Medicare Eligibility

Medicare Eligibility

You may be interested in signing up for Medicare or finding out alternatives to your existing coverage.   Understandably, insurance can be a difficult topic to try to grasp and the complications are compounded by so many separate options.   With Medicare, the important thing to get you started is your eligibility.   Finding out if you’re a candidate for Medicare is important and you’ll find that there’s only a few criteria you’ll need to review.   The Health Exchange Agency is skilled at determining eligibility and answering questions for you if you do have a unique situation.

When it comes to the Annual Election Period or “AEP,” being on schedule is very important. For 2021 coverage the timeline began on October 15th and ran through December 7th. For those interested in taking on the coverage for Medicare Advantage, the enrollment time-frame is available from January 1st to March 31st, 2021. This is the Medicare Advantage Open Enrollment, otherwise known as “MA OEP.” It’s important to remember that this is available to those already enrolled in Medicare Advantage plans. This is also the timeframe in which one can adjust from Medicare Advantage to the Original Medicare plan. In addition, there is the option for those are near the inception of their Medicare eligibility who can take advantage of the Initial Coverage Election Period, or “ICEP.” This time is designated for those who are newly eligible for Medicare to begin enrolling in the Medicare Advantage Plan for the first time. This happens at a different time of year than the Medicare Advantage Open Enrollment (MA OEP). It’s important to identify when the right time is for you to enroll as there are very few exceptions that fall into the Special Election Period. These exceptions, are limited to specific life events such as marriage or losing other health coverage elsewhere.

The principal criteria for determining eligibility with Medicare is age.   In order to qualify you must be 65 years of age.   If you are not yet 65 there are some specific conditions that would make you eligible like Lou Gehrig’s disease or End-Stage Renal Disease (ESRD).   If you have one of these conditions or have additional questions about your eligibility, contact The Health Exchange Agency directly to discuss your specific options.   Specified conditions are important to disclose in order to properly qualify an individual for coverage during an ongoing health concern.   Qualifying may be easier than you imagine.

After you’ve checked off the “65 years” bucket, you’ll need to evaluate a few other things.   It’s important that you’ve had Medicare-covered Employment for a minimum of 10 years leading up to your enrollment.   This means having at least 40 quarters of employment that has paid out Medicare taxes.   If you (or your spouse) did not pay these Medicare taxes, you still may be eligible.   There is additional criteria that would be the determining factor for your qualification.

In addition to the aforementioned criteria, another important qualifier is the citizenship or permanent residency status that you currently have.   You must have either the US Citizenship or Permanent Residency for a minimum of 5 years in order to move forward in your enrollment process.   If this sounds like you, you’re ready to enroll.   Taking the next step and signing up for Medicare may lead you to some new questions, be sure to gain clarity on questions you may have surrounding the process.

While Medicare has three major criteria for the enrollment of it’s clientele, it’s important to note that the individual circumstances of each person can make a difference in eligibility.   If you’re unsure based on your current status, we have answers to your questions.   While you may still be working part-time or full-time or carry insurance privately, Medicare still may be an important option for you to consider.   The benefits of having a supplementary plan assist in ensuring that you don’t end up paying out of pocket for costs that could otherwise be covered.   The Health Exchange Agency specializes in assisting men and women like you each day with their Medicare enrollment, you don’t have to do this alone.   We’re here to help and know that with the right personalization of the process, you’ll get the exact coverage you want and need.

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