Medicare is a federal health insurance program for people aged 65 and above, as well as for some younger people with disabilities and certain health conditions.
The program is divided into four parts, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage). While many Americans are eligible for Medicare, not all of them are automatically enrolled in the program. In this article, we will explore whether Americans automatically get Medicare Part A and Part B when they turn 65.
Who is eligible for Medicare Part A and Part B?
To be eligible for Medicare Part A and Part B, an individual must be a U.S. citizen or a legal resident who has lived in the United States for at least five years. They must also be 65 years old or older, or under 65 with certain disabilities or health conditions, such as End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). Also note that, If you’ve been getting Social Security disability benefits, you’ll get Medicare automatically after getting disability benefits for 24 months.
Automatic enrollment in Medicare Part A and Part B
Some Americans are automatically enrolled in Medicare Part A and Part B, while others need to sign up during their initial enrollment period. If you are already receiving Social Security benefits or Railroad Retirement Board (RRB) benefits at least four months before turning 65, you will be automatically enrolled in Medicare Part A and Part B. You will receive your Medicare card in the mail about three months before your 65th birthday.
Signingu up for Medicare Part A and Part B
If you are not automatically enrolled in Medicare Part A and Part B, you need to sign up during your initial enrollment period. This period starts three months before your 65th birthday, includes the month you turn 65, and ends three months after your birthday. You can sign up for Medicare online, by phone, or in person at your local Social Security office.
What happens if you don’t sign up for Medicare Part A and Part B?
If you don’t sign up for Medicare Part A and Part B during your initial enrollment period, you may have to pay a late enrollment penalty. The penalty for Part A can be up to $460 per month, while the penalty for Part B can be up to $462 per month. You may also have to wait until the general enrollment period, which runs from January 1 to March 31 each year, to sign up for Medicare.
Medicare Part A and Part B coverage
Medicare Part A and Part B provide coverage for various healthcare services, including:
Part A
- Inpatient hospital stays
- Skilled nursing facility care
- Hospice and home health care
Part B
- Doctor visits and services
- Outpatient hospital care
- Durable medical equipment
- Preventive services, such as mammograms and colonoscopies
Costs and premiums
While Medicare Part A is typically premium-free, Part B requires a monthly premium. The premium amount varies based on income level and is usually deducted from Social Security benefits.
Additional Medicare options
In addition to Part A and Part B, Medicare offers other coverage options, including:
- Part C (Medicare Advantage plans): Offered by private insurance companies, these plans combine Part A and Part B benefits and often include additional features, such as dental and vision coverage.
- Part D (prescription drug coverage): Helps cover the cost of prescription medications.
- Medigap (Medicare Supplement Insurance): Sold by private insurance companies, these policies help cover out-of-pocket costs, such as deductibles and copayments.
In truth, not all Americans automatically get Medicare Part A and Part B when they turn 65. While some individuals are enrolled in the program automatically, others need to sign up during their initial enrollment period. It’s essential to understand your eligibility and enrollment options to ensure you receive the healthcare benefits you need.
Remember, if you don’t sign up for Medicare during your initial enrollment period, you may have to pay a late enrollment penalty, so it’s crucial to act promptly.
