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Medicare Eligibility

Anyone who is at least 65 years old and have contributed to Medicare through their payroll taxes for at least 40 quarters, or 10 years, is able to receive benefits through Original Medicare, also known as Part A, B, and Part D. Also, people under 65 years old who have been on Social Security Disability for at least 2 years are also eligible for Medicare benefits.

Part A

  • Covers hospitalization and other services such as skilled nursing care and home health services.

  • You do not pay a premium for Part A as long as you contributed to Medicare through payroll taxes for at least 10 years.

  • Members have a $1,288 deductible for each benefit period (Not yearly deductible so it could be more than $1,288 per year)

  • $322 copay per day at the hospital between day 61-90 for each benefit period.

Part B

  • Covers most doctor services such as preventive care, hospital outpatient services, diagnostic tests, mental health, and durable medical equipment.

  • in 2016, most people pay $104.90 each month for Part B coverage.

  • Members have a $166 deductible per year and 20% coinsurance after the deductible is met.


Part D

  • Provides prescription drug coverage.

  • It is optional and can be obtained through private insurance companies who contract with Medicare to offer plans.

  • Premiums for Prescription Drug Plans (PDP) can vary widely.



How To Enroll in Medicare

Anyone receiving social security benefits prior to turning 65 will be automatically enrolled in Medicare Part A and Part B. A Medicare card is usually mailed to the member three months prior to the birthday month.

Coverage begins the first day of the birthday month. However, if you are born on the first of the month, the coverage will start the first day of the prior month.

Anyone not receiving social security benefits prior to turning 65 must enroll in Medicare directly by visiting the nearest social security office or online at

Seniors who continue working and have insurance through their employer have the option to delay enrollment in Part B until they retire and need it.

What Should I Know?

Seniors who decide not to enroll in Medicare Part B or Part D when eligible will pay higher premiums due to a late enrollment penalty. Part B and Part D premiums may go up 10% and 12% respectively for each full 12-month period that they could have had it.

Once you are enrolled in Medicare Part A and Part B, you have the option to enroll in a Medicare Advantage plan (Part C) or purchase a Medicare Supplement plan. Depending on the plan, there are different things to know before signing up for one of these plans. Click below to learn more.

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