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 Georgia residents get will be similar to Medicare coverage everywhere else in the country.


Medicare Is Available To Two Groups Of People.

Those 65 and older who are citizens of the United States or who have lived there lawfully for five consecutive years or more.

Those under 65 who have certain qualifying illnesses 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 Georgia, if you already get benefits from Social Security or the Railroad Retirement Board, you will usually get Part A and Part B coverage on the first day of the month you turn 65. If you are under 65 and disabled, you will automatically get Part A and Part B after getting disability benefits from Social Security or the Railroad Retirement Board for 24 months.

In either case, you'll get a Welcome to Medicare package with your Medicare card and full information about how Medicare works. You can sign up for Medicare during your Initial Enrollment Period if you don't meet these requirements (IEP). Your IEP is the 7-month period that starts three months before you turn 65 and ends three months after you turn 65.

When your IEP is over, if you qualify, you can sign up for Part A and Part B during a Special Enrollment Period. You can also sign up during the Medicare General Enrollment Period, which runs from January 1 to March 31 every year. However, if you choose this option, you may have to pay more and get coverage later.


Costs

Except for some hospital stay expenses, Part A coverage is free if you meet the requirements. The following conditions must be met in order to enroll and pay a premium even if you are not eligible for free Part A coverage:

You meet citizenship and residence requirements.
You are 65 years of age or older
You have enrolled in Medicare Part B coverage or are in the process of doing so.

In most situations, if you sign up for and pay for Medicare Part A, you also need to sign up for and pay for Medicare Part B separately.


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".  Our health plan specialists are happy to help.

We know how confusing choosing a health insurance plan can be.  Plan benefits, physician networks, deductibles, Rx coverage, price, and other factors all need to be carefully considered.

Our team of Medicare insurance professionals will gladly assist you in sorting through all of the details in order to find a high-quality health insurance plan that meets your needs and fits within your budget.   Our services are free.  call now.    706-865-0887