Medicare

Medicare Q & A
Source: Centers for Medicare & Medicaid Services

What is Medicare?
Who is eligible for Medicare?
How long will it take my clients to get enrolled into Medicare?
How do my clients apply for Medicare?
Will my clients have to renew their Medicare eligibility?
If my clients are immigrants, are they still eligible for Medicare?
Where can I get more information about Medicare?

What is Medicare?
Medicare is a Federal health insurance program for:

• People age 65 or older
• Some people with disabilities under age 65
• People with End-Stage Renal Disease (permanent kidney failure needing dialysis or a kidney transplant)

Medicare has two parts – Part A, which is hospital insurance, and Part B, which is medical insurance.

Is my client eligible for Medicare?
Generally, your clients are eligible for Medicare if:

• They are 65 years old or older
• They have been receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months. (If your client is receiving disability benefits because he/she has Amyotrophic Lateral Sclerosis [also called Lou Gehrig’s disease, the 24-month waiting period is waived. This means that your client will receive Medicare the first month he/she is entitled to disability benefits from Social Security or the Railroad Retirement Board.)
• They have End-Stage Renal disease (permanent kidney failure needing dialysis or kidney transplant)

How long will it take my clients to get enrolled into Medicare?
If your client is receiving benefits from Social Security or the Railroad Retirement Board, then he/she will automatically be enrolled in Medicare (Part A and Part B) when:

• He/she turns 65 years old
• He/she has been receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months. (If your client is receiving disability benefits because he/she has Amyotrophic Lateral Sclerosis [also called Lou Gehrig’s disease, the 24-month waiting period is waived. This means that your client will receive Medicare the first month he/she is entitled to disability benefits from Social Security or the Railroad Retirement Board.)

If your client is turning 65 and is not receiving retirement benefits from Social Security or the Railroad Retirement Board or he/she has End-Stage Renal Disease, then he/she must file an application for Medicare benefits. If your client is filing for retirement benefits, he/she can apply for Medicare at the same time.

How do my clients apply for Medicare?
The Social Security Administration handles Medicare eligibility and enrollment. Contact the Social Security Administration at 1-800-772-1213 to enroll in Medicare or to ask questions about whether your clients are eligible. You can also access information about Medicare enrollment/eligibility at www.medicare.gov and click on the Medicare Eligibility Tool or at www.socialsecurity.gov. If your client gets benefits from the Railroad Retirement Board (RRB), call the local RRB office or 1-800-808-0772.

Will my clients have to renew their Medicare eligibility?
There is no renewal process for Medicare eligibility.

If your clients are entitled to Medicare because they are age 65 or older, they will generally remain eligible for Medicare for the rest of their lives.

If your clients are entitled to Medicare because they are disabled, and SSA later determines they are no longer disabled, Medicare coverage will end. If they become disabled again or turn age 65, they will be eligible for Medicare.

If your clients are entitled to Medicare based on End-Stage Renal Disease (permanent kidney failure needing dialysis or kidney transplant), they will lose Medicare coverage if they stop dialysis treatments for at least 12 months or 36 months after they have a kidney transplant. If they return to dialysis within the 12-month period or they have another kidney transplant or begin dialysis within the 36-month period, Medicare coverage will continue. If Medicare coverage terminates and your clients resume regular dialysis or have another transplant, they can apply for Medicare again.

If my clients are immigrants, are they still eligible for Medicare benefits?
Lawfully admitted aliens, 65 years or older, living in the U.S. for five years are eligible to purchase Medicare, but they are not automatically enrolled.

Where can I receive more information about Medicare?
For more information about Medicare, please visit the Centers for Medicare & Medicaid Services Web site at www.cms.hhs.gov , or www.medicare.gov.

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