Medicare is a federal health insurance program that is run by the Centers for Medicare & Medicaid Services. There are some small differences from state to state, but most of Medicare is the same everywhere in the U.S., so the coverage South Carolina residents get will be similar to Medicare coverage everywhere else in the country.


Medicare Is Available To Two Groups Of People.

Those 65 and older who are citizens of the United States or who have lived there lawfully for five consecutive years or more.

Those under 65 who have certain qualifying illnesses or disabilities.

Medicare Part A

Inpatient hospital treatment, skilled nursing facility care, hospice care, and other types of qualifying home health care are all commonly covered under Medicare Part A, also known as Medicare hospital insurance. In most cases, inpatient care, including nursing, a semi-private room, prescription medicines, and other medically necessary services and equipment, are covered by insurance.

Moreover, hospice care is covered if the patient has been given a prognosis of six months or fewer to live. The hospice program covers medical treatment, nursing care, physical therapy, occupational therapy, medication, and caregiver breaks.

Care received at a long-term nursing institution is not covered by Part A. Facilities where the only support a recipient receives is with activities of daily living, like eating and bathing, are not covered.


Eligibility

If you paid Medicare taxes for at least ten years while working, you are automatically enrolled in free Part A coverage at the age of 65. (40 quarters). If your spouse is eligible for Part A coverage without paying a premium, you may be eligible as well.
You may also be eligible for free benefits if you or your spouse receive or are eligible for Social Security or Railroad Retirement payments. This benefit is provided even if the person requesting coverage's spouse is deceased or divorced. If you do not meet the work criteria, you can still enroll in Part A, but you must pay a monthly premium.

If you are under the age of 65, you may be eligible for Medicare Part A coverage if you meet the following criteria:

You have end-stage renal disease (ESRD) or permanent kidney failure that necessitates 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 to pay Medicare taxes and you meet Social Security disability program requirements
After receiving either of these disability benefits for a total of 24 months, you are automatically enrolled in Parts A and B. These months do not have to be in any particular order.


Enrollment

In South Carolina, if you are already receiving payments from Social Security or the Railroad Retirement Board, then in the vast majority of cases, you will automatically be enrolled in Medicare Part A and Part B coverage beginning on the first day of the month in which you reach 65 years old.

After receiving disability benefits from Social Security or the Railroad Retirement Board for a period of 24 months, you will be eligible for automatic enrollment in Medicare Parts A and B if you are under the age of 65 and disabled.

In either scenario, you will receive a Welcome to Medicare packet that contains your Medicare card as well as comprehensive information regarding the operation of Medicare.

In the event that you do not satisfy these prerequisites, you still have the opportunity to enroll in Medicare during your Initial Enrollment Period (IEP). Your Individualized Education Program (IEP) spans the seven months that begin three months before the month in which you turn 65 and end three months following the month in which you turn 65.

If you are eligible, you will be able to enroll in Medicare Part A and Part B during a Special Enrollment Period at the conclusion of your IEP. You can also sign up for Medicare during the General Enrollment Period, which runs from the first of the year until the thirty-first of the following month. If you choose this option, however, you may be subject to higher rates and a delay in coverage.


Costs

With the exception of some hospital stay deductibles, Part A coverage is free if you qualify. If you are not eligible for free Part A coverage, you may still sign up and pay a premium if you meet the following criteria:

You must meet certain citizenship and residency requirements, be 65 years old or older, and be enrolled in Medicare Part B coverage or in the process of doing so.

The amount of your premium will change based on how long you have worked and how close you are to reaching the required 40 Social Security credits.

In most circumstances, enrolling in and paying a separate premium for Medicare Part B is required if you want to pay for Medicare Part A.


Upcoming Article: Understanding Medicare Part B, C, and D.




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