The Centers for Medicare & Medicaid Services handle Medicare, a federal health insurance program. There are some slight variances across states, but the vast majority of Medicare is the same throughout the United States, so the coverage Texas people receive will be comparable to Medicare coverage across the country.


Medicare Is Available To Two Groups 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, generally known as Medicare hospital insurance, covers a variety of qualifying home health care services as well as inpatient hospital care, skilled nursing facility care, hospice, and other services. A beneficiary's inpatient treatment will typically also be paid if it includes medically essential services and supplies (such as nurse care, a semi-private room, prescription medications, etc.).

Hospice care is also covered if a beneficiary is determined to be terminally ill and has six months or less to live. Included are doctor and nursing services, hospice aide services, physical and occupational therapy, prescription medications, and caregiver respite care.

Benefits from long-term nursing homes or care facilities are not covered by Part A. Only settings where aid with personal care, such as assistance with eating and washing, is one of many services provided to a recipient are covered.


Eligibility

At age 65, you are automatically enrolled in free Part A coverage if you have paid Medicare taxes for at least 10 years while working (40 quarters). If your spouse is eligible for premium-free Part A benefits, you may also be eligible for premium-free benefits.
You may also be eligible for free benefits if you or your spouse receive or are eligible to receive Social Security or Railroad Retirement. This benefit is accessible even if the spouse of the person requesting coverage is deceased or divorced. If you do not meet the work requirements, you can still enroll in Medicare Part A by paying a monthly fee.

If you are younger than 65, you may be eligible for Medicare Part A if:

You have end-stage renal disease (ESRD) or permanent kidney failure that requires either ongoing dialysis or a transplant.
You receive disability benefits due to Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig's disease).
You're a child or widow(er) age 50 or older of someone who worked in a government job long enough where Medicare taxes were paid, and you meet Social Security disability program requirements.
If you received disability benefits due to a After receiving either of these disability benefits for a total of 24 months, you are automatically enrolled in Parts A and B. These months need not be in succession.


Enrollment

In Texas, usually, Part A and Part B coverage will be automatically added to your benefits package if you already receive Social Security or Railroad Retirement Board payments beginning on the first day of the month you turn 65.After receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months if you are under 65 and disabled, you will automatically get Parts A and B.

In either situation, you'll receive a Welcome to Medicare packet that includes your Medicare card and comprehensive information on how Medicare functions.

During your Initial Enrollment Period, you can enroll in Medicare even if you don't meet these conditions (IEP). The seven-month period known as your IEP is the time frame that starts three months before you turn 65 and ends three months after that month.

If you are eligible, you may enroll in Part A and Part B during a Special Enrollment Period following the conclusion of your IEP. You can also enroll during the Medicare General Enrollment Period (January 1 through March 31 annually), but if you do so, you could end up paying higher rates and delaying your coverage.


Costs

If you qualify, Part A coverage is free, but you may have to pay deductibles for hospital stays.If you don't qualify for free Part A coverage, you can still sign up and pay a premium if you meet the following conditions:

You are at least 65 years old.
You are enrolled in or in the process of enrolling in Medicare Part B coverage.
You meet citizenship and residency requirements. The cost of your premium will depend on how long you have worked and how close you are to getting the minimum of 40 Social Security credits.

Most of the time, if you enroll in and pay for Medicare Part A, you must also enroll in and pay a separate premium for Medicare Part B.


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




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