A Guide To Medicare Eligibility And Open Enrollment

A Guide to Medicare Eligibility and Open

Enrollment

Presented by

Medicare has been an important part of America's healthcare system since 1965. It offers seniors and most

receiving Social Security Disability Insurance (SSDI) the ability to receive quality healthcare at a reasonable price.

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Determining Eligibility

Age 65 or older and a U.S. citizen or have been a permanent legal resident for 5 continuous years; or

Have been receiving SSDI for at least 24 months or Railroad Retirement Board disability payments; or

Have end stage renal disease or need a kidney transplant; or

Have ALS (Lou Gehrig's disease); and

You or your spouse must have paid Medicare taxes for at least 10 years.

Medicare eligibility depends on a few factors. You must be:

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Disability Requirements If you're not sure what types of disabilities make you eligible for

Medicare before age 65, the Allsup website is a good place to

start.

Applying for SSDI can be a long and difficult process and

Medicare coverage comes only after a two-year waiting period.

So, you should apply immediately after becoming disabled.

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How to Apply

Seniors can begin the enrollment process three months before their 65th birthday to three months after.

People with disabilities who are eligible for Medicare have the three months before their month of eligibility to the three months after.

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Types Of Medicare Coverage

Medicare Part A covers hospital care and is usually free for

people who paid Medicare taxes while working.

Americans who didn't work may be able to buy Medicare Part A.

Many states offer assistance with the premiums for those who qualify for extra help.

Medicare Part A

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Types Of Medicare Coverage

Medicare Part B covers doctors' visits, outpatient hospital care, physical and occupational therapists and other medical services and supplies. Most pay a monthly premium, which is $96.40 a month in 2009.

To make the payment process easier, the monthly premium is usually taken directly out of each month's Social Security, Railroad Retirement or Civil Service Retirement payment.

Medicare Part B

Medicare Advantage

Medicare Advantage is available if you have Medicare Part A and B

coverage. Medicare Advantage can include HMOs, PPOs, private fee

for service plans and Medicare special needs plans.

Medicare Advantage allows you to get Medicare Parts A and B and

often other coverage under one plan. Medicare Advantage plans work just like regular insurance and can also include prescription drug benefits.

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Medicare Advantage

Plan comes with lower co-pays and extra benefits not included in traditional Medicare.

However, these benefits may include an additional monthly premium and may restrict beneficiaries to specific doctors or hospitals.

It's up to the you -- the Medicare recipient -- to determine which Medicare plan is best.

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Why You Shouldn't Wait To Enroll

Most enroll in Medicare during their initial enrollment period. If you missed your

window, you’ll need to wait until the next available enrollment period.

The cost of Medicare B will go up 10% each year you’re eligible for the program, but do not sign up. This penalty is imposed as long

as you are eligible for Medicare Part B coverage. There are some exceptions to this

rule. One exception being that if you or your spouse are working and covered under

a group health plan, you can delay enrollment in Medicare until you no longer

have health insurance coverage.

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Medicare Enrollment Periods

If you missed your initial enrollment period, you'll need to wait until the available Medicare enrollment period.

Annual enrollment period: takes place between November 15 – December 31 every year.

General enrollment period: available January 1 – March 31 each year for Medicare Part B enrollment.

Open enrollment period: available January 1 – March 31 each year for Medicare.

Special enrollment periods can occur anytime of year depending on circumstances.

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Making Sense Of It AllWith Medicare Part A, Medicare Part B,

Medicare Advantage and Medicare Prescription Drug Coverage, it's no

wonder that recipients are left confused as to which is the best Medicare plan for

them.

Help is available. Allsup helps people receive the benefits they're entitled to. Your A!sup Medicare Advisor works one-on-one with you and Medicare to help you determine which Medicare plan is

right for you.

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How Allsup Helps

Review your individual circumstances: your medications, healthcare requirements, your personal doctors and your finances.

Educate you on local Medicare options.

Prepare a detailed report outlining the plans that best meet your needs.

Help you enroll and answer questions.

Allsup's Medicare experts will:

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Why Allsup?Allsup isn't an insurance company. Allsup is a nationwide provider of

Social Security disability, Medicare and workers’ compensation services for

individuals, employers and insurance carriers.

Celebrating its 25th anniversary in 2009, Allsup employs about 600

professionals who deliver specialized services supporting people with

disabilities and seniors so they may lead lives that are as financially secure

and as healthy as possible.  

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