Medicare Eligibility and Enrollment

Am I Eligible for Medicare

Most people who are 65 years old are eligible for Medicare, as they have met the required work history. People who do not automatically qualify for Medicare still have the option to purchase it. Here are the scenarios in which enrollment will occur in some part of Medicare:

Scenario One: Social Security

If you are 65 and currently receiving Social Security, you will automatically be enrolled in Parts A and B. If you do not want Part B, since there is a premium, follow the instructions that are given with the card. You should only do this if you have other coverage.

Scenario Two: No Social Security (Not Automatic)

If you are not receiving Social Security, then you would have to call Social Security at 1-800-772-1213 (or enroll online at ssa.gov/benefits/medicare). You can do this 3 months before the month you turn 65, and up to 3 months after the month you turn 65 (a 7-month period total). In most instances, you should enroll in Part A since there is no premium. You would enroll in Part B if you do not have any other coverage that would take the place of it.

Since there is a premium for Part B, you may not want to enroll if you have other health insurance coverage. This would include employer (20 employees or more) or union health coverage. Employer coverage would not include such instances like COBRA, retiree, VA, or the Health Insurance Marketplace. It is recommended to talk with your benefits administrator to be sure how your employer coverage coordinates with Medicare. If you are on Medicaid, you should sign up for Part B.

Scenario Three: Social Security for Disability Benefits

People who are receiving disability benefits from Social Security for 24 months will automatically be enrolled in Parts A and B.

Enrollment Rules and Details

There are certain late penalties if you do not sign up for coverage when it first becomes available, and you do not have what is known as "creditable coverage," such as employer coverage as mentioned above. In addition, if you do not sign up during your initial enrollment period, you would have to wait for open enrollment, which could lead to gaps in health coverage.

If you are on Social Security, your Part B premium will be deducted from your Social Security amount. If you are not on Social Security, you will have to set up how you will pay. Medicare will bill you for 3 months at a time.

Still Have Questions on Enrollment

Do you still have questions? Take a look at our Medicare Basics outline, or give us a call at 931-287-0799.

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"Steve has been very instrumental in helping me navigate the available Medicare options. So, I was able to choose the Medicare Advantage Plan that was best for me. He has always maintained a professional demeanor. He is very pleasant and personable to interact with. He has taken an interest in me as a person, and is always available to answer any questions I may have. I look forward to many years of having Steve be my Medicare Health Insurance representative."
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**This is a personal website of Steve Walter and is not associated with or endorsed by any government agency. We do not offer every plan available in your area. Currently we represent 8 organizations which offer 56 products in your area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program to get information on all of your options.

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