The healthcare industry is experiencing harsh realities due to the COVID-19 pandemic. Vulnerable people all over the world are living in fear. Retired people especially are afraid because they incur many medical expenses as age catches up with them. Having a Medicare plan is a guarantee for affordable healthcare for seniors. They also come in handy for people living with disabilities. Medicare eligibility differs in different parts of the world, but the rules are very similar.
The Medicare program runs under centers for Medicare and Medicaid Services (CMS). However, the Social Security Administration determines who qualifies for Medicare. Here are some insights to help you know if you qualify for Medicare.
General Medicare Eligibility Rules
Anybody is eligible for Medicare as long as they meet the requirements for enrolment. As a general rule, you have to be a U.S. citizen. If you have been a legal resident for at least 5 years, you can qualify. You must have a stable U.S.A. address. If you live abroad, you can only receive your care when you return to the U.S.A. Imprisoned people are not eligible for Medicare. These days, you can enroll for Medicare even if you have other insurance covers. However, it is important to enquire with your provider to know which plans go well with Medicare.
Eligibility by Age
Most people join the Medicare eligibility age when they turn 65. The enrolment period begins 3 months before you turn 65. People who already receive Social Security benefits or Rail Road Retirement Board benefits are automatically enrolled.
Eligibility by Disability
People living with disabilities can enroll for Medicare even when they are below age 65. For you to enroll for disability Medicare, you have to meet all the criteria for Social Security Disability Benefits. Coverage includes hospital bills, home care, nursing care, and community-based services. Health care services are not tied to a person’s disability.
Eligibility Due to Special Conditions
People with special conditions that require special medical care qualify for Medicare. End-stage renal disease patients undergoing dialysis qualify for Medicare. Patients with ALS are also eligible for Medicare. If a patient receives an organ transplant and therefore no longer requires dialysis, they are taken off the Medicare plan.
What About Medicare Advantage?
Medicare Advantage involves private insurance companies that come in and pay for extra costs that are not covered by the original Medicare plan. This includes dental, hearing, and vision care. It also covers prescription drugs. Medicare Advantage eligible people must be eligible for original Medicare as well. You must pay all applicable Medicare eligibility premiums besides the extra ones for Medicare advantage.
Eligibility for Medigap
Medigap plans are designed to supplement costs that are not catered for by original Medicare. To be eligible for Medigap, you must qualify for Medicare. You must pay premiums required for the supplements. You must also live in proximity to where your plans apply.
Eligibility for Prescription Drugs
Medicare-approved insurance plans offer covers for prescription drugs. This is a support plan usually used side by side with the original Medicare. Therefore, to be eligible, the requirements for original Medicare apply.