Medicare Blog

how do you tell if you are eligible for medicare part a

by Lenore Casper Published 2 years ago Updated 1 year ago
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Generally, you’re eligible for Part A if you: Are 65 or older and you meet the citizenship and residency requirements. Get disability benefits from Social Security or the Railroad Retirement Board

Railroad Retirement Board

The U.S. Railroad Retirement Board is an independent agency in the executive branch of the United States government created in 1935 to administer a social insurance program providing retirement benefits to the country's railroad workers.

for at least 25 months. Get disability benefits because you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig

Lou Gehrig

Henry Louis Gehrig was an American professional baseball first baseman who played 17 seasons in Major League Baseball for the New York Yankees. Gehrig was renowned for his prowess as a hitter and for his durability, which earned him his nickname "The Iron Horse". He was an All-Star se…

’s disease).

If you're not sure if you have Part A or Part B, look on your red, white, and blue Medicare card. If you have Part A, “Hospital (Part A)” is printed on the lower left corner of your card. If you have Part B, “Medical (Part B)” is printed on the lower left corner of your card.

Full Answer

How can I find out if I am eligible for Medicare?

To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool. If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A.

What do I need to know about Medicare Part A?

In most cases, if you choose to buy Part A, you must also: Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. Pay monthly premiums for both Part A and Part B

Who is eligible for Medicare Part A?

Medicare Part A is free if you: Have at least 40 calendar quarters of work in any job where you paid Social Security taxes in the U.S. Are eligible for Railroad Retirement benefits.

When should I sign up for Medicare Parts A and B?

If you’re eligible for Medicare parts A and B when you turn 65 years old, initial enrollment consists of a 7-month period that includes: If you won’t be automatically enrolled in Medicare parts A and B when you turn age 65, you can sign up at any time during initial enrollment.

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Are you automatically enrolled into Medicare Part A?

Yes. If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. (Medicare is operated by the federal Centers for Medicare & Medicaid Services, but Social Security handles enrollment.)

Does everyone have Medicare Part A?

Most people get Part A for free, but some have to pay a premium for this coverage. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child.

Why do I not have Medicare Part A?

Medicare Part A is free if you: Have at least 40 calendar quarters of work in any job where you paid Social Security taxes in the U.S. Are eligible for Railroad Retirement benefits. Or, have a spouse that qualifies for premium-free Part A.

Does everyone get Medicare Part A for free?

coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called "premium-free Part A." Most people get premium-free Part A. The health care items or services covered under a health insurance plan.

What happens if you don't enroll in Medicare Part A at 65?

If you don't have to pay a Part A premium, you generally don't have to pay a Part A late enrollment penalty. The Part A penalty is 10% added to your monthly premium. You generally pay this extra amount for twice the number of years that you were eligible for Part A but not enrolled.

How much is Medicare Part A?

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $499 each month in 2022. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $499.

Is Medicare Part A & B free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

What is the difference between Medicare Part A and Part B?

If you're wondering what Medicare Part A covers and what Part B covers: Medicare Part A generally helps pay your costs as a hospital inpatient. Medicare Part B may help pay for doctor visits, preventive services, lab tests, medical equipment and supplies, and more.

Does Medicare Part A cover emergency room visits?

Medicare Part A is sometimes called “hospital insurance,” but it only covers the costs of an emergency room (ER) visit if you're admitted to the hospital to treat the illness or injury that brought you to the ER.

Is Medicare based on your income?

Medicare premiums are based on your modified adjusted gross income, or MAGI. That's your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS.

Do you automatically get Medicare with Social Security?

You automatically get Medicare because you're getting benefits from Social Security (or the Railroad Retirement Board). Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Does everyone automatically get Medicare?

Who is this for? Most people are automatically enrolled in Original Medicare when they turn 65 and get Social Security benefits.

What exactly is Medicare Part A?

Part A of the federal government’s Medicare program is commonly referred to as “hospital insurance,” and for good reason.

When exactly should I enroll in Part A?

Your first chance to enroll in Part A and Part B (commonly called “medical insurance”) of Original Medicare is a seven-month period surrounding you...

Is there a premium for Medicare Part A?

Who is eligible for free Medicare Part A ?

Is my spouse eligible for Medicare Part A?

Medicare eligibility and enrollment is an individual thing, so the rules regarding Medicare Part A spouse eligibility are the same for both people....

How much is the Part A monthly premium?

If you have Medicare Part A eligibility but haven’t paid Medicare taxes through an employer for at least 10 years (40 quarters), the monthly premiu...

How much is the Part A late enrollment penalty?

If you have to pay a Part A monthly premium because of your work history and you don’t have a reason for delaying enrollment in Part A that creates...

Is it possible to be eligible for Part A before age 65?

There are a few specific situations where you have Medicare Part A eligibility regardless of age: If you have collected Social Security disability...

Key Takeaways

Eligibility for Medicare Part A, commonly referred to as hospital insurance, typically begins at age 65 for U.S. citizens.

Medicare Part A Eligibility and Initial Enrollment

For most people, the trigger for Medicare Part A eligibility is simple: When you turn 65 years old, you become eligible.

Part A General Enrollment

If you have Medicare Part A eligibility but don’t enroll within six months of your 65th birthday, there are options for enrolling late. The options vary based on whether you’re among the majority of people who don’t have to pay a Part A monthly premium, or if you’re in the minority that do.

Open Enrollment for Part A

Your eligibility for Part A isn’t limited to when you first sign up for Medicare. If you switch from Original Medicare to a Medicare Advantage plan, you may want to go back to Original Medicare at some point. Medicare’s Open Enrollment Period (sometimes called the Annual Enrollment Period) is one of your chances to do so.

Medicare Advantage Open Enrollment

This enrollment window gives Medicare Advantage beneficiaries another chance to make changes to their coverage. Medicare Advantage beneficiaries can switch to another Part C plan or drop their Medicare Advantage plan and re-enroll in Original Medicare from January 1 to March 31 (the same dates as the General Enrollment Period).

What are the eligibility requirements for Medicare Part A?

Medicare Part A eligibility requirements. To meet the basic eligibility requirements, you must be a citizen or permanent resident of the United States and also be one of the following: To receive coverage under Part A, you must be admitted as an inpatient at the hospital or other treatment center.

What is Medicare Part A?

Medicare Part A is hospital insurance and is part of original Medicare. Generally speaking, you’re eligible for Part A if you’re age 65 or older, have a disability, or have ESRD or ALS.

What is covered under Part A?

To receive coverage under Part A, you must be admitted as an inpatient at the hospital or other treatment center. If you’re not formally admitted as an inpatient, the services received will be considered outpatient care, which is covered under Part B.

How old do you have to be to get a Part A?

Typically, many people who enroll in Part A are age 65 and older. However, some specific groups of people younger than 65 years old may also be eligible for Part A. These groups include people with:

What happens if you don't buy Part A?

In this case, your monthly premium can go up by 10 percent. You’ll be subject to this higher premium for double the amount of years that you were eligible but didn’t enroll.

How long do you have to be on Social Security to receive RRB?

You’re less than 65 years old and have a disability. You’ll be automatically enrolled after receiving Social Security or RRB disability benefits for 24 months. You have ALS. You’ll be automatically enrolled the month that you’re eligible to receive Social Security or RRB disability benefits.

When is Medicare open enrollment?

Open enrollment: October 15 to December 7. During the annual open enrollment period, anyone with Medicare parts A and B can change to a Part C plan or add, switch, or remove a Part D plan. New coverage will begin on January 1.

What does Medicare Part A cover?

Medicare Part A will cover the inpatient hospital care portion of your healthcare. But how do you know if you qualify for Medicare?

When will Medicare be mailed?

Your Medicare card will be mailed to you three months before your 65th birthday or on your 25th month of disability. If you aren’t getting benefits from Social Security (or the RRB) at least four months before you turn 65, you'll need to sign up with Social Security directly. 2.

What age do you have to be to get Medicare?

Understanding Medicare Part A Eligibility. You're 65 and already receive benefits from Social Security. You’re 65 and already receive benefits from the Railroad Retirement Board (RRB). You're under 65 , have a disability, and are receiving disability benefits.

Is ALS considered a Medicare Part A?

If any of the above Medicare Part A eligibility qualifications apply to you, then you’re considered Medicare eligible.

Is Medicare Part A part of Original Medicare?

Medicare Part A is automatically included when you are enrolled in or sign up for Medicare. Medicare Part A is only one component of Original Medicare. Part B, also known as medical insurance, is the other half of Original Medicare.

Do you have to pay Medicare premiums if you have worked?

You do not pay a premium for Medicare Part A if you have worked and paid Medicare taxes for at least 10 years, or 40 employment quarters. 3.

What age do you have to be to qualify for Medicare Part A?

Medicare Part A is the part that covers hospital treatment. People qualify once they reach 65 years of age. Those with end stage renal disease or Lou Gehrig’s disease may be eligible before this age.

When does Medicare Part A start?

Once a person has signed up for Medicare Part A, their coverage will usually begin in the month that they turn 65. However, this may not always be the case, depending on when a person signed up for Medicare. For example, a person might not sign up until after their birth month.

How much does Medicare cost if you don't work for 40 quarters?

If a person has paid Medicare taxes for 30–39 quarters, they can pay a reduced premium for Medicare Part A, at $259 per month. If a person has paid the taxes for fewer than 30 quarters, they may need to pay a $471 monthly premium.

How old do you have to be to get Medicare?

A person must be 65 or older to qualify for Medicare Part A. Unless they meet other requirements, such as a qualifying disability, they cannot get Medicare Part A benefits before this age. Some people may be 65 but ineligible for premium-free Medicare Part A.

How to contact SSA about Medicare?

If a person has a question regarding their eligibility for Medicare Part A or other aspects of Medicare, they should contact the SSA at 1-800-772-1213 (TTY: 1-800-325-0778).

How long does it take to get Medicare for ALS?

Amyotrophic lateral sclerosis (ALS): Those with ALS, or Lou Gehrig’s disease, qualify for Medicare Part A. They often do not have to wait 24 months for eligibility. A person will usually automatically start receiving Medicare Part A in the same month that they receive their disability benefits from the SSA or RRB.

What are some examples of Medicare Part A services?

Examples of services that Medicare Part A may cover include: care when a person stays at a hospital for at least 2 midnights. home healthcare (must include medical care, not just general care, such as help with feeding or bathing) hospice care. skilled nursing facility care.

Medicare eligibility: Key takeaways

Generally, you’re eligible for Medicare Part A if you’re 65 and have been a U.S. resident for at least five years.

Am I eligible for Medicare Part A?

Generally, you’re eligible for Medicare Part A if you’re 65 years old and have been a legal resident of the U.S. for at least five years. In fact, the government will automatically enroll you in Medicare Part A at no cost when you reach 65 as long as you’re already collecting Social Security or Railroad Retirement benefits.

Am I eligible for Medicare Part B?

When you receive notification that you’re eligible for Medicare Part A, you’ll also be notified that you’re eligible for Part B coverage, which is optional and has a premium for all enrollees.

How do I become eligible for Medicare Advantage?

If you’re eligible for Medicare benefits, you have to choose how to receive them – either through the government-run Original Medicare program, or through Medicare Advantage.

When can I enroll in Medicare Part D?

To be eligible for Medicare Part D prescription drug coverage, you must have either Medicare Part A or Part B, or both. You can sign up for Medicare Part D at the same time that you enroll in Medicare Part A and B.

Who's eligible for Medigap?

If you’re enrolled in both Medicare Part A and Part B, and don’t have Medicare Advantage or Medicaid benefits, then you’re eligible to apply for a Medigap policy.

What is Medicare premium?

premium. The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage. for. Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

How much will Medicare premiums be in 2021?

People who buy Part A will pay a premium of either $259 or $471 each month in 2021 depending on how long they or their spouse worked and paid Medicare taxes. If you choose NOT to buy Part A, you can still buy Part B. In most cases, if you choose to buy Part A, you must also: Have. Medicare Part B (Medical Insurance)

What is covered benefits and excluded services?

Covered benefits and excluded services are defined in the health insurance plan's coverage documents. from Social Security or the Railroad Retirement Board. You're eligible to get Social Security or Railroad benefits but haven't filed for them yet. You or your spouse had Medicare-covered government employment.

What does Part B cover?

In most cases, if you choose to buy Part A, you must also: Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. Contact Social Security for more information about the Part A premium. Learn how and when you can sign up for Part A. Find out what Part A covers.

What is premium free Part A?

Most people get premium-free Part A. You can get premium-free Part A at 65 if: The health care items or services covered under a health insurance plan. Covered benefits and excluded services are defined in the health insurance plan's coverage documents.

How many quarters of work do you need to get Medicare Part A?

Medicare Part A is free if you: Have at least 40 calendar quarters of work in any job where you paid Social Security taxes in the U.S. Are eligible for Railroad Retirement benefits. Or, have a spouse that qualifies for premium -free Part A.

What is QMB in Medicare?

If you or your spouse worked fewer than 30 quarters (7.5 years) If your income is low, you may be eligible for the Qualified Medicare Beneficiary (QMB) program, which pays for your Medicare Part A and B premiums and other Medicare costs.

Is Medicare Part A free?

Register. Medicare Part A is free if you: Have at least 40 calendar quarters of work in any job where you paid Social Security taxes in the U.S. Are eligible for Railroad Retirement benefits. Or, have a spouse that qualifies for premium -free Part A. [bsa_pro_ad_space id=3]

How Does Medicare Part A Work?

There are two main areas of eligibility for Medicare Part A. The first area deals with citizenship status. In order to enroll in Medicare Part A, you must be either a US citizen or a permanent legal resident. Permanent legal residents must have lived in the US for at least five consecutive years.

Enhancing Medicare Parts A and B

The gaps in Part A and B concern many people. To combat these out-of-pocket costs, people often supplement their Original Medicare coverage with private insurance.

Getting Help with Medicare Parts A and B

Medicare is a valuable benefit that lowers the cost of healthcare for millions of Americans, but an enrollee in this program still has the potential to rack up high out-of-pocket costs. In order to protect yourself, consider adding to supplemental coverage to Part A and B.

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