Medicare is a federal health insurance program that is run by the Centers for Medicare & Medicaid Services. There are some small differences from state to state, but most of Medicare is the same everywhere in the U.S., so the coverage Missouri residents get will be similar to Medicare coverage everywhere else in the country.


Medicare Is Available To Two Groups Of People.

People 65 and older who are American citizens or have been legal permanent residents of the United States for at least five years.

People under the age of 65 who have specified qualifying medical conditions or disabilities.

Medicare Part A

Part A is also called Medicare hospital insurance, and it usually covers hospital stays, skilled nursing facility stays, hospice care, and certain types of home health care that are eligible. Medically necessary services and equipment (like nursing care, a semi-private room, prescription drugs, etc.) are usually covered as well if they are part of an inpatient treatment plan for a Medicare beneficiary.

Hospice care is also covered if a person is told they have less than six months to live and have been told they have a terminal illness. Services from doctors and nurses, hospice aides, physical and occupational therapy, prescription drugs, and care for caregivers while they take a break are all included.

Part A doesn't pay for long-term care in a nursing home or other facility. Coverage only applies to places where a beneficiary gets help with things other than personal care, like eating and bathing.


Eligibility

Those who paid Medicare taxes while employed for at least ten years are automatically enrolled in free Part A coverage when they turn 65. (40 quarters). You might be eligible for premium-free Part A benefits if your spouse is. If they are, then you might be as well. If you or your spouse are currently receiving or are eligible for Railroad Retirement benefits, you may also be eligible for free benefits. Even if the applicant's spouse passed away or got divorced, this benefit is still available.
Even if you don't have a job, you can still enroll in Part A, but you'll have to pay a monthly premium.

In order to be eligible for Medicare Part A benefits if you are under 65, you must:

Meet the requirements for the Social Security disability program. You may be eligible if you have end-stage renal disease (ESRD) or permanent kidney failure that necessitates ongoing dialysis or a transplant, receive disability benefits due to Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig's disease), are the child or widow(er) of a worker who worked in a government job for a sufficient amount of time to have paid Medicare taxes, are 50 years of age or older, After receiving one of these disability benefits for 24 cumulative months, you are automatically enrolled in Parts A and B. These months don't have to be one after the other.


Enrollment

In Missouri, if you are already receiving Social Security or Railroad Retirement Board benefits, you will typically receive Part A and Part B coverage on the first day of the month you turn 65. If you are under 65 and disabled, you are automatically enrolled in Medicare Parts A and B after 24 months of receiving disability benefits from Social Security or the Railroad Retirement Board.

In either instance, you will receive a Welcome to Medicare packet containing your Medicare card and comprehensive information on how Medicare operates.

You can enroll in Medicare during the Initial Enrollment Period if you do not meet these conditions (IEP). Your IEP is the seven-month period beginning three months before your 65th birthday and ending three months after it. If you qualify, you may enroll in Medicare Parts A and B during a Special Enrollment Period following the conclusion of your IEP. You may also enroll during the Medicare General Enrollment Period (January 1 through March 31 each year), but this may result in higher costs and delayed coverage.


Costs

Part A coverage is free if you qualify, with the exception of some deductibles for hospital stays. Provided you are not eligible for free Part A coverage, you can still enroll and pay a premium if you meet the following criteria:

You are 65 or older.
You have or are about to enroll in Medicare Part B coverage.
You meet citizenship and residency requirements.

The cost of your premiums will vary based on how long you have worked and how close you are to reaching the minimum of 40 Social Security credits.

If you enroll in and pay for Medicare Part A, you must also enroll in and pay a separate premium for Medicare Part B in most situations.


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




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