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When Are My Parents Eligible for Medicare?

Summary:  

  • Most people become eligible for Medicare when they turn 65 or have been disabled for two years.
  • It’s possible to be retired and not eligible for Medicare.
  • There are annual enrollment periods for Medicare Advantage and Medicare prescription drug plans.

Making sure your aging parents have quality health care may be one of your top priorities. A first step is to know when your parents are eligible for Medicare. There are different times when your parents might become eligible for Medicare. When you know when they can enroll, you can make sure they have the coverage they need, when they need it.

Are My Parents Eligible for Medicare when They Retire?

Some people think they are eligible for Medicare once they retire. That may be true depending on when a person stops working. Most people generally cannot sign up for Medicare until they are turning 65. If your parent retires at 65 or later, they are eligible for Medicare right away.

Is My Parent Eligible for Medicare if They Become Disabled?

Your parent can also become eligible for Medicare before 65 if they become disabled or have a specific health condition. If they qualify for Medicare through disability, they typically must receive Social Security or Railroad Retirement Board benefits for 24 months. They may get a Medicare card at that time. If your parent does not receive a card in the mail, contact the Social Security office.Your parent may be eligible for Medicare sooner if he or she has certain disorders. Individuals with end-stage renal disease (ESRD) may be able to sign up for Medicare sooner. In most cases, they can sign up three months after dialysis begins or right after a kidney transplant. A person with Lou Gehrig’s disease (ALS) can sign up for Medicare when they start getting Social Security disability benefits.

What are the basics of Medicare?

Part A and Part B make up Original Medicare. Part A covers inpatient hospital days and skilled nursing facilities. Part B covers medical services outside the hospital, like a visit to their doctor. Individuals can sign up for Original Medicare when they turn 65 or receive Social Security disability benefits for 24 months. Original Medicare has some significant coverage gaps, like no coverage for most prescription drugs. Original Medicare also has no out-of-pocket maximum. These gaps lead many people to look for additional insurance.

Your parent can also choose to sign up for a Medicare Advantage or Prescription Drug Plan. These plans may offer more benefits your parent might need. Private companies approved by Medicare offer these plans. Some plans have extra costs like a monthly premium, deductible or copayments.

It is best to sign up for Part A as soon as your parent is eligible. Most people do not pay a monthly premium for Part A. Part B has a monthly premium. If your parent has insurance through an employer, they may wait to enroll in Part B to avoid the monthly cost.

Your parent should sign up for Part B as soon as their other coverage stops. There are penalties for going without coverage for eight months or longer. Your parent will pay the late enrollment penalty as long as they have Medicare Part B if they go this period without insurance.

Medicare Advantage is an alternative way to get Original Medicare. It may offer coverage for other services like dental or vision care as well. Part D Prescription Drug Plans cover your parent’s prescription medications. Many Medicare Advantage plans also offer prescription drug coverage.

When Can My Parents Sign Up for Medicare?

Your parent may be automatically enrolled in Medicare Part A and Part B (hospital and medical insurance) if he or she is turning 65 and already getting Social Security or Railroad Retirement Benefits. They will know because they will receive a card in the mail. If your parent doesn’t receive a card, they can sign up through the Social Security office. There are different times when your parents can sign up for other Medicare coverage, such as Medicare Advantage or stand-alone Medicare prescription drug plans.

Period When Can do what
Initial Enrollment Period 7 months, beginning three months before the month a person turns sixty-five. It includes those three months, the birthday month, and three months after. ·        Sign up for Medicare Part A and Part B

·        Sign up for a Medicare Advantage plan

·        Sign up for Medicare Part D prescription drug coverage

Annual Election Period (AEP) October 15 to December 7 each year ·        Change from Original Medicare to a Medicare Advantage plan

·        Enroll in a Medicare Part D prescription drug plan, among other things

General Enrollment Period/Medicare Advantage Open Enrollment Period January 1 to March 31 each year ·        Sign up for Medicare Part A and Part B

·        Change from one Medicare Advantage plan to a different one

·        Drop Medicare Advantage and return to Original Medicare

Your parent may have a higher premium if they sign up for Medicare Part B during the General Enrollment Period.

Another time to sign up for Medicare is during a Special Enrollment Period or SEP. This period occurs when your parent stops getting insurance coverage from their job or has another life change that makes them lose coverage, like moving out of a plan’s service area. The SEP generally starts when their current coverage ends.

These plans can help cover medical costs not covered by Original Medicare. To find plans in your area, enter your zip code on this page.

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