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What you need to know before signing up for Medicare

Medicare | Apr 06, 2017

As of 2015, 55 million Americans were signed up for Medicare, according to the Centers for Medicare and Medicaid Services. This health insurance program has certain requirements that people must meet prior to their enrollment. Let's take a closer look at the eligibility obligations needed to sign up for Medicare:

To apply for Social Security benefits, of which Medicare is a part, individuals need to present certain forms. The Social Security Administration often requires the following:

  • Social Security card, or record of a person's number.
  • Original birth certificate or other proof of birth.
  • Proof of U.S. citizenship or lawful alien status.
  • Copy of U.S. military service papers, such as Certificate of Release or Discharge from Active Duty, if person participated before 1968.
  • Copy of W-2 forms or self-employment tax return for previous year.

Seniors can qualify for Medicare once they reach the age of 65. While this is the most common way to become eligible for the program, there are other options. People under the age of 65 who are receiving Social Security Disability Insurance (SSDI) or those who have end-stage renal disease - also known as kidney failure - or ALS can also gain access to the benefit.

Understanding Medicare's various parts
Medicare has four different components people should be aware of when signing up for coverage. They are broken down as the following:

  1. Part A (hospital insurance): This helps people pay for inpatient care in a skilled nursing facility or hospital. It can also pay for some hospice and home health care.
  2. Part B (medical insurance): This sector pays for services from doctors and other healthcare providers whether in an outpatient setting or via home health care, preventative services or the need for durable medical equipment.
  3. Part C (Medicare Advantage plans): Seniors with Medicare Parts A and B can choose to receive all health care services through a private insurance company approved by Medicare to provide this coverage.
  4. Part D (Medicare prescription drug coverage): This segment helps cover the costs associated with prescription drugs.

Those covered under Medicare Part A - which is usually automatic if people are enrolled in Social Security and is free if seniors are paying taxes -  can sign up for Part B and will be asked to pay a monthly premium. With both of these types of coverage, seniors are then eligible for Parts C and D. People have the ability to opt out of Part B benefits, if they so choose.

"People may be eligible depending on their spouse's status."

Spousal factor
People are able to enroll in Part A coverage at the age of 65 if their spouse - living, deceased or divorced - receives or is eligible to receive Social Security benefits. Additionally, if this partner worked long enough in a government job through which he or she paid Medicare taxes, seniors are also entitled to Medicare.

The timeline
The CMS recommended that people wanting to enroll in Medicare do so three months or more before their 65th birthday. As a result, the agency can then distribute the necessary credentials - in the form of a card - as quickly as possible.

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