When Medicare Starts

Introduction

Medicare is a health insurance program for people who are 65 or older or disabled. It covers hospital stays, doctor visits, prescription drugs, and more. But not everyone who qualifies for Medicare will have to wait until age 65 to receive benefits. In fact, some people may qualify for Medicare as early as age 62 if they have certain health conditions. In this article, we'll explore how Medicare coverage starts—and how you can make sure your coverage begins on the right date.


Certain health conditions

You may be eligible for Medicare if you have a disability that is expected to last for at least 12 months. In that case, you'll qualify for enrollment through the Social Security Administration (SSA).

You may also be eligible if your disability is expected to last at least 60 months and is permanent. The SSA will consider these factors:

  • How severe is the illness or injury?

  • How long will it take to recover from your illness or injury?

Benefits start when you enroll

Medicare is broken into four main parts: Part A, Part B, Part C and Part D.

Your monthly premium may be higher if you enroll in a Medicare Advantage plan instead of Original Medicare.

Enrollment dates for each type of health care coverage are as follows:

  • When you're 65 years old or older (enroll in Parts A & B)

  • When you are disabled (enroll in Part A)

  • When you are 65 years old or older and have been receiving Social Security disability benefits for 24 months (enroll in Parts A & B)

  • If the U.S. Department of Veterans Affairs determines that a Veteran is eligible for VA health care benefits from any branch of service based on an honorable discharge from military service; certain medical conditions; exposure to specified environmental hazards while serving on active duty; or a combination thereof (enroll in Parts A & B).

Some benefits happen automatically

When Medicare coverage begins depends on when you enroll.

  • If you sign up for Part A and/or Part B between October 15 and December 7, the first day of your first full month of Medicare coverage will be January 1.

  • If you sign up between December 8 and December 31, the first day of your first full month of Medicare coverage will be the following July 1 or January 1 (if you’re already enrolled in a health plan that covers doctors’ visits).

Missing the deadline

If you miss the deadline to enroll in Medicare, you can still become eligible for coverage. However, it's important to know that if you don't enroll when first eligible and then try to sign up, later on, your premiums will be higher than they would have been had you enrolled at the right time.

If this happens and your income changes, later on, there are some options available to help make things easier financially:

  • If your income increases beyond what was projected when you signed up for Part B or Part D (or if someone else moves into your household who has a higher income), consider applying for Extra Help through Social Security. This program helps low-income people pay their Medicare premiums with no out-of-pocket costs. You'll also receive free preventive services through Medicare like blood pressure checks or cancer screenings.

  • If you're eligible for Medicaid under another state program before age 65 (for example, disability benefits), it may cover all of the costs associated with paying for Part A until age 65—but only if Medicaid is available where you live!

Medicare Advantage plans

If you're enrolled in Medicare and you like the coverage you have from your current plan, you may not want to switch. You can keep your current coverage as long as it doesn't put you over the federal spending limit (for more information on this, see What Is a Medicare Advantage Plan?).

If your plan doesn't cover all of the services covered by Original Medicare, such as prescription drugs or hearing aids, it's important to find out what those services are and how much they cost before deciding whether or not to stay with it.

If you don't like what your existing medical plan offers and want to find another option that provides better benefits for less money (or no additional cost), there are several different ways to do so:

  • Enroll in an HMO or PPO with lower premiums than your current plan.

  • Enroll in a Private Fee-for-Service (PFFS) Plan—if available in your area—that offers lower premiums than standard commercial health plans but higher out-of-pocket costs for some services (like routine visits).

  • Shop around for a new Medicare Advantage Plan or other types of health insurance offered by private companies through www.medicareadvantageplans2019.com

Your health care coverage during a disability

Medicare is the primary payer for these services.

  • Inpatient hospital care. Medicare covers hospital stays, skilled nursing care and home health services when you need them because of an injury or illness. It also covers hospice care if you're terminally ill; hospice is a kind of palliative care to ease your pain and symptoms as you near death.

  • Skilled nursing facility (SNF). If your doctor recommends treatment in an SNF, Medicare will cover it—but only up to 100 days per year in most cases. This limit may be higher if you’re recovering from surgery or are determined to have a permanent condition that requires frequent visits to an SNF during the 100-day period, such as heart failure or a stroke.

In addition, Medicare pays for short-term rehab services that aren’t available in other settings but are medically necessary after certain kinds of medical procedures or injuries: spinal cord injury rehabilitation therapy, hip replacement therapy and knee replacement therapy within 21 days after surgery (if needed), cardiac rehabilitation therapy after heart attack treatment or bypass surgery (up to 90 days). You must also meet certain requirements before entering into these programs so they don't become entitlements; they must be medically necessary and appropriate for what's been recommended by your doctor(s).

Coverage for younger people with disabilities

>Medicare is a federal program that provides health insurance to older Americans and people with disabilities. If you are age 65 or older, or under 65 but have certain disabilities, Medicare can help pay for medical expenses like doctor visits, hospital stays, and prescription drugs.

>If you're younger than 65 and disabled (meaning your disability prevents you from working), then there's another special way to qualify for Medicare coverage: Supplemental Security Income (SSI) benefits. In order for SSI to be used as proof of eligibility for Medicare Part B coverage, it must be determined by the Social Security Administration (SSA) that you cannot work because of your disability.



Plan ahead

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease. Medicare has two parts: Part A (hospital insurance) and Part B (medical insurance).

You have options when choosing your Medicare plan. If you have vision or hearing issues, you may also be eligible for extra benefits under the Medicare Advantage Plan. The following information will help you understand how to enroll in your coverage and manage it once it begins. For more information, you can go to https://www.uhc.com/medicare/medicare-education/medicare-faq.html


Conclusion

About Preferred Senior Benefits in Meridian, Idaho

Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts - Part A and Part B - and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818 2523. We cannot wait to help you learn about your options.

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