The Centers for Medicare & Medicaid Services (CMS) run the Medicare health insurance program on behalf of the federal government. The Medicare coverage that Florida residents receive will be largely similar to the Medicare coverage that is provided throughout the United States, with a few small exceptions.


Medicare Is Open To Two Categories Of People

Individuals 65 and older who are citizens of the United States or who have lived in the country legally for at least five years straight.

Individuals younger than 65 with certain qualifying illnesses or disabilities.

Medicare Part A

Part A, generally known as Medicare hospital insurance, covers inpatient hospital treatment, skilled nursing facility care, hospice care, and certain types of qualifying home health care. Nursing services, a semi-private room, prescription medications, and other medically essential services and equipment are normally reimbursed if part of a beneficiary's inpatient treatment.

Hospice care is also covered if a beneficiary is diagnosed with terminal illness and has six months or less to live. Included are doctor/nursing services, hospice aide services, physical/occupational therapy, prescription medicines, and caregiver respite care.

Part A does not provide benefits for long-term nursing homes or care facilities. Coverage is limited to institutions where support with personal care, such as eating and bathing, is not the only aid provided to a beneficiary.


Eligibility

If you paid Medicare taxes for at least ten years while working, you are automatically enrolled in free Part A coverage at the age of 65. (40 quarters). If your spouse is eligible for Part A coverage without paying a premium, you may be eligible as well.
You may also be eligible for free benefits if you or your spouse receive or are eligible for Social Security or Railroad Retirement payments. This benefit is provided even if the person requesting coverage's spouse is deceased or divorced. If you do not meet the work criteria, you can still enroll in Part A, but you must pay a monthly premium.

If you are under the age of 65, you may be eligible for Medicare Part A coverage if you meet the following criteria:

You have end-stage renal disease (ESRD) or permanent kidney failure that necessitates ongoing dialysis or a transplant.
You receive disability benefits because you have Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig's disease).
You are the child or widow(er) of someone who worked in a government job long enough to pay Medicare taxes and you meet Social Security disability program requirements
After receiving either of these disability benefits for a total of 24 months, you are automatically enrolled in Parts A and B. These months do not have to be in any particular order.


Enrollment

In Florida, if you already get Social Security or Railroad Retirement Board benefits, you'll usually obtain Part A and Part B coverage on your 65th birthday. If you're under 65 and handicapped, you get Part A and Part B after 24 months of Social Security or Railroad Retirement benefits.

In all circumstances, you'll get a Welcome to Medicare packet including your card and information about Medicare. If you don't satisfy these standards, you can enroll in Medicare during your IEP (IEP). IEP is the 7-month period starting 3 months before your 65th birthday and ending 3 months after.

After your IEP finishes, you can enroll in Parts A and B during a Special Enrollment Period. You can also enroll during the Medicare General Enrollment Period (January 1 to March 31), but you may pay more and have your coverage delayed.


Costs

Other than hospitalization costs, Part A coverage is free for those who qualify. If you do not qualify for free Medicare Part A coverage, you may still enroll and pay a premium if you meet one of the following conditions:

You are at least 65 years old.
You are enrolled or in the process of enrolling in Medicare Part B.
You meet the citizenship and residency requirements.

The amount of your premiums will vary based on the number of years you've worked and how close you are to earning 40 Social Security credits. In most situations, if you enroll in and pay for Medicare Part A, you must also enroll in and pay for Medicare Part B.


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




Now that you are armed with information, contact a local Medicare health insurance broker.  When it comes to selecting the best health care plan for you and your family, the expertise an insurance broker can provide is essential.  A good Medicare insurance broker can assist you with every part of the health insurance plan buying process.  They can review and discuss with you the advantages and disadvantages of plans your are considering.

Speaking with a Medicare health insurance broker is the smart logical step you should make before any health plan purchasing decision.  Best of all, assistance from a Medicare health insurance specialist is normally free.


Choosing a health insurance plan is not something to take "lightly".  We are happy to assist.

We understand how difficult it can be to choose the best plan for you and your family's needs.  Plan benefits, physician networks, deductibles, Rx coverage, and other components of a health insurance plan, should all be carefully considered.

Our licensed Medicare insurance professionals are happy to assist in sorting through all of the details in order to acquire a quality, affordable health insurance plan that meets the needs of you and your family.  Our services are free.  call now.    904-708-0460