Medicare

Medicare is a federal health insurance program available to people age 65 and older and certain disabled individuals. Medicare is a vast program with many healthcare options available and many different ways to get benefits.

Medicare has two main components, Part A and Part B. Part A is hospital insurance that almost everyone is automatically enrolled in when they turn 65 because they or their spouse paid Medicare taxes while working. Part B is optional medical insurance for which most people pay a monthly premium.

You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in the Original Medicare Plan, which allows you to choose your own doctor and hospital. You may want to consider a Medicare Prescription Drug Plan to add drug coverage. Or, you may want to consider a Medicare Advantage Plan, offered through an insurance company, that provides all your Part A, Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall.

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:
-You already get retirement benefits from Social Security or the Railroad Retirement Board.
-You are eligible to get Social Security or Railroad benefits but haven’t yet filed for them.
-You or your spouse had Medicare-covered government employment.

If you are under 65, you can get Part A without having to pay premiums if you have:
-received Social Security or Railroad Retirement Board disability benefits for 24 months.
-End-Stage Renal Disease and meet certain requirements.

While you do not have to pay a premium for Part A if you meet one of these conditions, you must pay for Part B if you want it. The premium for Part B is based on your income level.

The best way to determine how to enroll in Medicare and what eligibility requirements you meet is by visiting the Medicare Eligibility Tool provided by the US Department of Health and Human Services.

The New York State Office for the Aging also provides a service to assist you with navigating the ins and outs of the Medicare Program. It’s called Health Insurance Information, Counseling, and Assitance (HIICAP). Call 1-800-701-0501 to locate the HIICAP program near you.

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