Part 1 of the Bailey Group’s Guide to Medicare discussed the different parts of the Medicare system in which eligible individuals may enroll. This installation will cover the eligibility rules and outline the process of applying for Medicare. There are many resources for seniors related to the initial enrollment process – including the Social Security Administration (SSA), the Medicare website, and your local individual health insurance agents at the Bailey Group.
Are you eligible for Medicare?
Most American citizens aged 65 or older are eligible for Medicare coverage. The criteria for eligibility is outlined by the SSA and in general, if you are eligible to receive Social Security benefits, you are also eligible for free Part A insurance and other premium-based Medicare benefits. There are additional eligibility rules for people under age 65 with specific qualifying conditions (including disabilities like permanent kidney failure or ALS).
If you believe you are eligible – based on either your age (approaching 65) or a chronic condition, you may use the Eligibility and Premium Calculator on the Medicare website or contact your current health insurance agent or provider. The remainder of this guide will pertain largely to those who are approaching or are newly aged 65 – so whether you have turned or are soon to turn 65 – here is a small, but helpful, birthday gift to you!
How do you apply for Medicare?
The most efficient way to apply is to enroll yourself online with the Social Security Administration’s Apply for Benefits tool.
Initial enrollment for free Medicare Part A hospital insurance occurs on a rolling basis. Ideally, you should begin the application process three months prior to your 65th birthday for coverage to begin on the first day of your month of birth. For example: Tom contacted the SSA just after the January 1, 2014, and his Medicare coverage will begin on his birthday, March 1, 2014. It is important to note that you can sign up for Medicare even if you do not plan to retire at age 65.
Anyone who is either eligible for or currently enrolled in Medicare Part A has the annual opportunity to change the voluntary portions (Parts B-D) of their plan. The federal government, as well as supplemental insurance providers, understand that individual health is variable and thus, that your coverage needs may change. There are various enrollment periods that happen each year; however the most important for current Medicare subscribers is the Medicare Open Enrollment Period that occurs between October 15 and December 7, for changes to take place on January 1st of the next year.
Even if you do not want to make changes to your plan, it is important to check in with Medicare to maintain your status as satisfied. Enrollment periods for Parts C and D of Medicare vary more than does enrollment for Parts A and B, or Original Medicare. The Department of Health and Human Services has issued a guide for those interested in also enrolling in Parts C and/or D.
- Social Security Administration website
- Medicare website
- Medicare’s “Medicare and You” publication (free download)
- Contact Medicare directly via phone or mail
- Contact an individual health agent at the Bailey Group
Hannah Ferris was a past intern at the Bailey Group. Her interests in social policy and public health yield unique insights into health care reform. Ferris entered the MSc Social Policy and Development program at the London School of Economics in 2014. She loves traveling, fashion, and writing her own personal blog, "Hannah's Happenings."