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Am I eligible for Medicare?

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If you are turning 65 or at the age of retirement, the thought of applying for Medicare can seem overwhelming, especially with certain misconceptions out there that raise the question of what exactly makes you eligible to apply.

Here’s how to know if you’re eligible:

Age matters!

If you retire at 62 or earlier, this does not make you eligible for Medicare. Once you retire, chances are that whatever health insurance or benefits you had with your previous company will end. You can still collect Social Security benefits starting at age 62, but don’t expect anything from Medicare just yet unless you have been drawing Social Security disability benefits for 24 months, have Lou Gehrig’s Disease (ALS), or End-Stage Renal Disease. Otherwise, you’ll have to wait until you’re 65 before you begin enrolling for Medicare plans. However, you are eligible to apply for Medicare three months before you turn 65.

Now that you know age plays an important role in your eligibility, let’s discuss some other factors that determine when you can begin applying for Medicare.

Am I eligible for Medicare Part A?

Being eligible for Medicare Part A is actually quite simple because most people are already eligible at age 65. You also have to be a citizen of the United States, or at least be a legal permanent resident for five years. 

Am I eligible for Medicare Part B?

With Medicare Part B, you will already be eligible and should be enrolled automatically if you are receiving Social Security benefits so there’s no need to enroll. However, you will have to enroll yourself if you don’t receive Social Security. If you receive your Medicare card in the mail, you can see if you are enrolled in Medicare Part A and B. If you don’t receive your card, or if you receive it and just have Part A, you will need to go online to ssa.gov to sign up or call your local social security office.

Am I eligible for Medicare Part C?

As long as you are enrolled in both Medicare Parts A and B, you’ll be eligible for Medicare Part C, known as the Medicare Advantage Plan. However, if you do happen to have End-Stage Renal Disease, you will not be eligible for Part C unless you enroll during your initial enrollment period.

Am I eligible for Medicare Part D?

If you are enrolled in either Medicare Part A or Part B, you are eligible for Medicare Part D. Typically you must enroll yourself in a plan, but if you have Medicare and Medicaid and don’t enroll yourself,  you’ll be automatically enrolled in Part D. Each plan has a list with certain drugs called a formulary. If the drug you are needing is not on the list, you can choose to pay out-of-pocket, make a request for that drug, or file an appeal. However, each plan must have at least two drugs in each therapeutic category and must cover these drugs:

  • HIV/AIDS treatment
  • Antidepressants
  • Antipsychotic medications
  • Anticonvulsive treatments for seizure disorders
  • Immunosuppressants
  • Anticancer drugs (unless covered by Part B)
  • Most vaccines (unless covered by Part B)

Questions or concerns?

One big question that arises is if it’s necessary to sign up for Medicare. It’s not. If you’re already enrolled in Social Security benefits, you’ll automatically be enrolled into Medicare Part A once you are 65. If you have worked in the U.S. for 10 years or more, then Part A is usually free. 

At Bobby Brock Insurance, we offer Medicare help for free! If you have any other questions regarding your eligibility for Medicare, our well-trained and experienced agents are here to give you the answers you need. We can help you compare costs of plans, estimate your savings, and help you with the enrollment process, so give us a call at 877-877-5505.

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