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What is Original Medicare, who qualifies, and more importantly, are you eligible for Medicare coverage?

In the United States, health insurance might be broken down into two general categories–Medicare and non-Medicare private health coverage. Medicare is the government run, Federal health insurance program for people 65 years or older, disabled people who have worked the minimum number of years to qualify for Social Security Benefits, and people of any age who have End Stage Renal Disease (ESRD). All other insurance, with the exception of the Federal Employees Health Benefits program and Mail Handlers is private insurance.

Original Medicare coverage includes medical insurance that covers visits to doctors, Medicare supplies and equipment, hospital outpatient care, and many other medical services, such as labs, radiology, and physical therapy. This is the Part B side of Medicare. The Part A of Medicare helps pay for inpatient services. Part A would include coverage for inpatient hospital days, skilled nursing facility stays, and Home Health benefits.

Generally speaking, eligibility is not complicated. If you are a U.S. Citizen or naturalized citizen nearing the age of 65, or disabled or have End Stage Renal Disease, you are probably eligible. Eligibility questions, however, can be addressed to the Social Security Administration at 1-800-772-1213.

Enrollment into Medicare Part A and B is automatic if you are receiving Social Security benefits at the time you turn age 65. If you have been receiving Social Security Disability Insurance for 24 months, you enrollment is also automatic at the end of the 24 month. Generally speaking, you should receive your red, white and blue Medicare card about 3 months prior to the month of your enrollment.

Those nearing 65 but not yet receiving Social Security benefits must submit an application to the Social Security Administration. All Medicare applicants have a 7 month, initial enrollment period that begins 3 months before the sixty-fifth birthday and ends on the last day of the third month following the month of your sixty-fifth birthday.

To wrap up, Medicare enrollment is done through the Social Security Administration. If you are already receiving Social Security, railroad, civil service, or disability benefits, your enrollment will occur automatically. If not, and you are within 3 months of your 65 birthday, contact the SSA in order to submit an application to begin receiving your benefits.

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What is Original Medicare, who qualifies, and more importantly, are you eligible for Medicare coverage?

In the United States, health insurance might be broken down into two general categories–Medicare and non-Medicare private health coverage. Medicare is the government run, Federal health insurance program for people 65 years or older, disabled people who have worked the minimum number of years to qualify for Social Security Benefits, and people of any age who have End Stage Renal Disease (ESRD). All other insurance, with the exception of the Federal Employees Health Benefits program and Mail Handlers is private insurance.

Although Medicare is now considered to have 4 parts, Original Medicare is most often associated with what is called Part A and Part B. Part A covers hospital inpatient, skilled nursing facility, and home health care benefits. Part B covers doctors’ services, medical supplies and equipment, and hospital outpatient care. Part B also covers many other services such as clinical laboratory services, imaging, ambulatory surgery, cancer treatments, preventive services, and much more.

Are you eligible for Medicare? This is not difficult to determine. Basically, if you are receiving Social Security benefits and you are a U.S. citizen, or naturalized citizen who has resided in the United States for the last 5 years, you are eligible. Persons eligible for Social Security Disability Insurance (SSDI) have a 24 month waiting period before automatic enrollment into Medicare. People with Disability benefits due to Amyotrophic Lateral Sclerosis may have the 24 month waiting period waived. Questions about eligibility should be addressed to the Social Security Administration at 1-800-772-1213.

If you have elected to start receiving Social Security benefits prior to turning age 65, then your enrollment into Medicare Part A and Part B will be automatic. In your case, about 3 months before your sixty-fifth birthday, you will receive an initial enrollment packet including your Medicare card.

If you are approaching age 65 but not yet receiving Social Security Benefits, the procedure is a little different. In this case, you need to initiate the enrollment process yourself by submitting an application with Social Security. You can do this through your local office, or call the number given above for more information. In either case, whether you are already receiving SSA benefits or not, you have a 7 month initial enrollment period to sign up. This includes the 3 months before the month of your birthday, the month of your birthday, and the three months immediately following the month in which you turn 65.

The one stable piece of information to hold onto is that Medicare enrollment is always done through the Social Security Administration. If you are already receiving benefits, your enrollment will be automatic and you won’t need to do anything at all. If you are not receiving SSA benefits by your sixty-fifth birthday, you will need to submit an application through the Social Security Administration. As this is quite an important change in your life, you should not hesitate to seek answers to your questions through the Social Security Administration toll free number, 1-800-772-1213.

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categories: Original Medicare Coverage,Medicare enrollment,Medicare eligibility,Medicare Advantage plans,Original Medicare