Age 65 or Older

Age 65 or older, a U.S. citizen, or a permanent legal resident who has lived in the U.S. for at least five years, you will be eligible to receive Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Younger Than Age 65 For those below age 65, you must meet at least one of the following: 0btaining Social Security disability benefits for at least 24 months in a row. With Lou Gehrig's disease (amyotrophic lateral sclerosis). With an end-stage renal disease (ESRD). For Premium-Free Medicare Part A When you meet any one of these conditions, then there will be no need for payment: You or your spouse worked for at least 40 quarters or ten years while paying Medicare Taxes. You or your spouse have Medicare-covered government employment. A retiree paid for Medicare payroll taxes while working but without payment for Social Security.

Medicare and Medicaid are two of the most important government programs in America. The programs are designed for different sets of people. However, it is possible to be eligible in both and have a more substantial chance of getting approved if you're applying under the right circumstances.

Medicare coverage has certain limits and exclusions, which means that there are some items or services that are not covered under Medicare Part A & B. If you need these services, you will have to pay for them out of pocket unless you have additional coverage such as Medicaid or a Medicare Advantage Plan that covers them. Some examples of items and services that are not covered by Part A and B are:

·         Long-term care

·         Most dental care

·         Eye exams for prescription glasses

·         Dentures

·         Cosmetic surgery

·         Massage therapy

·         Concierge care items or services received from an opt-out doctor or provider, unless it is an emergency or urgent need. It is also worth noting that some Medicare Advantage plans may cover some additional services such as vision, hearing, and dental services.  

Hospital Coverage (Part A) Medicare Part A is the part of the original Medicare that covers your hospital costs and other inpatient care. Most people do not pay a monthly premium for Part A because they paid into the program through taxes during their working years. Medical Coverage (Part B) Medicare Part B is the part of original Medicare that covers the costs of your outpatient care. You'll pay a monthly premium for this coverage based on your income level. Medicare Advantage Plans Medicare Advantage is a type of private insurance contracted through Medicare. It provides the same coverage as parts A and B of Medicare, plus extra services. The government pays a set amount each month to the provider, which helps to contribute to your overall coverage. Prescription Drug Coverage While all prescription medication coverage plans must offer a standard coverage set by Medicare, different plans can choose which medications they list in their drug lists or formularies. It is important to remember that the plans must cover all medically necessary drugs.

You have three opportunities during which you can make changes to your Medicare coverage, they are: Initial Enrollment Period: when you first become eligible for Medicare. Annual Enrollment Period: between October 15 - December 7th of each year Medicare Advantage Open Enrollment Period: between January 1st - March 31st of each year, during this time if you're enrolled in a Medicare Advantage Plan you can switch to another Medicare Advantage Plan or switch to Original Medicare. Note that you can only switch plans once during this period.