This article defines Medicare eligibility and provides helpful information for navigating Medicare eligibility.
Am I eligible for Medicare?
You are eligible if you are 65 or older, under 65 with a disability, or have end-stage renal disease.
When and where can I sign up for Medicare?
Most people sign up for Part A and B at age 65. You may begin the enrollment process 3 months before your 65th birthday. If you are starting your Social Security benefits and are approved, Part A coverage will be granted automatically, but you will have to enroll in Part B by filling out Form CMS-40B.
You can enroll in Medicare by visiting Social Security and signing up online at www.ssa.gov/benefits/medicare/. You can also enroll by calling Social Security at 1-800-772-1213.
For persons under 65, everyone eligible for Social Security Disability Insurance (SSDI) is also eligible for Medicare 24 months after being awarded disability benefit entitlement.
Thereafter, the general enrollment period and when changes may be made to plans is Jan. 1 – March 31 every year.
What if I am still working at 65?
If you or your spouse are still working at a job with more than 20 employees and have insurance, you can wait until you or your spouse stops working (or lose health insurance if that happens first), and you won’t pay a late enrollment penalty for Part B. Your job-based insurance pays first, and Medicare pays second. If you or your spouse’s employer employs fewer than 20 persons, you need to verify with the employer if you need to sign up for Part A and B because your job-based insurance may not cover the costs for services. If you or your spouse are still working and have non-job-based insurance (Medicaid or ACA Marketplace), the rules vary on coverage with Medicare, and you will need to answer a few questions to determine your coverage.
What if I return to work but am an under-65 disabled Medicare recipient?
Social Security’s Ticket to Work program allows beneficiaries an opportunity to resume their working careers. If you earn under $1350 during the Trial to Work period, your benefits will remain intact for those 9 months. If you return to work and begin earning more than $1350, you will lose your SSDI benefits, but you will retain premium-free Medicare Part A and B coverage for up to 93 months. After 93 months, beneficiaries will then have the opportunity to purchase Part A and B coverage if they continue to have a disability.
What can BioMatrix do to help with my Medicare eligibility?
BioMatrix can check your Medicare benefits and let you know about your eligibility and anticipated coverage. From there we can provide additional information based upon your needs.
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