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Medicare Eligibility Requirements & Personalized Enrollment Guidance
Medicare is health insurance for people 65 or older who meet citizenship or residency requirements. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). Some people get Medicare automatically, others have to actively sign up -- it depends if you start getting retirement or disability benefits from Social Security before you turn 65. If you plan to work past age 65, you will need to compare the health insurance you get from your employer from what you would get through Medicare.
MEDICARE ELIGIBILITY
If you become eligible for Medicare by turning 65, your IEP begins three months before the month of your 65th birthday and ends three months after your 65th birthday month.
If you become eligible due to disability, your IEP begins three months before the month of your 25th Social Security Disability Insurance (SSDI) benefit payment and ends three months after that month.
If you become eligible due to medical condition, your IEP will happen much sooner: within a few months if you have end stage renal disease (ESRD), or right away if you have amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease).
ENROLLMENT GUIDANCE
# 1 - Start by understanding Medicare eligibility requirements and identifying your current situation on ELIGIBILITY. Enrollment will be classified as your Initial Enrollment Period (IEP) when enrolling for the first time. The enrollment period is 7 months, surrounding your 65th birthday (3 months before, the month of, and 3 months after).
# 2 - Contact licensed Medicare Agent to schedule a non-bias, no obligation, no cost appointment to provide information, education, and choice options based on your preferences & lifestyle needs.
# 3 - Create a "My Social Security" account online by going to ssa.gov. You should check your work history and options if choosing to apply for social security & Medicare part A and part B, this is the beginning process to Original Medicare.
# 4 - REVIEW plan paths based on needs analysis, medical preferences, lifestyle & financial situation. Contact licensed Medicare Agent, go to medicare.gov or state health assistant program.
# 5 - EDUCATE for greater understanding of plan options, plan types, prescription formulary, premium part B & IRMMA, coverages, summary of benefits, and cost.
# 6 - ENROLL once you feel confident after reviewing all plan options, have a clear understanding, and are in eligibility period.
# 7 - FOLLOW UP, confirmation of activation, welcome package from carrier, enroll in websites; medicare.gov. & ssa.gov for resources and access to providers information.
# 8 - ALWAYS ask questions, never assume, and always COMPLETE ANNUAL REVIEW.
Providing Education, Resources, Material, and REASSURANCE
Educating on Original Medicare, Medicare Advantage, Medigap, and Prescription Plans
Assistance with Enrollment, Annual Reviews, and Follow-Ups
Plan Options, Comparisons, Summary of Benefits, & Cost
Enrollment Periods
IEP, AEP, SEP, & OEP
Plan Types
PPO, HMO, HMO-POS, PFFS
Importance of Needs Analysis, Preferences, and Lifestyle
Medicare Eligibility and Guidelines
Four Parts of Medicare
Part A (Hospital), Part B (Hospital)
Part D (Prescription Drug)
Part C (Medicare Advantage)
Supplements/Medigap
Part B IRMMA, Penalty
and rules on Part D and Part B
Enrollment Process Options
Resources
Medicare.gov, SSA.gov
Cms.gov