Medicare Eligibility and Your Options

 

Who is eligible for Medicare?

Medicare is available for individuals age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.

Two important things to know: 

First, everyone who joins the Medicare program enrolls in Original Medicare. This is health insurance provided by the federal government.

Second, there are other Medicare coverage options offered by private insurance companies approved by Medicare such as "HUMANA". It’s important to understand what these are and how they work.

Step one enroll in Original Medicare:

When you become eligible for Medicare, you may enroll in Medicare Part A, Medicare Part B or both. Learn more how you can enroll in Medicare and how you can get your Medicare card.  (Call a licensed agent in Pennsylvania) 

Step two enroll in additional Medicare plan: 

Even if you enroll in Part A and Part B, Original Medicare doesn’t cover everything. So you need to enroll in additional plans to get 100% covered. These plans include Medicare and Medicare-related plans offered through private insurance companies. 

If you have both Part A and Part B, you have two options to choose:

1. Add stand alone prescription drug coverage (Part D), and a Medicare supplement insurance or both to Original Medicare.
2. Enroll in a Medicare Advantage (Part C) plan. Most Medicare Advantage plans include drug coverage and additional benefits not offered by Original Medicare such as Dental, vision, and hearing coverages. 

 You need to make your own choices based on your health care needs and your budget. And your choices don’t have to be forever. You have the opportunity to change your Medicare coverage choices each year during Medicare Open Enrollment or during a Special Enrollment Period if you qualify for one. Learn which plan is better choose for you. 

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