Medicare Coverage

Medicare Coverage

When you understand your Medicare benefits you have more control, more power and more confidence in your coverage.

Medicare Benefits are provided into 4 parts; each part covers different healthcare services.

Original Medicare benefits include both Parts A and B. Optional Parts include Parts C and D.

Medicare Part A covers inpatient hospital visits, certain skilled nursing facilities, hospice care, and certain home health care. For most, Part A is free.

Part B covers doctors’ visits, outpatient services, and other services. A monthly premium is typically required for Part B coverage; premium values are generally income-based.

Medicare Part D covers drugs and if you don’t have prescription drug coverage when you’re first eligible, you could incur a Part D penalty.



Medicare Explanation of Coverage & Benefits for 2019

Turing 65 means Medicare benefits eligibility. If you’ve been receiving Social Security Disability Insurance for over 24 months, you may be Medicare-eligible before 65.

This period will begin the first month you receive a check; also known as the two-year waiting period. At the beginning of the 25th month, you’ll automatically be enrolled in Medicare.


Who Qualifies for Medicare Coverage

Generally, the Medicare benefits age is 65 and older. Although, people who are younger with disabilities, or have End-Stage Renal Disease can get benefits through Medicare.


When Do Medicare Benefits Start

The Medicare benefits age is 65. The Initial Enrollment Period will include the 3 months prior, the month of your birthday, and the 3 months following.

If you don’t enroll in Medicare Part B during your Initial Enrollment Period, it’s okay.

You’ll have one more opportunity to sign up during the General Enrollment Period. This takes place from January 1st through March 31st.

You may ask, when do Medicare benefits start? They’ll begin July 1st of the same year you enroll.


Medicare Benefits Schedule

The Medicare benefits schedule is when you can expect your benefits to begin. These dates are important, so mark them down in your calendar.

October 15th – December 7th is the Annual Election Period. This period allows you to change your Medicare health or prescription drug coverage for the upcoming year.

Additionally, this period allows you to return to Original Medicare or join a Medicare Advantage Plan. January 1st is when new coverage will start if you made changes.

January 1st – March 31st is the Open Enrollment Period for those enrolled in an annually changing policy. This is your second opportunity to change plans; however, you can only make one change during this enrollment period.

If you make any changes to your plan, changes will be effective the 1st of the following month.


Requirements for Medicare Benefits

Certain requirements for Medicare benefits must be met before coverage will begin.

Requirements include if you or your spouse: 

  • Are a U.S. citizen or permanent legal resident who’s lived in the United States for a minimum of 5 years
  • Worked long enough (40 credits from about 10 years of working) to receive Social Security or Railroad Retirement benefits
  • Are an employee of the government
  • Or retiree who’s not paid into Social Security but paid Medicare payroll taxes while working

Although, you may still qualify for Medicare benefits if you’re under 65.


Medicare requirements for those under 65 include:

  • Entitled to Social Security benefits for a total of 24 months
  • Currently receiving a disability pension from the Railroad Retirement Board
  • Diagnosed with Lou Gehrig’s disease (which would qualify you immediately)
  • Permanent kidney failure that requires regular dialysis treatment (or had a kidney transplant)
  • Or your spouse paid Social Security taxes for a certain period (depending on your age)


Which of the following criteria would not make a person eligible to receive Medicare benefits?

Having a terminal illness is one of the only reasons a person wouldn’t be eligible to receive Medicare benefits; this is providing all other requirements for eligibility have been met.


Are Medicare benefits taxable?

If you have a Health Savings Account (HSA), you may no longer add to your HSA once Medicare begins.

When you contribute to your HSA after your Medicare coverage begins, you might be hit with a tax penalty.

If you’re asking, “are Medicare benefits taxable”? The answer, no.

In detail, Medicare enrollees don’t need to include benefits received as reimbursement from Medicare on annual income tax returns.


Can you lose Medicare benefits?

You may be wondering if you can lose Medicare benefits if you don’t make your premium payments? Well, yes, it’s possible.

Should you find yourself unable to make your monthly premium payments, you’ll get warning letters in the mail.

First, receive a notice after your usual payment. then, a Second Notice. Finally, a Delinquent Notice that is intended to encourage you to make a payment.

The Second Notice is a reminder that provides a due date for payment.

The Delinquent Notice is mailed out after your initial deadline has passed.

When this notice is received, you have until the 25th of the month to make your payment.

If you don’t make this payment, Medicare coverage will be terminated.

You can lose your Medicare benefits if you were previously disabled, and now you no longer have a medical disability.


Apply for Medicare benefits

Even if you’re not quite ready for retirement, you may still apply for Medicare.

If you’re wondering how to apply for Medicare benefits you can simply apply online here. Applications take less than 10 minutes to complete online and there will be no further forms required.

When applying for Medicare, you may sign up for Part A and B.

There is no requirement to enroll in Part B. However, Part B requires a premium. Although, if you later decide to enroll, you could face a Part B late-enrollment penalty.

Monthly premiums will increase 10% for every 12-month period you were eligible but didn’t sign up for Part B. The only exception is if you qualify for a Special Enrollment Period.


We’re here for you!

Following the effectiveness of coverage under Medicare Part B, we encourage you to further enroll yourself in a Medigap plan. Medigap plans help cover additional out-of-pocket costs.

For more information on Medigap Plans contact one of our qualified Medicare agents and get the healthcare coverage you need. You can reach a Medicare expert at the number above or by filling out our online rate form.