A Guide To Medicare Eligibility And Open Enrollment
A Guide to Medicare
Eligibility and Open
Medicare has been an important part of America's
healthcare system since 1965. It oﬀers seniors and most
receiving Social Security Disability Insurance (SSDI) the
ability to receive quality healthcare at a reasonable price.
Medicare eligibility depends on a few factors.
You must be:
Age 65 or older and a U.S. citizen or have
been a permanent legal resident for 5
continuous years; or
Have been receiving SSDI for at least 24
months or Railroad Retirement Board
disability payments; or
Have end stage renal disease or need a kidney
Have ALS (Lou Gehrig's disease); and
You or your spouse must have paid Medicare
taxes for at least 10 years.
If you're not sure what types of
disabilities make you eligible for
Medicare before age 65, the
Allsup website is a good place to
Applying for SSDI can be a long
and diﬃcult process and
Medicare coverage comes only
after a two-year waiting period.
So, you should apply immediately
after becoming disabled.
How to Apply
Seniors can begin the enrollment
process three months before
their 65th birthday to three
People with disabilities who are
eligible for Medicare have the
three months before their month
of eligibility to the three months
Types Of Medicare Coverage
Medicare Part A
Medicare Part A covers hospital
care and is usually free for
people who paid Medicare taxes
Americans who didn't work may
be able to buy Medicare Part A.
Many states oﬀer assistance
with the premiums for those
who qualify for extra help.
Types Of Medicare Coverage
Medicare Part B
Medicare Part B covers doctors' visits,
outpatient hospital care, physical and
occupational therapists and other
medical services and supplies. Most pay
a monthly premium, which is $96.40 a
month in 2009.
To make the payment process easier,
the monthly premium is usually taken
directly out of each month's Social
Security, Railroad Retirement or Civil
Service Retirement payment.
Medicare Advantage is available if
you have Medicare Part A and B
coverage. Medicare Advantage can
include HMOs, PPOs, private fee
for service plans and Medicare
special needs plans.
Medicare Advantage allows you to
get Medicare Parts A and B and
often other coverage under one plan.
Medicare Advantage plans work just
like regular insurance and can also
include prescription drug beneﬁts.
Plan comes with lower co-pays and
extra beneﬁts not included in
However, these beneﬁts may include an
additional monthly premium and may
restrict beneﬁciaries to speciﬁc doctors
It's up to the you -- the Medicare
recipient -- to determine which
Medicare plan is best.
Why You Shouldn't Wait To
Most enroll in Medicare during their initial
enrollment period. If you missed your
window, you’ll need to wait until the next
available enrollment period.
The cost of Medicare B will go up 10% each
year you’re eligible for the program, but do
not sign up. This penalty is imposed as long
as you are eligible for Medicare Part B
coverage. There are some exceptions to this
rule. One exception being that if you or
your spouse are working and covered under
a group health plan, you can delay
enrollment in Medicare until you no longer
have health insurance coverage.
Medicare Enrollment Periods
If you missed your initial enrollment period,
you'll need to wait until the available
Medicare enrollment period.
Annual enrollment period: takes place
between November 15 – December 31 every
General enrollment period: available January
1 – March 31 each year for Medicare Part B
Open enrollment period: available January 1
– March 31 each year for Medicare.
Special enrollment periods can occur
anytime of year depending on circumstances.
Making Sense Of It All
With Medicare Part A, Medicare Part B,
Medicare Advantage and Medicare
Prescription Drug Coverage, it's no
wonder that recipients are left confused
as to which is the best Medicare plan for
Help is available. Allsup helps people
receive the beneﬁts they're entitled to.
Your A!sup Medicare Advisor works one-
on-one with you and Medicare to help
you determine which Medicare plan is
right for you.
How Allsup Helps
Allsup's Medicare experts will:
Review your individual circumstances:
your medications, healthcare
requirements, your personal doctors
and your ﬁnances.
Educate you on local Medicare
Prepare a detailed report outlining the
plans that best meet your needs.
Help you enroll and answer questions.
Allsup isn't an insurance company.
Allsup is a nationwide provider of
Social Security disability, Medicare and
workers’ compensation services for
individuals, employers and insurance
Celebrating its 25th anniversary in
2009, Allsup employs about 600
professionals who deliver specialized
services supporting people with
disabilities and seniors so they may
lead lives that are as ﬁnancially secure
and as healthy as possible.