Medicare and Seniors

Medicare Eligibility

The following groups are eligible for Original Medicare (both Part A and B)

  • In general if you are senior and meet criteria for certain disabilities.
  • A U.S. citizen or if you have been a Permanent Resident of the U.S. for the past 5 years.
  • Even if you are already receiving Social Security benefits, you need to be a senior to get Medicare.
  • You are a senior (Your spouse's age does not apply).
  • You can still be eligible for Medicare when a senior even if you are not receiving Social Security benefits.

Medicare Benefits

Here's a brief look at what Medicare Part A and Part B cover

Part A

most medically necessary hospital, skilled nursing facility, home health and hospice care.

  • Inpatient hospital care
  • Psychiatric hospital care
  • Home health care
  • Skilled nursing facility care
  • Blood transfusion during your hospital stay

Part B

most medically necessary doctor's services, preventive care and other medical service not requiring hospital stay.

  • Doctors' services
  • Outpatient medical & surgical services
  • Ambulance services
  • Outpatient mental health care.
  • Laboratory services
  • Durable medical equipments(Wheelchairs, Home oxygen supplies, etc...)*
  • Outpatient physical, occupational, speech-language therapies
  • Certain Preventive care services
* Services and supplies must be medically necessary to treat a disease or dondition.

You must be entitled to Medicare Part A and enrolled in Medicare Part B and live in the plan's service area to be eligible for these plans. You must continue to pay your Medicare Part B premium.

Medicare Resources

Centers for Medicare and Medicaid Services

Part A

  • Most people don't pay a monthly premium
  • Member pay $1,364 deductible for each benefit period. Days 1-60: $0 coinsurance for each benefit period.
  • Enrollment is simple. You cannot be denied coverage because of current or past health problems.
  • You may have to pay more for long term hospital stay.
  • Hospital inpatient stay longer than 60 days requires co-insurance per day of each benefit period.
  • You may need to pay separate co-insurance for each hospital stay.
  • Original Medicare allows you to go to any hospital that accepts Medicare.
  • In general, health care you get in a foreign hospital isn't covered.

Part B

  • There is no yearly limit for what you pay out-of-pocket.
  • In general, after your deductable, you pay 20% of the Medicare-approved amount of the service
  • You may have to pay a late enrollment penalty if you don't sign up for Part B when you are first eligble.
  • Enrollment is simple. You cannot be denied coverage because of current or past health problems.
  • Part B offers the same benefits throughout the U.S. The services you receive are not limited to a particular state or region
  • However, in general, Part B does not cover medical services you receive outside the U.S.
  • You can see any provider who is participating in Medicare and who is accepting new Medicare patients.
  • There are limits on certain preventive care services.