Medicare Eligibility : Who qualifies?

Age 65 or older qualify for full Medicare benefits if:

• You've been a citizen or lawful permanent resident of the US for the last five years.

• You are a recipient of or are eligible for Railroad Retirement Payments or Social Security benefits.

• You or your spouse work for the government or are a retiree who has paid Medicare payroll taxes while employed but hasn't contributed to Social Security.

Under age 65 or older qualify for full Medicare benefits if:

• For at least two years, you are eligible for Social Security disability payments.

• You satisfy the requirements for a Railroad Retirement Board disability pension.

• Lou Gehrig's illness affects you (ALS).

• You have either had kidney transplantation or renal dialysis.

Medicare parts A-D

What are the differences between the four parts of the program?Part A:

Hospital insurance

• Covers the care you get as a hospital or skilled nursing facility patient.

• For Part A, most consumers don't pay a premium. However, there will be a deductible and co-pays.

• The hospitalization deductible in 2023 is $1,600. Depending on how long you remain in the hospital, coinsurance costs might vary from $0 to $800.

• Make sure to stop contributing to your HSA six months before applying if you are already saving there.

Part B:

Medical insurance

• includes emergency medical treatments, regular medical services including flu vaccines, and doctor visits.

• For the majority of offered services, you pay a 20% co-pay and a $226 deductible.

Part C:

Medicare Advantage

• Medicare Advantage plans, which are offered by private insurance firms, provide Medicare Parts A and B as well as certain extra benefits such as coverage for preventative care, vision, and dental care.

• By the insurer, services provided, and location, premiums vary.

• Government regulations control rates. Premiums are often less expensive than Medicare Parts A and B.

• Plans may impose additional restrictions on provider access and higher obstacles to care.

Part D:

Prescription Drug Plan (PDP)

• Provides coverage for prescription medications.

• These plans, which are managed by private insurers, may be added to your Medicare Advantage plan options or bought alongside Original Medicare.

• By plan, coverage and pricing might differ.

• Note: Beginning in 2023, Medicare beneficiaries will benefit from more thorough vaccination coverage and a $35 monthly ceiling on the cost of insulin.

Medicare Supplemental Insurance (Medigap)?

• Due to the fact that original Medicare does not cover all medical costs, many individuals choose to purchase "Medigap" coverage, which is a kind of commercially accessible Medicare supplement insurance. Although private insurance firms sell and manage Medigap plans, they are regulated by the federal government. Medigap insurance is standardized and distinguished by letters to make it easier for you to compare prices and provider options. (Take notice that Massachusetts, Minnesota, and Wisconsin have differing standards for Medigap plans.)

• Due to the fact that Medigap plans cannot reject your application or charge you a higher premium because of pre-existing problems, the optimal time to get Medigap coverage is when you first enroll in Plan B. In most states, Medigap plans may reject your application beyond the Initial Enrollment Period or impose higher rates.

• After the first enrollment period, if you discover that you need to apply for a Medigap plan or modify the one you are already in, you may want to speak with your local State Health Insurance Program to seek advice on your alternatives.