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Medicare
Medicare Q & A
Source: Centers for Medicare & Medicaid
Services
 What
is Medicare?
Who
is eligible for Medicare?
How
long will it take my clients to get enrolled into Medicare?
How
do my clients apply for Medicare?
Will
my clients have to renew their Medicare eligibility?
If
my clients are immigrants, are they still eligible for
Medicare?
Where
can I get more information about Medicare?
What
is Medicare?
Medicare is a Federal health insurance program for:
- People age 65 or older
- Some people with disabilities
under age 65
- People with End-Stage
Renal Disease (permanent kidney
failure needing dialysis or a kidney transplant)
Medicare has two parts – Part A, which is hospital
insurance, and Part B, which is medical insurance.
Is
my client eligible for Medicare?
Generally, your clients are eligible for Medicare if:
- They are 65 years old or older
- They have been
receiving disability benefits from Social Security or the Railroad
Retirement Board for 24 months. (If your client is receiving
disability benefits because he/she has Amyotrophic Lateral Sclerosis
[also called Lou Gehrig’s disease, the 24-month waiting period
is waived. This means that your client will receive Medicare the
first month he/she is entitled to disability benefits from Social
Security
or the Railroad Retirement Board.)
- They have End-Stage Renal disease
(permanent kidney failure needing dialysis or kidney transplant)
How
long will it take my clients to get enrolled into Medicare?
If your client is receiving benefits from Social
Security or the Railroad Retirement Board, then
he/she will automatically be enrolled in Medicare
(Part A and Part B) when:
- He/she turns 65 years old
- He/she has been receiving
disability benefits from Social Security or the Railroad Retirement
Board for 24 months. (If your client is receiving
disability benefits because he/she has Amyotrophic Lateral Sclerosis
[also called Lou Gehrig’s disease, the 24-month waiting period
is waived. This means that your client will receive Medicare the first
month he/she is entitled to disability benefits from Social Security
or the Railroad Retirement Board.)
If your client is turning 65 and is not receiving retirement benefits
from Social Security or the Railroad Retirement Board or he/she
has End-Stage Renal Disease, then he/she must file an application for
Medicare benefits.
If your client is filing for retirement benefits, he/she can apply
for Medicare at the same time.
How
do my clients apply for Medicare?
The Social Security Administration handles Medicare
eligibility and enrollment. Contact the Social
Security Administration at 1-800-772-1213 to enroll
in Medicare or to ask questions about whether
your clients are eligible. You can also access
information about Medicare enrollment/eligibility
at www.medicare.gov
and click on the Medicare Eligibility Tool or
at www.socialsecurity.gov.
If your client gets benefits from the Railroad
Retirement Board (RRB), call the local RRB office
or 1-800-808-0772.
Will
my clients have to renew their Medicare eligibility?
There is no renewal process for Medicare eligibility.
If your clients are entitled to Medicare because they are age 65 or older,
they will generally remain eligible for Medicare for the rest of their lives.
If your clients are entitled to Medicare because they are disabled, and SSA
later determines they are no longer disabled, Medicare coverage will end. If
they become disabled again or turn age 65, they will be eligible for Medicare.
If your clients are entitled to Medicare based on End-Stage Renal Disease (permanent
kidney failure needing dialysis or kidney transplant), they will lose Medicare
coverage if they stop dialysis treatments for at least 12 months or 36 months
after they have a kidney transplant. If they return to dialysis within the
12-month period or they have another kidney transplant or begin dialysis within
the 36-month period, Medicare coverage will continue. If Medicare coverage
terminates and your clients resume regular dialysis or have another transplant,
they can apply for Medicare again.
If
my clients are immigrants, are they still eligible for Medicare benefits?
Lawfully admitted aliens, 65 years or older, living in the U.S. for five years
are eligible to purchase Medicare, but they are not automatically enrolled.
Where
can I receive more information about Medicare?
For more information about Medicare, please visit the Centers for Medicare & Medicaid
Services Web site at www.cms.hhs.gov , or www.medicare.gov.
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