Medicare is a federal health insurance program run by the Centers for Medicare & Medicaid Services. There are a few minor variances across states, but the vast majority of Medicare is the same throughout the United States, so the coverage South Carolina people receive will be comparable to Medicare coverage around the country.


Two Categories Of Individuals Are Eligible For Medicare.

Individuals aged 65 or older who are citizens of the United States or have been permanent legal residents for at least five years.

Individuals under the age of 65 with certain qualifying medical conditions or disabilities.

Medicare Part A

Part A, usually referred to as Medicare hospital insurance, typically covers inpatient hospital care, skilled nursing facility care, hospice care, and a limited number of home health care services that are qualified. If part of a beneficiary's inpatient treatment, medically essential services and supplies (such as nurse care, a semi-private room, prescription medications, etc.) are also typically reimbursed.

If a beneficiary is determined to be terminally ill and has six months or fewer to live, hospice care is also covered. Prescription medications, physical and occupational therapy, doctor and nursing services, hospice aide services, and caregiver respite care are all provided.

Long-term nursing home or care facility benefits are not covered under Part A. Sole settings where support with personal care, such as eating and bathing, is not the only service a beneficiary receives are covered.


Eligibility

If you have worked and paid Medicare taxes for at least 10 years prior to turning 65, you will have free coverage under Part A automatically enrolled for you (40 quarters). If your spouse is eligible for Medicare Part A benefits without having to pay a premium, then you may also be qualified for these benefits without having to pay a premium if you meet the requirements.
You or your spouse may be eligible for free benefits if either of you receives, or is eligible to receive, Social Security or Railroad Retirement benefits, or if either of you receives benefits from those programs. This benefit is still accessible even if the spouse of the individual seeking coverage has passed away or the couple has split.
You are still able to sign up for Medicare Part A even if you do not meet the work requirements; however, you will be required to pay a monthly payment.

If you're under age 65, you can qualify for Medicare Part A coverage if:

You have end-stage renal disease (ESRD) or permanent kidney failure that requires either 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 where they paid Medicare taxes, and you meet the requirements for the Social Security disability program.
You are eligible if you received a disability award from the Department After receiving either of these types of disability benefits for a total of 24 months, you are qualified for automatic enrollment in Medicare Part A and Part B. It is not necessary for these months to be in consecutive order.


Enrollment

In South Carolina, usually, Part A and Part B coverage will begin on the first day of the month you turn 65 if you already get Social Security or Railroad Retirement Board benefits. If you are disabled and under 65, you will automatically get Parts A and B after 24 months of receiving disability benefits from the Railroad Retirement Board or Social Security.

You'll receive a Welcome to Medicare packet in both situations, which includes your Medicare card and comprehensive information about how Medicare functions.

You can enroll in Medicare during your Initial Enrollment Period even if you don't match these criteria (IEP). Your IEP is the seven-month term that starts three months prior to the month you turn 65 and ends three months thereafter.

If you're eligible, you can enroll in Part A and Part B during a Special Enrollment Period after your IEP expires. You can also enroll during the Medicare General Enrollment Period (which runs from January 1 through March 31 each year), but doing so could result in higher rates and a longer wait for coverage.


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.




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