It's important to know when you are eligible to enroll in Medicare. If you miss your window, you may have to pay more to join, or you may have fewer choices.
If you are a retiree covered by an employer-sponsored health care plan, it may be a good idea stay in your current plan. Before you evaluate your choices, check with a human resources or union representative at your former employer to make sure you understand the full extent of your current medical coverage.
Medicare Parts A and B (sometimes called "Original Medicare")
Who is eligible for Medicare Parts A and B?
- Most people 65 and older, who are U.S. citizens or legal residents who have lived here for at least five consecutive years.
- People under age 65 with certain disabilities.
- People of all ages with end-stage renal disease.
To be eligible for Medicare Advantage plans, people ages 65 and older or with qualifying disabilities must:
- Have both Medicare Part A and Part B.
- Continue to pay the Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
- Reside in the service area of the plan.
- Not have end-stage renal disease (ESRD). (Exceptions apply.)
Medicare Part D Plans
You are eligible for a Part D plan if:
- You are entitled to Medicare benefits under Part A or enrolled in Medicare Part B.
- You reside in the service area of the Part D plan, which includes the United States, Washington, D.C. and United States territories.
Rules about Part D eligibility include:
- You may be enrolled in only one Medicare prescription drug plan (Part D) at a time.
- You must continue to pay your Medicare Part B premium if not otherwise paid for by Medicaid or by another third party.
- If you are enrolled in a Medicare Advantage HMO, POS, PPO or Private Fee-for-Service (PFFS) plan that includes Medicare prescription drug coverage and you enroll in a PDP, you will be automatically disenrolled from the HMO, POS, PPO or PFFS plan.
- If you are in a PFFS plan that does not provide Medicare prescription drug coverage, or a Medicare Advantage Medical Savings Account (MSA) plan, you may enroll in a Medicare Part D prescription drug plan. Additionally, if you are in an 1876 Cost plan, you may enroll in a prescription drug plan.
Medicare Supplement Insurance plans
If you choose Medicare Parts A and B (sometimes called "Original Medicare"), you can add a Medicare Supplement Insurance policy, to get additional coverage.
Medicare guarantees you the right to buy any Medicare Supplement Insurance policy available where you live during the six months after you turn 65 and enroll in Medicare Part B. This is also called your open enrollment period. The insurer can't consider your medical history or current health in setting the premium during this time. There are certain situations in which you have the right to buy a policy, regardless of your health, after your open enrollment period ends.
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