7/24/2023
The first thing you need to understand is that the health insurance known as Medicare is for people 65 years of age or older. Your eligibility begins 3 months before your 65th birthday.
But if you have Lou Gehrig's disease (ALS), ESRD or a disability, you can get into this program earlier. Below, we will show you the steps to do so.
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Medicare Basics
Although we cannot go into this section in depth, the important thing to know is that Medicare gives you several alternatives for insurance. In essence, the program consists of two main parts: A and B. The first refers to hospitalization insurance and the second involves extended medical insurance.
To the above must be added the costs of each and parts C (Advantage Plan), D (Medication) and the Medigap (supplementary plan). With respect to expenses, we will simplify the information shown by the government on the website of this program. This is the data for the year 2023:
Part A
The premium usually costs $0 if you have 10 years of Medicare taxes deducted. If you don't qualify, you can pay the remainder. This 2023, the premium may be $278 or $506 a month depending on what you have been taxed on.
The deductible is $1,600 each time you are admitted to the hospital during a benefit period (unlimited) and before original Medicare begins to pay. We remind you that to access Part A, you must apply for Part B first.
Part B
The premium for health insurance costs $169.90 or more each month depending on your income. Although this amount may vary over the years, you must pay the premium, even if you do not use the coverage of the services associated with Part B.
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The deductible is $226 each year before original Medicare begins to pay. When you don't sign up for Part B while eligible, you may be charged a penalty. Late enrollment costs you 10% more for each year you choose not to join the plan.
This penalty is added to your monthly Part B premium and lasts as long as you have this benefit. If you qualify for a special enrollment period, you won't have to pay the penalty. This happens when you or your partner are working and have health insurance.
How do you enroll in Medicare?
The next step is the actual enrollment in Part A and Part B. For these plans, you must first contact the Social Security Administration or the Railroad Retirement Board. This process is simple because you do not need to open a Medicare account.
Once you obtain a program identification number, you can proceed to obtain an account. You also have the option to purchase supplemental insurance or join a plan. As a reminder, you can only enroll in Part B at the indicated time.
Do you want to apply for Part A and Part B or only Part A?
Three months before your 65th birthday, you are eligible for Medicare. When this happens, you have 2 options:
- Sign up for coverage.
- Apply for Social Security benefits. If you are approved, you will automatically be assigned Part A. When you apply for benefits, you choose whether to apply for Medicare. When you apply for benefits, you choose whether you want Part B.
With either of these alternatives, you receive a welcome package and a Medicare card.
At the time you consider, you can contact Social Security to join the program. This can be done in several ways:
- Contact your local Social Security office.
- Call 1-800-772-1213. If you have TTY, you can call 1-800-325-0778.
- If your partner worked for the railroad system, call the Railroad Employees Retirement Board: 1-877-772-5772.
- Apply online at the Social Security website. This is the easiest way to enroll in Medicare and get financial help. You must create your 'my Social Security' account to enroll in the program or get the benefits listed above.
I already have Part A, but I want to add Part B.
In this case, you have to contact Social Security to register for Part B. This can be done in 4 ways:
- Contact your local Social Security office.
- Call 1-800-772-1213. If you have a TTY, you can call 1-800-325-0778.
- If your spouse worked for the railroad system, contact the Railroad Retirement Board: 1-877-772-5772.
- Complete Form CMS-40B (Application for Medicare Part B Enrollment). When you have it ready, mail or fax it to the appropriate Social Security office.
I want to enroll in Medicare because I lost my job insurance or I am retiring.
If you want to qualify for the Special Enrollment Period, your employer must complete Form CMS-L564. If they can't, fill out section B as best you can and don't sign because you must provide proof of employment-based health insurance.
You can also register online or send the form to your local Social Security office.
Español: ¿Cómo aplicar para Medicare o para alguna de sus partes?