Medicare Enrollment and Eligibility.
At age 65, you need to make several critical life decisions. One of the most important is signing up for Medicare, a federal health-care program in the United States.
Enrolling in Medicare can be an extremely confusing process, but the experts at Sunnyside Medicare make it easy to navigate. Here’s what you need to know about Medicare enrollment and eligibility in Michigan.
Medicare Age Requirements for Enrollment
You become eligible for Medicare when you turn 65. The initial enrollment period opens three months before your 65th birthday and closes three months following your birthday month.
For example, say that you turn 65 on March 15. Your enrollment period will open on December 1 and will close at the end of June.
You can incur penalties if you do not enroll during this time, and your premiums may increase. Additionally, certain benefits are only available during the initial enrollment period.
Working with a qualified Medicare insurance agent can help you avoid penalties or critical lapses in coverage.
Additional Medicare Eligibility Requirements
To qualify for Medicare, you must be a US legal resident for five continuous years. You or your spouse must also pay Medicare taxes for at least 10 years.
While under the age of 65, you may receive coverage if you meet one of the following criteria:
- You have a disability and receive Social Security Disability Insurance (SSDI) benefits or Railroad Retirement disability benefits.
- You have end-stage renal disease and need a kidney transplant or receive continuing dialysis.
Keep in mind that if you currently receive Social Security payments, the government will automatically enroll you in Medicare.
Medicare Part A Eligibility
Part A Medicare covers care at hospitals, nursing facilities, hospices, and homes. There are two types: premium and premium-free.
To qualify for premium-free Part A, you must meet one of the following criteria:
- You are 65 or older and you or your spouse have paid Medicare taxes for at least 10 years.
- You are eligible for or receiving Social Security or Railroad Retirement benefits.
- You or a spouse had a Medicare-covered government job.
- You are a kidney dialysis or kidney transplant patient.
If you do not qualify, you could purchase Part A if you are 65 or older and are a legal US resident.
Medicare Part B Eligibility
Part B Medicare covers two types of health-care services:
- Medically necessary services, which are necessary to diagnose or treat a medical condition
- Preventive services, which detect and prevent illnesses at an early stage for the best treatment efficacy
If you are eligible for premium-free Part A, you may enroll in Part B. If you pay a premium, you must be 65 years or older and a legal US resident to qualify for Part B.
Medicare Part C Eligibility
Private health-care companies offer plans for Part C Medicare, or Medicare Advantage. You retain most of the benefits of Part A and Part B.
You qualify for Part C Medicare if you meet the following criteria:
- You are already enrolled in Medicare Parts A and B.
- You live in an area where an insurer offers a Medicare Advantage plan.
Medicare Part D Eligibility
Part D Medicare reduces the cost of generic and brand-name prescription drugs. You are eligible for Part D insurance if you are already enrolled in Medicare.
Medicare Eligibility with Disability
If you have a disability, you may qualify for Medicare before turning 65. To be eligible, you must have received SSDI or Railroad Retirement disability benefits for at least 24 months. If you have amyotrophic lateral sclerosis (ALS) or end-stage renal disease, you could sign up for Medicare sooner.
Medicare Eligibility for Green Card Holders
As a green card holder, you are eligible for Medicare benefits if you have legally lived in the US for at least five continuous years. Additionally, you or your spouse must have worked in the US and paid Medicare taxes for at least 10 years, or 40 quarters.
Medicare Home Health-Care Eligibility
Part A and Part B Medicare cover home health-care services, such as nursing care and medical social services.
You are eligible if you have Part A or Part B coverage and meet the following conditions:
- You are under a doctor’s care and following their treatment plan.
- You require, and your doctor certifies that you require, physical therapy, occupational therapy, speech-language pathology, or intermittent skilled nursing care.
- Your doctor certifies that you are homebound.
Medicare Hospice Eligibility
Part A Medicare covers critical services like hospice, nursing care, and hospital stays.
You may qualify for hospice if you have Part A coverage and meet the following requirements:
- Your hospice doctor certifies that you have a terminal illness with a life expectancy of six months or less.
- You are receiving palliative care rather than Medicare-covered treatment for your illness.
- You sign a statement choosing hospice care.
Frequently Asked Questions about Medicare
When Am I Eligible for Medicare Coverage?
Generally, you must be 65 years or older to qualify for Medicare. If you have a disability or a certain medical condition, you may be eligible at a younger age.
How Do I Calculate Medicare Payments?
Your Medicare costs will depend on several factors, such as the types of plans you have and whether you qualify for premium-free coverage. An insurance agent from Sunnyside Medicare can calculate your estimated premium.
How Old Do You Have to Be to Draw Medicare?
The initial enrollment period for Medicare starts three months before your 65th birthday. The enrollment period ends three months after your birthday month.
How Can I Estimate My Medicare Costs?
To estimate your Medicare costs, you will need to assess the following:
- Your premiums
- Your prescription drug coverage
- Your marital status
- Your tax filing status
- Whether you worked in a Medicare-taxable job
- Whether you receive any group health benefits
What Qualifies a Person for Medicare?
To qualify for Medicare, you must meet the following criteria:
- You are 65 years or older.
- You or your spouse has paid Medicare taxes for a minimum of 10 years.
- You are a legal US resident for five years.
If you are under 65, you may qualify if you have end-stage renal disease or have a disability and receive SSDI benefits.
What Is the Difference between Medicare and Medicaid?
Medicare is for seniors and people with disabilities. Medicaid is for low-income individuals.
If you want to learn more about Medicaid in Michigan, check out these eligibility guidelines from the Michigan Department of Health and Human Services.
The Medicare landscape is difficult to navigate by yourself—so don’t go through it alone. Call Sunnyside Medicare for personalized care, a dedicated agent, and advice from experts in the field.
At Sunnyside Medicare, we’re experts you can trust for the same price as any agent, no matter where you are. You might as well choose the best.
Other Medicare FAQs
Our Medicare FAQs below help answer many common questions. If you still have questions or don’t see the answer you’re looking for? No problem! Contact us today and a Sunnyside Agent will get you the information you need!
- Why work with Sunnyside to get Medicare?
- What is Medicare?
- What does Medicare cover?
- What does Medicare cost?
- How and when do I enroll in Medicare?
- What are Medicare penalties for late enrollment?
- What is a Medicare Advantage Plan?
- What is a Medicare Supplement Plan?
- What is a Prescription Drug Plan?
- What is a Medicare Ancillary product?
- How are Medicare agents paid?
Looking for a Helping Hand?
Call us at 1-248-277-5948 to talk with a Sunnyside Agent. Our licensed Medicare Agents are friendly, knowledgeable and always willing to take the time to find the right plan for you! Not ready to talk on the phone? Send us an online message and an Agent will get back to you shortly. We look forward to helping you.