Am I Eligible for Medicare?
Medicare and You →
Apply for Medicare Online
→
Medicare Coordination →
Medicare
is available to individuals age 65 and older. You can
start the application process 3 months before the month in
which you turn
65.
You’ll
be able
to keep his current providers,
as
long as they are participating in the Medicare program. Medical
providers, suppliers and groups must enroll in the Medicare program to
be eligible for payments for Medicare-approved services. To
find out if your provider is participating, call you provider directly. Your
provider will fall into one of three categories:
Participating
providers accept
Medicare and always take assignment. Taking assignment means that the provider
accepts Medicare’s approved amount for health care services as full
payment.
Non-participating
providers accept
Medicare but do not agree to take assignment in all cases (they may on a
case-by-case basis). This means that while non-participating providers have signed
up to accept Medicare insurance, they do not accept Medicare’s approved amount
for health care services as full payment.
Opt-out
providers do
not accept Medicare at all and have signed an agreement to be excluded from the
Medicare program. This means they can charge whatever they want for services but
must follow certain rules to do so.
After
confirming you provider’s status, you should start the application process and set
up your account with the Centers
for Medicare & Medicaid Services (CMS).
Once
you’re
ready to apply, you’ll need the
following information on hand, before you
begin
the online application process:
Date
and Place of Birth If they were born outside the United States or its
territories:
•
Name of birth country at the time of their birth (it may have a different name
now)
•
Permanent Resident Card number (if they are not a U.S citizen)
Current
Health Insurance
•
Employment start and end dates for their current employer who provides them health
insurance coverage through a Group Health Plan
•
Start and end dates for the Group Health Insurance provided by their current
employer
First
you
will need to
create a my Social Security account if you
don’t
have
one already at: https://www.ssa.gov/myaccount/ (This
will allow
you to check
on your
application
and
access your personal
information).
Once
you have your account established, go
to: https://www.ssa.gov/benefits/medicare/ to
actually apply.
Once there, scroll down to
select the blue button “Apply for Medicare
Only" button
Apply and complete the
application (which normally takes 10 to 30 minutes).
Select “Submit Now”
to send your application electronically.
Print/Save your receipt /
confirmation page and application number.
(You
can always go back to your my Social Security account to check status with this
info)
After
enrollment, you will be
mailed a letter with the determination and how to proceed. The representatives
at
CMS will take you
through
the whole process from that point forward.
When
can I apply?
You
can start the application process 3 months before the month you turn 65. This includes
the month you turn age 65 and ends three months after that birthday. Avoid enrolling
late, as it will make you subject to penalties (part-b-late-enrollment-penalty & part-a-late-enrollment-penalty).
Will
I be able to keep my current providers?
You
may be able to keep your current providers as long as they too are participating in the
Medicare program. Medical providers, suppliers and groups must enroll
in the Medicare program to be eligible for payments for
Medicare-approved services. A suggested way to start-off would be by
reaching out to each of your providers to ask them to confirm if they are enrolled. You
may come to discover they will fall in to one of 3 categories of providers:
Participating
providers accept Medicare and always take assignment. Taking assignment
means that the provider accepts Medicare’s approved amount for health care
services as full payment.
Non-participating
providers accept Medicare but do not agree to take assignment in all cases
(they may on a case-by-case basis). This means that while non-participating providers
have signed up to accept Medicare insurance, they do not accept Medicare’s
approved amount for health care services as full payment.
Opt-out
providers do not accept Medicare at all and have signed an agreement to be
excluded from the Medicare program. This means they can charge whatever they want for
services but must follow certain rules to do so.
Once
you've gone through the application process and the Centers for Medicare &
Medicaid Services finalize your application / account, and it comes time to choose a
plan and other options, CMS will be able to verify if the providers are participating or
if you may have to search for new ones.
Where
can I find more detailed information about applying and how Medicare
works?
Please
consider downloading and reading the useful digital guides provided (below?) before
applying for Medicare.
How
do I get started once I am eligible and ready to apply?
One
you are ready to apply, you'll need the following information on hand, before you
begin the online application process:
Date
and Place of Birth If they were born outside the United States or its
territories:
•
Name of birth country at the time of their birth (it may have a different name
now)
•
Permanent Resident Card number (if they are not a U.S citizen)
Current
Health Insurance
•
Employment start and end dates for their current employer who provides them health
insurance coverage through a Group Health Plan
•
Start and end dates for the Group Health Insurance provided by their current
employer
First
you'll have to create a my Social Security account if you dont have one
already at: https://www.ssa.gov/myaccount/ (this
will be the way you can check on your application and personal info and data, later as
well)
Then you'll need to go to: https://www.ssa.gov/benefits/medicare/ to
actually apply.
Once
there, scroll down to select the blue button “Apply for Medicare
Only" button
Apply and complete the application (which
normally takes 10 to 30 minutes).
Select “Submit Now” to send your
application electronically.
Print/Save your receipt / confirmation page and
application number.
(you can always go back to your my Social Security
account to check status with this info)
You'll
eventually be mailed a letter with the determination and how to proceed. The reps at CMS
will take you through the whole process from that point forward.
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