The Centers for Medicare & Medicaid Services (CMS) run the Medicare health insurance program on behalf of the federal government. The Medicare coverage that Florida residents receive will be largely similar to the Medicare coverage that is provided throughout the United States, with a few small exceptions.


Medicare Is Open To Two Categories Of People

Those 65 and older who are citizens of the United States or who have lived there lawfully for five consecutive years or more.

Those under 65 who have certain qualifying illnesses or disabilities.

Medicare Part A

Part A is sometimes known as Medicare hospital insurance, and it typically covers inpatient hospital treatment, skilled nursing facility care, hospice, and certain forms of qualifying home health care. Medically essential services and equipment (e.g., nurse services, a semi-private room, prescription medicines, etc.) are normally reimbursed if part of a beneficiary's inpatient treatment.

Hospice care is also covered if a beneficiary is diagnosed as terminally ill and has six months or less to live. Doctor/nursing services, hospice aide services, physical/occupational therapy, prescription medicines, and caregiver respite care are all provided.

Part A does not cover long-term nursing home or care facility benefits. Only institutions where assistance with personal care, such as eating and bathing, is provided are covered.


Eligibility

If you paid Medicare taxes for at least ten years while working, you are automatically enrolled in free Part A coverage at the age of 65. (40 quarters). If your spouse is eligible for Part A coverage without paying a premium, you may be eligible as well.
You may also be eligible for free benefits if you or your spouse receive or are eligible for Social Security or Railroad Retirement payments. This benefit is provided even if the person requesting coverage's spouse is deceased or divorced. If you do not meet the work criteria, you can still enroll in Part A, but you must pay a monthly premium.

If you are under the age of 65, you may be eligible for Medicare Part A coverage if you meet the following criteria:

You have end-stage renal disease (ESRD) or permanent kidney failure that necessitates ongoing dialysis or a transplant.
You receive disability benefits because you have Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig's disease).
You are the child or widow(er) of someone who worked in a government job long enough to pay Medicare taxes and you meet Social Security disability program requirements
After receiving either of these disability benefits for a total of 24 months, you are automatically enrolled in Parts A and B. These months do not have to be in any particular order.


Enrollment

In Florida, if you already get Social Security or Railroad Retirement Board benefits, you'll usually obtain Part A and Part B coverage on your 65th birthday. If you're under 65 and handicapped, you get Part A and Part B after 24 months of Social Security or Railroad Retirement benefits.

In all circumstances, you'll get a Welcome to Medicare packet including your card and information about Medicare. If you don't satisfy these standards, you can enroll in Medicare during your IEP (IEP). IEP is the 7-month period starting 3 months before your 65th birthday and ending 3 months after.

After your IEP finishes, you can enroll in Parts A and B during a Special Enrollment Period. You can also enroll during the Medicare General Enrollment Period (January 1 to March 31), but you may pay more and have your coverage delayed.


Costs

Other than hospitalization costs, Part A coverage is free for those who qualify. If you do not qualify for free Medicare Part A coverage, you may still enroll and pay a premium if you meet one of the following conditions:

You are at least 65 years old.
You are enrolled or in the process of enrolling in Medicare Part B.
You meet the citizenship and residency requirements.

The amount of your premiums will vary based on the number of years you've worked and how close you are to earning 40 Social Security credits. In most situations, if you enroll in and pay for Medicare Part A, you must also enroll in and pay for Medicare Part B.


Upcoming Article: Understanding Medicare Part B, C, and D.




Speaking with a true Medicare health insurance specialist will be the best way to sum up all the information you acquired, and turn it into a smart health plan choice.  When it comes to choosing the right health care plan, knowledge and expertise are an irreplaceable necessity.

A good insurance broker can help you with all aspects of the health insurance plan purchasing process.  Because their expert assistance is normally free, getting assistance from a licensed Medicare insurance professional is a smart, sensible step in any insurance purchasing decision.


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Our licensed Medicare insurance professionals are happy to assist in sorting through all of the details in order to acquire a quality, affordable health insurance plan that meets the needs of you and your family.  Our services are free.  call now.    (321) 228-4213