Medicare Eligibility Guide: When to Sign Up | GoMedigap

Medicare Eligibility Guide: When to Sign Up

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Medicare Eligibility

As you near your 60s, you may begin wondering about when you’ll be eligible for Medicare, what it will cover, and when you can sign up. Medicare has three parts that you will need to enroll in separately. In some cases, you may be enrolled automatically.

What is Medicare Part A?

At its core, Medicare Part A is the most basic and important part of Medicare. Part A covers many costs associated with your inpatient hospitalization needs, including care received while in a hospital or skilled nursing facility.

What are the Medicare Eligibility Requirements for Part A?

There are certain eligibility requirements that you must meet before you can enroll in Medicare Part A. These requirements include:

  • Age: You must be 65 years or older in most cases in order to apply for Medicare Part A.
  • U.S. citizenship: You must be a U.S. citizen or permanent resident for at least 5 years.
  • Benefits: You are already receiving retirement or disability benefits.
  • Diagnoses: You have been diagnosed with End-Stage Renal Disease or ALS/Lou Gehrig’s Disease.

Will I Be Automatically Enrolled in Part A?

Many seniors find that they are automatically enrolled in Medicare Part A. To receive automatic enrollment in Medicare Part A, you must:

  • Already be receiving Social Security retirement benefits,
  • Receive benefits from the Railroad Retirement Board (RRB), or
  • Have worked in the U.S. for at least 10 years or 40 quarters.

If you are automatically enrolled in Medicare Part A, your benefits will begin on the first day of the month you turn 65. If you have worked in the U.S. for at least 10 years or 40 quarters, you will likely be eligible for premium-free Part A, meaning you will not need to pay a monthly payment to receive your Part A benefits.

What does Medicare Part B Cover?

Medicare Part B covers your outpatient medical services that are deemed either medically necessary or preventative.

How Do I Qualify for Medicare Part B?

Medicare Part B eligibility requirements are similar to those of Medicare Part A. If you are at least 65 or older and you are a U.S. citizen or permanent resident of at least 5 years, you are eligible to enroll in Medicare Part B. In addition, if you are eligible for premium-free Part A, you are automatically eligible for Medicare Part B.

Some may be able to receive automatic enrollment in Part B based on their disability status. For example, if you have ALS or ESRD, you may be able to enroll in Part B prior to turning 65. Additionally, receiving Railroad Retirement Benefits and Social Security retirement benefits will allow for automatic enrollment in Part B.

How Much Does Medicare Part B Cost?

You must pay a monthly premium to receive Medicare Part B coverage. You will likely pay the standard Part B premium amount, which is $135.50 in 2019. However, you may pay more dependent on your income bracket.

When Am I Eligible for Medicare Part D?

If you are eligible for Medicare Parts A and B, this means you are eligible for Medicare Part D, which covers your prescription drug costs. However, in order to enroll in Part D, you must already be enrolled in Medicare Parts A and B.

You will likely pay a monthly premium for your Medicare Part D. The Part D premium may vary depending on your medications, preferred pharmacy, and the plan you choose. Because of this, when choosing a Part D plan, it is important to include your location, preferred pharmacy, and the medications you are currently taking to most accurately determine your monthly premium.

How Can I Check My Medicare Eligibility?

Thankfully, Medicare provides an easy-to-use tool for seniors to help determine their Medicare eligibility. To use this tool, simply choose “Find out if I’m eligible,” and answer the required questions. If you want to find your potential premiums each month, click on “Calculate my premium.”

Medicare only uses this tool to help you determine your eligibility status. It does not sign you up when you enter your information. Additionally, Medicare states on their website that none of the information you enter in this form will be saved. When you close your browser, Medicare erases the provided information to protect your privacy.

When Should I Enroll in Medicare?

Once you determine that you are eligible for Medicare, you may wonder when it is time for you to sign up. For those who receive automatic enrollment, Medicare will enroll you in Medicare Part A, and sometimes Medicare Part B, depending on your eligibility. You will typically receive your Medicare card in the mail three months before your 65th birthday, or three months before your coverage begins.

For those who do not qualify for automatic enrollment, Medicare offers a seven-month period around your 65th birthday when you can enroll in Medicare without penalty. This period starts three months before you turn 65 and ends three months after your 65th birthday. It is very important that you enroll for Medicare during this time to avoid any penalties.

Unlike Medicare Parts A and B, Medicare Part D has an additional period when you can sign up for a plan. This period is Annual Enrollment Period, which takes place every year from October 15 through December 7. During this time, you can switch or drop your Part D plans.

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