Wednesday, December 12, 2012

The Criteria For Medicare Admission

Eighty-four percent of Medicare beneficiaries are senior citizens.


Medicare is available in four parts: Original Medicare, Parts A and B, offer benefits for hospital services, preventive care, home health and hospice. Part C, Medicare Advantage, allows Medicare users to buy their Original Medicare benefits from a private insurance company. Part D is also bought from private companies and covers prescription drugs. Medicare is available nationwide, but all U.S. citizens are not eligible for it. You must meet certain criteria before enrolling in any part of the program.


Age


Medicare was designed mainly for those aged 65 years and over. Once you reach your 65th birthday, you are automatically eligible for Medicare if you are a U.S. citizen or permanent resident. If you are already receiving Social Security benefits when you reach 65, you will be enrolled automatically. If not, you will need to contact the Social Security Administration yourself to enroll. Your initial enrollment period runs from three months before your birthday month until three months after. During this period, you can enroll in both Part A and Part B, although Part B is not mandatory.


Disability


Those under the age of 65 may enroll in Medicare if they have certain health conditions and disabilities. If you have already been receiving Social Security disability benefits for 24 months, you are eligible for Medicare no matter your age. You also qualify if you receive Social Security disability benefits because of having Lou Gehrig's disease or permanent kidney failure requiring a transplant or dialysis.


Marriage


If you are younger than age 65 years old but your spouse is 65 or over, you generally do not qualify for Medicare until you reach the qualifying age yourself. The only common exception to this is if you personally have a health condition that makes you eligible for Social Security disability benefits. If you are 65 or older, however, you do qualify for premium-free Part A Medicare along with your spouse if he has paid 10 years of Medicare taxes.


Part B


You can enroll in Part B during your initial enrollment period but it is not required. However, if you do not enroll at this time and then later change your mind, you will be responsible for paying a late enrollment penalty. The cost for Part B goes up 10 percent for every 12 months you were eligible for it but did not take it, and you'll have to pay this penalty for as long as you keep Part B.


Premiums


Medicare comes with several out-of-pocket costs. Most beneficiaries can enroll in Part A without paying premiums. If you don't qualify for free Part A, you can still participate in the program if you pay a Part A premium. Part B and Part D Medicare always require monthly premiums, unless you get Part D benefits bundled in a Medicare Advantage policy. Medicare Advantage plans may or may not require them, depending on the insurance company and the kind of plan you want to purchase.







Tags: Social Security, disability benefits, Medicare Advantage, Part Medicare, Security disability