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Medicare Eligibility

Medicare is a health insurance program run by the federal government which helps eligible persons with the costs associated with healthcare. Medicare consists four parts, Part A, B, C and D, and each part covers a separate area in the Medicare health care system. There are three main requirements you need to meet in order to qualify for Medicare benefits, they include the following:

  • You must have paid taxes into the Medicare system for at least 10 years (usually automatically deducted from your paycheck)
  • You must be 65 years or older
  • You have a disability or permanent kidney failure

Medicare Part A covers hospital insurance which aids with the costs associated with inpatient care in a hospital, a skilled nursing facility (following a hospital stay), some home health care and hospice care. Most eligible individuals do not have to pay a premium for Part A due to the following circumstances:

  • You receive or are eligible to receive Social Security benefits
  • You receive or are eligible to receive railroad retirement benefits
  • You contributed Medicare taxes when you were employed in a government job
  • You are the dependent parent of someone who worked long enough in a government job where Medicare taxes were paid

Medicare Part B covers medical insurance which helps pay for doctor visits, outpatient hospital care and other medical services which Part A does not cover. Any individual eligible for Part A can enroll in Part B by paying a monthly premium.

Medicare Part C is a Medicare Advantage plan, which incorporates several different plans in order to meet as many individuals needs as possible. You are eligible for Part C if you are currently enrolled in Medicare Part A and B. Due to the extra benefits Part C offers, most individuals have to pay a monthly premium. Typically, Part C plans have networks and you are required to use the doctors and hospitals that belong to the network of the specific plan you chose.

Medicare Part D pertains to prescription drug coverage. Medicare Part D assists individuals with the high costs of prescription medication. Anybody enrolled in a Medicare Part A, B or C is eligible for Part D coverage. Enrolling in a Medicare Part D program is voluntary so there is a monthly premium which is to be paid to the insurance provider.

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