Am I Eligible for Medicare?

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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:

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:

 

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 reprepresentatives 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 don't 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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