Original Medicare Coverage: Medicare Eligibility Explained
Many people approaching the age of 65 are asking the question
, "What is Original Medicare coverage?" This is a serious question, and these same people are often uncertain whether they are eligible and how to enroll.Although the Medicare program has evolved since it first started in 1965, Original Medicare is the single payer, Federal health insurance program for U.S. citizens and legal residents age 65 or older. It now also includes coverage for individuals eligible for Social Security Disability benefits, those who have kidney failure, or ALS (Lou Gehrig's disease). There is one other Federal insurance payer, the Federal Employees Health Benefits program that covers Federal employees.
What does Original Medicare coverage include? In short, the program provides a broad range of services through Part A and Part B. Part A helps cover inpatient services such as hospital inpatient stays, skilled nursing facility services, and home health care. Part B is your Medical insurance covering doctor visits, hospital outpatient services and surgery, medical supplies and equipment, and physical therapy.
Generally speaking, eligibility is not complicated. If you are a U.S. Citizen or naturalized citizen nearing the age of 65, or disable or have End Stage Renal Disease, you are probably eligible. Eligibility questions can be addressed to the Social Security Administration at 1-800-772-1213.
If you have elected to start receiving Social Security benefits prior to turning age 65, then your enrollment into Medicare Part A and Part B will be automatic. In your case, about 3 months before your sixty-fifth birthday, you will receive an initial enrollment packet including your Medicare card.
Those nearing 65 but not yet receiving Social Security benefits must submit an application to the Social Security Administration. All Medicare applicants have a 7 month, initial enrollment period that begins 3 months before the sixty-fifth birthday and ends on the last day of the third month following the month of your sixty-fifth birthday.
The one stable piece of information to hold onto is that Medicare enrollment is always done through the Social Security Administration. If you are already receiving benefits, your enrollment will be automatic and you won't need to do anything at all. If you are not receiving SSA benefits by your sixty-fifth birthday, you will need to submit an application through the Social Security Administration. As this is quite an important change in your life, you should not hesitate to seek answers to your questions through the Social Security Administration toll free number, 1-800-772-1213.
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