Medicare Eligibility
Medicare Eligibility is available to anyone turning 65, disabled prior to the age of 65 or with ESRD. People turning age 65 need to have 40 quarters of working credits or have a spouse with 40 quarters. You must also be a U.S resident or be legally in the U.S. for 5 concecutive years. The CMS website has a lot of very detailed information on this topic. Click for CMS details on Medicare A and B enrollment
You have Medicare Eligibility for parts A and B, 3 months prior to the month you are turning 65. You are also eligible the month you turn 65 and up to three months after age 65. If you are 65 or older without A and B can sign up from Jan 1 through March 31st for a July 1 start date. If you are 65 or older and losing health coverage through an employer or through a spouse, you can sign up for A and B. The time frame to sign up is 63 days after losing the coverage. (regardless of the time of year)
Once you enroll in A and B it is time to figure out the best option for your health coverage. There are a number of plans and companies to choose from. As a result, costs range from $0 a month up to about $260 a month for the most expensive options. It is easy to find the right plan type and company but the first step is to sign up for A and B . If you are drawing Social Security, Medicare signs you up automatically. If you are not drawing Social Security, you need to sign up online or through the local Social Security office. I have listed the steps to follow below…
Steps for Medicare eligible people
- Step 1- It is easy to sign up for Medicare A and B online. CLICK HERE FOR THE SITE TO SIGN UP FOR MEDICARE A AND B . Please note, your Medicare A and B will start on the first of the month you turn 65. Medicare will charge most people $134 a month for part B. They either bill quarterly or draw it out of your Social Security check. (for those taking Social Security)
- Those over the age of 65 can not enroll in A and B online. Please call your local Social Security office to enroll in A and/or B.
- Step 2- Some people do not have to pay the $134 monthly premium. If you are single and make less than $2,435.40 or as a couple make less than $3,284.10 you are eligible for a program called Medicare Savings Program (MSP), Enrolling in MSP will provide a number of benefits and you will no longer need to pay the monthly part B premium of $134 a month. CLICK TO LEARN MORE ABOUT MSP (we can help you with the MSP application)
- Higher income Part B Penalty– People making an annual income over over $85,000 (single) or $170,000 (couple) will pay a higher amount for part B. CLICK HERE FOR INCOME LEVELS
- Step 3- The next step is to figure out which type of plan works for you. There is a lot to choose from including Medicare Advantage plans, Medicare supplement plans (also called Medigap) and/or a Medicare Part D drug plan. There are a number of companies offering these plans. Contact our office to see which plan type is best for you. When a chocie is made, our office will help ensure you are enrolled properly. Applications must be sent in prior to the 1st of the month you turn 65 in order to get the appropriate start date.
Notice about the Part D rx penalty
Notice to those signing up for Medicare over age 65: If you are signing up for Medicare A and/or B past the age of 65 please read the following: Medicare charges a penalty (called the Part D Rx penalty) for anyone that was without prescription drug coverage after the age of 65. As a result, if you are signing up for a plan (Medicare Advantage plan or Medicare Part D rx plan) over the age of 65, you will receive a letter stating you need to pay a part D penalty. If you had other drug coverage during that time, you will not need to pay the penalty. Proof of the other coverage will be needed to waive the penalty. The letter you will have instructions about how to appeal. It will take about 2 months for the appeal process. Appeals are processed by a company called Maximus. Please call or email us if you need a generic copy of the appeal form.
Currently enrolled in Medicare: Click here to check your enrollment
Medicare Eligibility: Other Resources
Sign up for Medicare after age 65 ( Medicare general enrollment period)
Medicare Part D Rx income penalty
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