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Medicare Eligibility – Who is Qualified?

Generally, individuals who have a citizenship of the U.S, have been living there continuously for 5 years and are also above the age of 65 years are qualified for enrollment in Medicare. It has different parts; Medicare part A (Hospital Insurance) and Medicare part B (Medical insurance). There are different terms and conditions for eligibility in different parts depending upon your living conditions as well. As young people who are suffering from end-stage renal disease or disabilities are qualified for Medicare before the retirement age. Different terms and conditions and criteria to get eligible for Medicare services are as follows:

Reach the Retirement age

You get retired at the age of 65 years and become eligible for social security benefits.  As soon as you are taking social security benefits at the time of retirement, you will automatically get enrolled in Medicare hospital insurance. In other cases, if you are not taking social security benefits at the time of retirement you need to sign up for Medicare insurance as it will not be automatic.  

Disability benefits

If you have any disabilities and you are taking disability services from social security or Railroad retirement board for 24 months, this will make you automatically qualified for enrollment in Medicare part A and part B. You do not need to sign up for the subscription as you will automatically get registered once the 24 months

end. 

End-stage renal disease

If you have an end-stage renal disease i.e. permanent kidney failure and you need regular dialysis or a kidney transplant you are eligible for a Medicare subscription. This will not be restricted to the age as you can enroll yourself at any age if you are suffering from this disease. The subscription will not be automatic, you will have to sign up for the program.

Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis (ALS))

 If you are suffering from ALS, you will be automatically enrolled for Medicare in the same month when your disability services begin.

Who is qualified for Premium free Part an Enrollment?

If you or your spouse have paid Medicare taxes while working for 10 years or 40 quarters, you will be eligible for the enrollment of premium free Medicare part A. If the individual is not eligible for premium-free Medicare, he/she will have to pay a $471 monthly amount for part A. whereas, for part B you will have to pay the standard amount of $148.50 monthly. The cost for part B increases with the increasing income and you also have to pay a 10% penalty along with the premium in case of late enrollment.

Eligibility Criteria for Medicare part B

The enrollment of Medicare part B is conditional on Medicare hospital insurance. If you are eligible for part A you will be eligible for part B as both have nearly the same eligibility criteria. If you are not signing up for part A services, you need to meet the following criteria for having a Part B subscription. You should be at the retirement age i.e. 65 years or older and be a permanent citizen of the U.S. if you are a legal citizen of the U.S, for having a subscription in this part you must have been living in the U.S for the past 5 years. Just like other parts, you are automatically eligible without any age restriction if you have any disability, end-stage renal disease, or ALS.

Eligibility criteria for Part C

Medicare part C is also known as the Medicare advantage plan, it is another way to get Medicare Part A and Medicare part B services. There are private insurers who provide these Medicare advantage plans to the individuals. The eligibility for part C (Medicare advantage) is conditional on the enrollment of hospital insurance and part B. You must be enrolled for Medicare part A and part B if you want to subscribe for part C i.e. Medicare advantage. You must be living in the area of coverage of the Medicare advantage plan for which you are signing up. Licensed insurance companies and brokers could provide more information and details about the subscription process of the part C advantage plan.

The initial coverage election period is just like the initial enrollment period of part A and part B. That time starts before the three months of reaching age 65 and ends three months after the retirement age. You can also enroll during the annual election period or special election period. The annual election period is from the 15th

th

of October to the 7th

th

of December.

Eligibility criteria for Part D

Private insurers who are approved by Medicare are providing part D subscription that covers prescription drugs. Just like the advantage plan, to enroll for part D, it is necessary to have a subscription in hospital insurance and medical insurance, and you must be living in the service area of the prescription drug advantage plan.

FAQs

Who is qualified for Medicare Enrollment? 

If you want to enroll yourself in Medicare, make sure that you are a U.S citizen or are a legal resident of the U.S and have been living there for straight 5 years. At the retirement age i.e. 65 years, you get qualified for enrollment in Medicare. You will get an automatic subscription for hospital insurance when you are taking social security services or Railroad retirement boards at the time of retirement. If you are not automatically enrolled, you can enroll yourself for part B manually when you reach retirement age. If you are taking disability benefits from social security, you will get automatic enrollment for hospital insurance and part B after 24 months of disability benefits time. There is automatic enrollment in the case of Amyotrophic Lateral Sclerosis (ALS). You can get a subscription before reaching retirement age if you are suffering from an end-stage renal disease that requires regular dialysis or kidney transplant.

Who is qualified for Medicare part A that’s Premium free

For getting premium-free part A enrollment you or your spouse must be paying Medicare taxes for 10 straight working years or 40 quarters. If you are not qualified for a premium-free part A subscription you will be paying a monthly amount of $471 for hospital insurance and $148.50 monthly cost for medical insurance. The amount for medical insurance increases with the increasing income.

Who is qualified for Medicare part C?

If you want to sign up for Medicare part C you must have part A and part B enrollment first. You must be taking hospital insurance and medical insurance services if you want to take a Medicare advantage plan. You can get a subscription via private insurers who are providing insurance services. The people who are living in the coverage area of the advantage plan are qualified for part C. Qualified individuals could get enrollment in an initial coverage election period, annual election period, or special election period.

Who is qualified for Medicare part D?       

Medicare-approved private insurance companies or brokers are providing part D subscriptions. It covers prescription drug plans. The subscription of part D is conditional on the enrollment for hospital insurance and medical insurance of Medicare. You must be living in the same area of the coverage of the prescription drug plan you are taking.