NW Florida Medicare Serving the Panhandle

A Brief Overview of Medicare Eligibility for Each Part

Since signed into law in 1965, Medicare, the federally-sponsored health benefits program for citizens aged 65 and older, has been a great option for many.

If you worked and paid into Social Security taxes for at least 10 years, you are entitled to Medicare Part A benefits for little or no cost.  The other parts of Medicare…Part B, Part C, (also known as Medicare Advantage), and Part D are all options for people as they transition from their working years to retirement.

If you are 65 or approaching 65, you will want to know some facts about Medicare eligibility. This article will help you determine if and when you qualify.

Medicare Eligibility Part A

Medicare Part A is coverage for hospital visits and expenses. You are eligible for this coverage when:

  • you’re at least 64 years and 9 months old
  • you’re under 65 but live with a certain disability or condition
  • you have end-stage renal disease (ESRD)

If you are already retired and receiving Social Security or Railroad Retirement benefits, you will be automatically enrolled in Part A as soon as you qualify. If you are still working at age 65, you will need to physically enroll for Parts A and B on your own, either online or through an agent.

Medicare Eligibility Part B

Part B is the other half of Original Medicare. This is medical coverage, and it is optional. However, if you apply outside your Initial Enrollment Period (three months before and after your 65th birthday,) you may incur a penalty fee.

The Part B eligibility requirements are the same as for Part A. However, you will pay a premium for this benefit, which is determined by your annual income.

Medicare Eligibility Part C

Medicare Part C is also known as Medicare Advantage and is offered as an alternative to Original Medicare. It is administered by private insurance companies and includes coverages not found in Original Medicare, such as dental, vision, and hearing benefits.

To qualify for Medicare Part C if you must be 65 or older and have enrolled in Medicare parts A and B. You must also live in the coverage area for any Medicare Part C plan you select.

Which is better, Original Medicare (Parts A and B) or a Medicare Advantage (Part C) plan? It depends on income, health issues, and premiums in your area. You can consult with a reputable agent, or do use an eligibility/premium calculator to determine your costs.

Medicare Eligibility Part D

Part D covers prescription drugs. It is an optional complement to Original Medicare (Parts A and B) and usually an automatic inclusion in Part C. (Medicare Advantage)

All Part D plans cover a wide range of prescription drugs that seniors and disabled people take. Many Medicare drug plans and Medicare Advantage plans with drug coverage use specific classes of drugs to determine your coverage. For example, a drug in a lower class costs less than a drug in a higher class.

To be eligible for Part D, you must currently be signed up for both Parts A and B.

Medicare Eligibility Check

You can consult the Medicare website to find more information on Medicare eligibility and coverage options.

When choosing a plan, consider costs, plan doctors, convenience, lifestyle and travel plans, and your health. These factors will help determine the right Medicare choices for you and yours.

If you want information on Medicare options in Northwest Florida and lower Alabama areas, contact us for a personal consultation. We can guide you in your search for the best plan, and assist you in your enrollment.

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