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Who Qualifies for Medicare A - D?

With the rise of health care costs and the demand for such services, people are seeking ways to save on costs while securing the health care coverage suitable for them. Because of this concern, the government took the initiative to provide extensive health care coverage for the people.

With the collaboration of private companies, the public is now provided with more choices. People can now receive health care coverage known as Medicare and they can select the ideal plan for them — Part A, B, C, D, or a combination of these plans — to make sure they can have the best health care service possible.

Part A is also known as the Original Medicare Part. Part A covers most of the services on health care as well as some drugs. Almost every hospital in the United States accepts Medicare. Consumers are automatically enrolled in this type of plan once they sign up for Medicare. According to Medicare, if you are eligible to receive retirement through Social Security, you will be automatically signed up for Medicare Part A. This plan covers hospital insurance which is free from premium costs and provides more convenience for the plan holder. The hospitalization coverage includes inpatient care; receive treatment in a nursing facility care; limited home health care; and hospice care. However, these services can be maximized provided you meet certain requirements by Medicare. While a plan holder can do away with premium costs, Medicare said there is the disadvantage of paying for costs not covered by Part A, such as co-insurance, co-payments, and deductions. These are called "gaps" which are covered by a Medigap policy that the plan holder might want to look into. Requisites for eligibility under Part A (without the need of premiums) are seen below.

For Ages 65 and above

  • You or your spouse have been employed for a minimum of ten years in an employment covered by Medicare.
  • A bona fide citizen of the United States
  • You have begun to receive your retirement benefits from Social Security or the Railroad Retirement Board
  • You have been receiving your retirement benefits from Social Security or Railroad Retirement Board for at least two years.
  • You either have a disability or are suffering from End-Stage Renal disease subject to additional requirements by Medicare.

Based on Medicare information, you are automatically signed up for Parts A and B if you are already eligible to receive your retirement benefits from Social Security. Part B covers essential medical services such as doctor's services, blood, and outpatient treatment among others. This plan also includes a one-time physical exam during the first twelve months of your coverage. If you were enrolled in Part B in 2008, you are required to pay only 20% of the approved amount by Medicare and without deductibles. This Part also includes other preventive services which can be seen in the handbook given to plan holders upon enrollment.

However, unlike Part A, Part B has premium costs for medical insurance coverage. It is your choice as a plan holder if you want to retain your Part B coverage. The date the enrollment becomes effective under this plan can be seen on the front of your Medicare card. A plan holder who opts to forego this plan must inform Medicare before the effective date. Eligibility for Part B is the same with Part A with the added requirement that you pay a premium of $96.40 per month. The amount may increase depending on your income.

Category: Insurance

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