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Home » Golden Years

Medicare Eligibility De-Mystified

Submitted by on February 7, 2011 – 12:05 am2 Comments



Medicare could be the best birthday gift that people in their mid-sixties could get, particularly when one tries understanding the varied components of the Medicare plan & the mammon of healthcare reserves they could offer.

Medicare is a federally managed system of health insurance obtainable for individuals in their mid-sixties onwards to assist them in paying their medical expenditures.

Ever since it came into effect in the mid-sixties, Medicare expansion has taken place for providing cover for several disabled younger individuals & those having advanced staging kidney ailment. President Bush founded Medicare Part D eight years ago, which is basically a plan devised for assisting individuals having Medicare in paying for their prescription medications. Medicaid is a federally-managed insurance plan for low-waged individuals also devised at the analogous instant.

Prior to reaching sixty-five years of age, majority of the individuals receive health insurance via group plans which their company or their partner’s company/boss offer. Individuals who are freelancing or those not insured via their occupation might themselves procure individual policy.

On turning sixty-five, though, one would perhaps be entitled to one of the biggest group health programs across the globe. Medicare could be deployed as the person’s solo health insurance cover or as back-up coverage/ companion coverage for insurance one has via one’s company, partner, ex-boss or association.

Medicare is multi-sectional & multi-part.

  • Part A, Part B are mostly called as Traditional Medicare or FFS (fee-for-service). Medicare Part A assists the person in paying his/her hospital billing, & majority of the individuals have done payments towards their Part A premium amounts via tax on incomes paid by company (payroll tax) when they were employed. Medicare Part B provides assistance for payments going towards physicians’ visitations & several medical facilities, inclusive of screening for cardiovascular ailment, diabetes & a number of cancer forms.
  • Medicare Part C plans (or known as MA/ MA-PD or Medicare Advantage Plans) are Medicare-consented programs furnished by private insurers. They are a substitute to Traditional Medicare. It covers physicians & hospitals and mostly covering prescription-only medications also.
  • Medicare Part D plans are Medicare-consented private programs which provide assistance to individuals having Part A, B for paying towards prescription-only medications.

Medicare does payments for several health facilities; however it does not provide coverage for the individual’s entire healthcare expenses. Despite having Medicare, the person would have to pay some deductible, co-payment or deductible.

Medicare Eligibility

In majority of the scenarios for Medicare eligibility & garnering full-ranging advantages, one has to be sixty-five years old & having garnered the needed quarters of cover – usually translating to one being entitled in case you/ your partner were working - & have been paying Medicare & SS payroll tax for a decade in the least.

But, in case a person has some disability or is meeting other requisites then he/she too could be eligible – but he/she must be a permanent resident/citizen in the United States.

An IEQ or initial enrolment questionnaire would be mailed to the person around 3 months prior to him/her turning sixty-five. In case one does not obtain the mail or are not sure if one has Medicare eligibility then one could contact Social Security gratis number (800-772-1213) or be calling its locally placed office.

Comprehensive info regarding Medicare eligibility at mid-sixty or in particular scenarios – is obtainable via Medicare’s website or social-security.

Medicare & One’s Kin

Disparate to a lot of health insurance programs, Medicare doesn’t offer kin cover. In case you’re sixty-five years of age and qualifying, you are provided insurance via Medicare as a person though not insuring your kids or your younger partner via your Medicare program. Similar to you, your partner is entitled to personal Medicare cover no sooner has he/she turned sixty-five.

Even though younger adults till twenty-six years of age could presently continue to have insurance under a parent’s company or private health insurance program because of the novel health care law then the analogous is untrue for cover under Medicare.

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2 Comments »

  • Zoe says:

    There are certain myths about medicare, one of which is that medicare plans covers all the long term care expenses. Nope. Medicare only wraps medical expenses which are needed to care for an accident or illness. Long-term care expenses actually are for help with daily living activities, like taking medications, using the restroom, bathing, etc. which are not true medical expenses and generally are not covered by most medical insurance plans.

  • daisy says:

    You do not entirely pay your medicare expenses. 37 percent is funded by payroll taxes, shared equally between employers and employees; 13 percent by premiums collected from current retirees; 43 percent come from general revenues. This means that our medical expenses are paid collectively by taxpayers. Finally, 7 percent comes from miscellaneous resources. So, get off the myths.

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