Medicare Eligibility and Coverages
Medicare Health Insurance Eligibility, Coverages and Costs
The Centers of Medicare and Medicaid Services provide Medicare to nearly 40 million Americans, making it the largest health insurance program in the U.S. Medicare health insurance provides coverage for people who are age 65 or older, for some people with disabilities regardless of age and for anyone with end-stage renal disease. Before applying for this health insurance program, learn more about Medicare coverages, eligibility and Medicare costs.
Explanation of Medicaid and Medicare Coverages
There are two parts of Medicare coverages, Part A and Part B. Medicaid and Medicare health insurance coverages include:
- Part A of Medicaid health insurance provides coverage for inpatient hospital care, skilled nursing facilities, some home health care, hospice care and critical access hospitals.
- Part B of Medicare health insurance covers visits to the doctor, some home health care, outpatient hospital care and some physical and occupational therapy services. Medicare coverages under Part B also provide coverage for supplies and services if they are deemed medically necessary.
Medicare Eligibility: How to Apply, Average Monthly Premiums
Eligible American residents can apply for Medicaid at any Social Security office. If the person applying for health insurance or their spouse has worked for at least 10 years in Medicare-covered employment, there is typically no cost for Medicare health insurance Part A and applicants are automatically eligible. However, there are costs for Medicare Part B. This portion of the Medicaid health insurance has a general sign-up or enrollment period that started on January 1st and ends on March 31st each year. Medicare coverage begins on July 1st of the year of enrollment. Although eligibility is fairly open, there are mitigating factors that can increase standard Medicare costs.
What Will Increase Medicare Premiums and Medicare Costs
The Medicare costs for Part B average $96.40 each month, according to the Medicare website. The costs for Medicare may increase by as much as 10% for each year that applicants for health insurance were eligible but did not enroll in the program, for as long as they have the insurance. The Medicare website has an online penalty calculator to help determine costs for late enrollment. In addition, if an individual’s annual income is higher than $82,000 or if a married couple’s joint income is higher than $164,000 (according to tax returns), the monthly Medicare premiums will be more costly. Applicants for health insurance impacted by the higher Medicare costs can protest the increase in premium. Information about how to refute higher Medicare costs is enclosed with the letter that explains the premium increase.
Learn more about health insurance including comparing PPOs and HMOs, paying for prenatal healthcare and getting help with unpaid medical debts.
