance. Now, you will only be eligible for these benefits if you have worked for ten years and above and have paid the required taxes. You are also eligible for the Part A of the program benefits if either of the following applies to you.
• You are already a recipient of social security benefits
• You have qualified to receive social security benefits
• You already are a recipient of railroad retirement benefits – RRB.
• You are eligible for RRB benefits
• You or your spouse have worked for more than ten years in a government job that offered the health care program.

Typically, suppose you already are a recipient of either the social security or railroad benefits and have been receiving the benefits for at least the last four months before you turned 65 years old. In that case, you are eligible for the Part A of the program benefits. If this is not the case, you can seek eligibility by writing or filing an application with the social security administrators. However, for this eligibility application to be approved, you will need to have the basic requirements of the program; 65 years of age and program taxes.

Part B Medicare Benefits: How Do I Become Eligible?

If you are already eligible for Part A benefits of the health care program, you have automatic eligibility for Part B benefits according to Clearmatchmedicare. Essentially, Part B benefits offer a health care program that follows a voluntary model. Typically, the program requires that you pay a set of monthly premiums for you to be eligible. Depending on your income, the premium can be as low as $144.60 or higher – according to the 2020 standard. However, enrollment for Part B benefits follows a particular deadline. If you miss this deadline, you might be liable for penalties levied due to late enrollment. Like with the Part A benefits, if you have already received the Social security benefits or the railroad retirement benefits for a minimum of 4 months before reaching 65 years of age, your eligibility becomes automatic – excluding residents of Puerto Rico. You can decide not to enroll in this program. However, when you choose to enroll in the future, you will be penalized for late enrollment.

Medicare Eligibility for Persons Who Never Worked

If you or your spouse did not work for more than ten years and have not paid the taxes associated with the program, you will need to purchase the Part A benefits by paying premiums. However, you will still have to be a US citizen aged 65 years and above. In 2020, people without premium-free coverage of the Part A benefits must pay $458 per month if they had already paid taxes for 7.5 years. For those who had paid the taxes for more than 7.5 years, their payment for the premium was $252 each month.

Essentially, if you fall under this category, you will not get an immediate enrollment. First, you will need to apply to the social security administrators and enroll for either Part A or Part B during the various enrollment periods. In addition, you will not have the option of purchasing Part A benefits alone.

Medicare Eligibility for People Less Than 65 Years

If you are younger than 65 years, you are eligible for the program benefits if you:
• Already have received social security disability insurance for more than 24 months
• Are suffering from terminal – end-stage – renal disease
• Are suffering from amyotrophic lateral sclerosis disease – commonly known as Lou Gehrig’s disease.
To get the Part A and B benefits, you are eligible if:
• You have already received the SSDI benefits for more than 25 months.
• You have ALS. Enrollment is automatic immediately after you get the first month of SSDI benefits.

Part C and D: The Private Insurance Options

Eligibility for Part C is pegged on the following.
• Existing enrollment into parts A and B of the program
• Availability of the plan in the area
• No end-stage renal disease

Private insurance firms offer part C benefits, and therefore the premium amounts might vary.
Eligibility for Part D requires the following.
• Existing enrollment in parts A and B of the program
• Enrolment in part C benefits
This program is also referred to as a Drug coverage plan.

Conclusion

Eligibility for this health care program is mainly dependent on age and special conditions. In addition, for parts C and D, you will need pre-existing enrollments for parts A and B. It is advisable for people living with end-stage renal disease to apply for all the benefits applicable to them. This is because their treatment could involve dialysis, transplant of the kidney, and other sophisticated procedures.