ELIGIBIITY and REQUIREMENTS for MEDICARE

Medicare is available to individuals based on age, disability, or specific health conditions. You may qualify if you meet any of the following criteria:

• Age 65 or Older: The majority of people are eligible for Medicare when they turn 65. If you or your spouse have worked for at least 10 years (40 quarters) in a job where Medicare taxes were paid, you are likely eligible for premium-free Part A.
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• Qualifying Disability: You can be eligible for Medicare before age 65 if you have a qualifying disability and have received Social Security Disability Insurance (SSDI) for at least 24 months. After the 24th month of receiving SSDI benefits, you will automatically be enrolled in Medicare.
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• End-Stage Renal Disease (ESRD): If you have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), you may be eligible for Medicare regardless of age.
• ALS (Amyotrophic Lateral Sclerosis): If you have been diagnosed with ALS (Lou Gehrig’s disease), you are eligible for Medicare immediately upon receiving Social Security Disability benefits.
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Medicare enrollment involves certain requirements based on your circumstances:

• Medicare Taxes: To receive premium-free Medicare Part A, you or your spouse must have worked and paid Medicare taxes for at least 40 quarters (equivalent to 10 years). If you have not met this requirement, you may still enroll in Part A, but a monthly premium will be required.

• You must be a U.S. citizen or a legal permanent resident of at least five continuous years to be eligible for Medicare.

To get Medicare coverage, it’s important to enroll at the right time. Here are the key enrollment periods:

• When: The IEP is a 7-month window that starts 3 months before the month you turn 65 and ends 3 months after the month of your 65th birthday.
• What to Do: During this time, you can sign up for Medicare Part A and/or Part B. It’s important to sign up during this period to avoid any late enrollment penalties.

• When: If you or your spouse are still working and covered by an employer-sponsored health plan, you may qualify for a SEP when that coverage ends. This period allows you to enroll in Medicare without facing penalties.
• How Long: The SEP is usually an 8-month window that begins after employment ends or group coverage ends, whichever comes first.

• When: If you missed the IEP and do not qualify for an SEP, you can enroll in Medicare during the GEP from January 1 to March 31 each year.
• Coverage Start Date: If you enroll during the GEP, your coverage will begin on July 1 of that year. Be aware that late enrollment penalties may apply.

To enroll in Medicare, you will need to provide some documentation to confirm your eligibility:

• Proof of Age: A birth certificate or other document showing your date of birth.
• Social Security Information: Your Social Security number to verify eligibility.
• Work History Information: Documentation regarding your work history and Medicare tax payments (if applicable).
• Legal Residency Status: If you are not a U.S. citizen, you will need documents proving permanent residency for at least five continuous years.
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In certain cases, you may be automatically enrolled in Medicare:

• Receiving Social Security Benefits: If you are already receiving Social Security benefits when you turn 65, you will be automatically enrolled in Medicare Parts A and B. You will receive your Medicare card by mail, usually around 3 months before your 65th birthday.
• Receiving SSDI Benefits: If you are under 65 and have been receiving Social Security Disability benefits for at least 24 months, you will be automatically enrolled in Medicare Parts A and B.

If you are not automatically enrolled, you can sign up for Medicare in several ways:

1. Online: Visit the Social Security website at ssa.gov to complete the online enrollment.
2. By Phone: Call Social Security at 1-800-772-1213 for assistance.
3. In Person: Visit your local Social Security office to apply.
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Our team at The Medicare Firm is available to help you through the enrollment process, ensuring you understand your options and make informed decisions regarding your coverage.

It’s important to sign up for Medicare during the appropriate enrollment period to avoid late enrollment penalties:

• Medicare Part B Penalty: If you delay enrollment in Part B, you may face a penalty of 10% for each full 12-month period that you could have had Part B but didn't sign up.
• Medicare Part A Penalty: If you have to buy Part A and delay signing up, you may have to pay a higher premium—up to 10% more for twice the number of years you could have signed up but didn’t.

Navigating Medicare eligibility and enrollment can be overwhelming. The Medicare Firm is here to help guide you through every step, providing support and advocacy to ensure you receive the healthcare coverage you deserve. Our specialists are available to answer your questions, clarify the requirements, and help you understand the best enrollment period for your needs.