Medicare Eligibility and Enrollment
Medicare Eligibility and Enrollment
Medicare: Am I Eligible? AARP's Medicare Question and Answer Tool works as an online planning resource, designed to assist those who are eligible for Medicare benefits as well as those who are unsure. The Medicare Q and A Tool acts also as a guide, explaining in plain English eligibility, how to enroll, when to enroll and how to choose the best plan for you. AARP's Medicare Question and Answer Tool is a starting point toward an informed decision about your Medicare coverage and your eligibility. Eligibility
Q: A: You can qualify for Medicare on the basis of either age or disability.— Q: A: No. You must wait until you are 65 to become eligible for Medicare, unless you’re younger and qualify because of disability. — Q: A: No. There is no family coverage in Medicare. — Q: A: Your wife must wait until she is 65 to qualify for Medicare. Only people who receive Social Security disability benefits are eligible for Medicare at an earlier age. — Q: A: No. In most cases you must have been receiving Social Security disability benefits for two years before Medicare coverage begins. But there are two exceptions. — Q: A: Yes, you may qualify for Medicare at any age if you have permanent kidney failure that requires regular dialysis or a kidney transplant, and if you meet certain conditions. — Q: A: The best time to buy Medigap insurance depends on your age, where you live, and when you qualify for protections provided under federal or state law. — Q: A: Yes, if you are 65 or older and buy a policy during defined periods when you receive protections known as “guaranteed issue” under federal law. But if you are under 65 and qualify for Medicare through disability, it depends on whether your state provides similar protections. — Q: A: No. Medicare doesn’t cover medical care outside the United States, except for very limited situations along the Canadian and Mexican borders. If you’re living overseas when you become eligible for Medicare, it’s important to understand your options for enrollment. — Q: A: Medicare doesn’t pay for medical services outside the United States and its territories except in rare circumstances, but certain types of additional insurance may pay in emergencies.— Q: A: Yes — provided that you meet the conditions for Medicare eligibility.— Initial Enrollment
Q: A: First you must select a Part D drug plan out of many available in your state. Then there are several options for the process of signing up.— Q: A: Medicare assigns a quality rating to each plan, based on its customer service and other measures, to help beneficiaries choose a plan. — Q: A: You need to enroll directly with the plan, during a designated enrollment period.— Q: A: You can join a Part D prescription drug plan, or switch to another, during a designated enrollment period.— Q: A: You may not need Part D if you have “creditable” drug coverage from elsewhere. But otherwise, the only way Medicare will help pay for your prescription drugs is if you join a stand-alone Part D drug plan. — Q: A: No, Part D is a voluntary benefit. But if you don’t enroll in a Part D drug plan when you’re first eligible — and if you don’t have comparable drug coverage from elsewhere — you risk delayed coverage and permanent late penalties if you want to join at a later date. — Q: A: You should seriously consider enrolling in a Part D prescription drug plan, if you don’t have comparable drug coverage from elsewhere, to protect yourself against possible high drug costs in the future. — Open Enrollment
Q: A: Medicare’s open enrollment period runs from Oct. 15 to Dec. 7 each year. It gives people who are already enrolled in Medicare the opportunity to review their current coverage and, if they want, switch to a different plan for the following year. — Q: A: Yes, you can make this change during the open enrollment period or during the annual “disenrollment period” that soon follows it. — Q: A: If your Medicare Advantage plan ceases coverage, you can transfer to another Medicare Advantage plan of your choice or return to coverage provided under the original Medicare program. — Q: A: Yes, you can switch plans, but only at certain times, according to your circumstances. — Q: A: If you’re happy with your current coverage, you don’t need to do anything during open enrollment. But it’s still worth considering the alternatives to ensure that you continue to get your best deal.— Q: A: If you switch to a different Medicare plan during open enrollment (Oct. 15 to Dec. 7 each year), coverage begins on Jan. 1. — Q: A: If you drop your Part D coverage without having comparable drug coverage from elsewhere, you will pay late penalties when you reenroll in Part D. — Q: A: You always get one opportunity each year to change from one Part D drug plan to another during open enrollment, but you may be able to change at other times of the year in certain circumstances. — Q: A: You cannot use Medigap insurance in a Medicare Advantage plan. — Q: A: No. Medicare’s open enrollment period (which runs from Oct. 15 to Dec. 7) does not apply to Medigap supplemental insurance. — Q: A: No. If you’re happy with your plan, you don’t need to reenroll. But you should check whether the plan’s costs and coverage will change for the coming year. — Special Enrollment
Q: A: Yes, you can still sign up for Medicare after turning 65, but exactly when you can do so depends on your circumstances. — Q: A: Probably not, if you have health insurance from your own or your spouse’s employer. But it may also depend on whether the employer has at least 20 employees or fewer than 20.— Q: A: You can delay Part B without risking late penalties only in two situations: if you have health care coverage through active employment, or if you’ve been living abroad and are not entitled to Part A benefits without paying premiums for them. — Q: A: To avoid late penalties, you need to enroll in a Part D prescription drug plan within two months after losing creditable drug coverage from elsewhere.— Q: A: If you move out of your drug plan’s service area partway through the year, you get a special enrollment period to sign up with another plan in your new location. You need not — and should not — wait for open enrollment.— Late Enrollment
Q: A: If you delayed Part B enrollment because you were covered by health insurance provided by an employer for which you or your spouse actively works, there are no adverse consequences — provided that you sign up for Part B within eight months of the job ending. Otherwise, you will likely face a prolonged gap in coverage and be liable for late penalties. — Q: A: To avoid late penalties, you need to enroll in a Part D prescription drug plan within two months after losing creditable drug coverage from elsewhere.— Q: A: In most situations, you are liable for late penalties if you go for more than 63 days without Part D coverage or comparable drug coverage from elsewhere. The penalties are waived in some circumstances.— Penalties
Q: A: The vast majority of Medicare beneficiaries do not pay premiums for Part A, so they cannot be liable for late penalties. But those who pay premiums for Part A are liable for penalties if they miss their enrollment deadline.— Q: A: You will likely face permanent late penalties if you miss your deadline for enrolling in Part B. How much you’d pay each month depends on how long you delayed enrollment and the amount of the standard Part B premium in any given year.— Q: A: In most situations, you are liable for late penalties if you go for more than 63 days without Part D coverage or comparable drug coverage from elsewhere. The penalties are waived in some circumstances. Today' s Topics
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