Medicare is health insurance for individuals who are 65 years old or older. It is also available for those under 65 and have certain disabilities. If an individual has End-Stage Renal Disease (ESRD), he/she may get Medicare regardless of age.

 

Medicare is broken up into three parts; Hospital Insurance (Part A), Medical Insurance (Part B) and Prescription Drug Coverage (Part D).

 

There is another part called Part C, also known as Medicare Advantage.  Medicare Advantage is a combination of Part A, Part B, and usually includes Part D as well.  Part C is really a defined benefit plan, better known as Medicare Advantage Prescription Drug Plan

 

Individuals currently receiving Social Security benefits or the Railroad Retirement Board (RRB), will automatically be enrolled in Part A and Part B on the first day of the month they turn 65. Those folks who have birthdays on the first day of the month, will have Part A and Part B coverage beginning the first day of the previous month.

 

Disabled individuals who are under 65, will automatically receive Parts A and B if they receive disability benefits from Social Security or from the Railroad Retirement Board for a minimum of 24 months.

 

Those with ALS (Lou Gehrig’s disease) will receive Parts A and B automatically in the month their Social Security disability benefits activate.

 

Those individuals who become automatically enrolled, will receive their red, white, and blue Medicare card in the mail three months prior to their 65th birthday, or at the 25th month of receiving disability benefits. A monthly premium for Part B will be required if you decide to keep it. You may elect not to keep Part B and not pay a monthly premium; however, if you later change your mind, you may not be able to enroll right away and a penalty will be assessed once you do enroll.  You will have to pay this penalty for as long as you keep Part B.

  

Some individuals will not become automatically enrolled and will have to sign up for Part A, Part B, or both. These individuals are those who are close to 65, but are not receiving Social Security or Railroad Retirement Board (RRB) benefits. You can enroll as early as three months before your 65th birthday by contacting your local Social Security. Railroad employees must contact the Railroad Retirement Board. Individuals who do not enroll in Part B when first eligible may end up paying a late enrolment penalty for as long as they keep Part B.

 

Puerto Rico residents receiving Social Security or the RRB benefits, will automatically be enrolled in Part A on the first day of the month they turn 65 years old, or after they receive disability benefits for a minimum of 24 consecutive months. To become enrolled in Part B, however, Puerto Rico residents will have to complete an “Application for Enrollment in Part B Form”.  Individuals who do not enroll in Part B when first eligible may end up paying a late enrollment penalty for as long as they keep Part B.

 
 
 
Medicare Basics