Who is eligible for Medicare?
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 age 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 (ESRD) and meet certain requirements
While you don’t have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. The Standard Part B monthly premium in 2016 is $121.80. (The Part B premium will remain $104.90 for individuals enrolled in Medicare and receiving Social Security benefits in 2015 or earlier.) This premium amount may be greater according to your income. Your Medicare Part B premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement deposit. If you don’t receive any of the income sources above, Medicare sends you a bill for your Part B premium every 3 months.
Note: You might be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits.
If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, please call Social Security at 1-800-772-1213 or visit or call your local Social Security Office. TTY users should call 1-800-325-0778. You can also get information about buying Part A as well as Part B if you don’t qualify for premium-free Part A.
Enrolling in Medicare
Part A (Hospital Insurance) – Helps pay for care in a hospital and skilled nursing facility, home health care, and hospice care.
Part B (Medical Insurance) – Helps pay for doctors, outpatient hospital care, and other medical services.
General Enrollment Period
Important: The cost of Medicare Part B will go up 10% for each full 12-month period that you could have had Medicare Part B but didn’t take it, except in special cases. You will have to pay this penalty as long as you have Medicare Part B.
If you already have Medicare Part A and need Medicare Part B you can sign up for Part B at your local Social Security office or by calling 1-800-772-1213 (TTY users should call 1-800-325-0778).
Special Enrollment Period
* Anytime you are still covered by the employer or union group health plan through your or your spouse’s current or active employment.
* During the 7 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first).
If you are disabled and working (or you have coverage from a working family member), the Special Enrollment Period rules also apply.
When is coverage is effective if you sign up during a Special Enrollment Period?
* If you enroll in Medicare Part B while covered by the group health plan or during the first full month after coverage ends, your Medicare Part B coverage starts on the first day of the month you enroll. You can also delay the start date for Medicare Part B coverage until the first day of any of the following 3 months.
* If you enroll during any of the 7 remaining months of the Special Enrollment Period, your Medicare Part B coverage begins the month after you enroll.
Are you eligible for a Special Enrollment Period?
To find out if you are eligible for a Special Enrollment Period, please contact the Social Security Administration
at 1-800-772-1213. You may also contact your local Social Security office.
If you don’t enroll in Medicare Part B during your Special Enrollment Period, you’ll have to wait until the next General Enrollment Period, which is January 1 through March 31 of each year. You may then have to pay a higher Medicare Part B premium because you could have had Medicare Part B and didn’t take it.