Medicare Eligibility/Enrollment

Medicare benefits protect millions of Americans. To find out if you are eligible for Medicare, continue reading. 

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What Is Medicare?

Medicare is a federal health insurance program that covers senior citizens and people with disabilities. The federal government administers the Social Security system, which oversees Medicare. Through Medicare, people receive essential benefits, like prescription drug coverage, hospital insurance, and medical insurance.

Enrolling In Medicare

Before you can enroll in Medicare Supplement, Prescription drug plan, or Medicare Advantage plan you must apply for original Medicare. This can be done over the phone, in person, through the mail, or online. Simply go to the website to get started with your application. I suggest you do this about 3 months before your birthday month of turning 65. Please note that your Medicare will be effective the first day of the month of your birthday month. If your birthday is on the first of the month your benefits will be effective a month earlier. Call for questions.

Once your application has been accepted, you need to enroll in coverage. This can only be done during specific enrollment periods. These enrollment periods include:

  • Initial Enrollment – Starts three months before your 65th birthday and ends three months after your 65th birthday. You use this period when you first become eligible for Medicare.
  • General Enrollment – Starts January 1 and ends March 31. You use this period if you miss your Initial Enrollment Period. Using this period means your coverage won’t begin until July 1, and you will most likely have to pay late enrollment penalties.
  • Special Enrollment – This allows you to delay your enrollment with no late enrollment penalty or make changes to your coverage because of special circumstances, which can include:
    • Having coverage through your employer
    • Changing where you live
    • Losing your current coverage
    • And other special circumstances
  • Annual Enrollment – Starts October 15 and ends December 7. You can review and make changes to your coverage during this period. Changes you can make include:
    • Switching from one Medicare Advantage plan to another
    • Switching to Original Medicare from Medicare Advantage (and vice versa)
    • Enroll, switch, or drop a Part D prescription drug plan

Who Is Eligible For Medicare?

Anyone age 65 or older is eligible for Medicare, as long as they are a U.S. citizen or permanent resident. People who are currently incarcerated are excluded. 

If you are below age 65 and wish to get Medicare benefits, you must be diagnosed with a disability that qualifies you to receive Social Security disability benefits. After you begin receiving benefits, you must wait 24 months to be eligible for Medicare. 

Sometimes, it’s possible to avoid the waiting period. For example, people with End-Stage Renal Disease often become eligible soon after diagnosis. 

Find Medicare Benefits Today

To find out if you are eligible to enroll in Medicare benefits, contact an insurance broker today. Duncan Market Insurance is here to help. Give us a call to get started with a free consultation.