Qualifying for Medicare is considered a major milestone, but there is some confusion around how qualifying for Medicare Part A and B works, and how plans are issued. In this blog, we’ll discuss what Medicare Part A and B cover, who qualifies for Medicare Part A and B, and who qualifies for automatic enrollment in Medicare. Show
What does Medicare Part A and B cover?There are four total parts of Medicare: Medicare Part A, Part B, Part C, and Part D. However, the two main parts of Medicare are Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). So what exactly does Medicare Part A and Part B cover? Medicare Part A covers:1
You can find more information on the circumstances in which Medicare Part A may be applied on Medicare.gov. Medicare Part B covers:2
You can find more information on the circumstances in which Medicare Part B may be applied on Medicare.gov. Who qualifies for Medicare Part A and B?With so many rules and regulations surrounding Medicare Part A and B, it can be difficult to understand who qualifies for Medicare Part A and Part B coverage. Generally, Medicare Part A and B are available for: people 65+, those under age-65 with disabilities, and those with End Stage Renal Disease. Let’s break that down. Who qualifies for Medicare Part A?Those who qualify for premium-free Medicare Part A must meet one of the following criteria:3
Those who do not qualify for premium-free Medicare Part A can purchase Medicare Part A if they meet the following criteria:4
Get a Medicare Supplement plan that allows you to choose your doctor.Our licensed agents can help you pick a plan based on your needs.Who qualifies for Medicare Part B?According to the Centers for Medicare & Medicaid Services, the “eligibility rules for Part B depend on whether a person is eligible for premium-free Part A or whether the individual has to pay a premium for Part A coverage.”5 Those with a premium-free Medicare Part A qualify for enrollment in Medicare Part B once they are entitled to Medicare Part A coverage. However, those who pay a premium for Medicare Part A must meet the following criteria in order to qualify for Medicare Part B:5
For more information on enrolling in Medicare Part A and Medicare Part B, please head to Medicare.gov or CMS.gov. Will I be enrolled in Medicare Part A and B automatically?Some people will be enrolled in Medicare automatically, however some won’t.6 Whether or not you qualify for automatic enrollment in Medicare is largely determined on whether or not you are already getting Social Security or Railroad Retirement Board benefits. However, there are other factors involved in determining if you qualify for automatic enrollment. Select which situation best applies to you to determine if your enrollment in Medicare Part A and B will be automatic.6
There are a number of ways one can qualify for Medicare Part A and B, and a series of factors that determine if you qualify for automatic enrollment in Medicare. For more information on Medicare Part A and B, qualifying for Medicare, and automatic enrollment, please head to Medicare.gov. * Some home health care may be covered
under Medicare part B. Sources
AD-1200 Are you automatically enrolled in Medicare?You get Part A automatically. If you want Part B, you need to sign up for it. If you don't sign up for Part B within 3 months of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.
How do I know if I'm enrolled in Medicare?You will know if you have Original Medicare or a Medicare Advantage plan by checking your enrollment status. Your enrollment status shows the name of your plan, what type of coverage you have, and how long you've had it. You can check your status online at www.mymedicare.gov or call Medicare at 1-800-633-4227.
Does everyone automatically get Medicare at 65?If you are receiving Social Security retirement benefits or Railroad Retirement benefits, you should be automatically enrolled in both Medicare Part A and Part B. If you are not receiving Social Security retirement benefits or Railroad Retirement benefits, you will need to actively enroll in Medicare.
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