The Basics of Medicare
What is Medicare?
Medicare is a federal health insurance program system for:
people age 65 or older;
people under age 65 with certain disabilities; and
people of all ages with chronic illnesses such as End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) and Lou Gehrig’s Disease (neurodegenerative disorder that results in the loss of motor neurons that control voluntary muscle contraction).
Medicare v.s. Medicaid
Unlike Medicare, which is a federal program that sets standards for costs to ensure that coverage is the same no matter what state you live in, Medicaid is a joint federal and state health insurance program that helps cover medical costs for people with limited income.
The federal government sets broad guidelines that all state Medicaid programs have to follow, but each state runs its own programs, which means that the eligibility requirements and benefits differ from state to state.
Medicare specifically covers people of retirement age, or people with disabilities or chronic illnesses. Medicaid covers a broader spectrum of people with limited resources.
Medicare Eligibility
Approximately 85% of the people enrolled in Medicare are:
at least 65; and
have paid into Medicare tax system for at least 40 quarters (equivalent to 10 years of work).
There’s still a way to qualify for Medicare even if you don’t have the required 40 quarters of work history. If you’ve been married for at least one year to someone who’s at least 62 years old and eligible for Social Security, you can draw Medicare eligibility from their work record.
In the case of divorce, you can still receive benefits from your ex-spouse if the marriage lasted for at least 10 years, with no remarriage before the age of 60.
In the event of your spouse’s death, you can still receive benefits as long as the marriage lasted at least 9 months, with no remarriage before the age of 60. Even if you were divorced from the deceased spouse, you may still be eligible so long as the marriage lasted at least 10 years.
In any of these cases, you must still have at least 40 quarters, either from your own work record or someone else’s, though you will have to provide additional documentation if you’re drawing quarters from someone else’s record.
Approximately 15% of those enrolled in Medicare are under the age of 65. They qualify due to disability or chronic illness.
Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:
You already get retirement benefits from Social Security or the Railroad Retirement Board.
You are eligible to get Social Security or Railroad benefits but have not yet filed for them.
You or your spouse had Medicare-covered government employment.
If you are under 65, you can get Part A without having to pay premiums if:
You have received Social Security or Railroad Retirement
Board disability benefit for 24 months. You are a kidney dialysis or kidney transplant patient.
While you don’t have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don’t get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.
Author: Jason White with Sylk Insurance Group, a Retirement Gurus founder
https://www.sylkinsurancegroup.com/medicare-basics