The Centers for Medicare & Medicaid Services are in charge of managing the federal health insurance program known as Medicare. While there are a few minor variations from state to state, Medicare is largely the same across the country, thus the coverage received by residents of South Carolina will be quite similar to Medicare coverage across the country.


Medicare Is Open To Two Categories Of People

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 is commonly known as Medicare's hospital insurance, and it normally covers hospital inpatient care, skilled nursing facility care, hospice care, and certain forms of qualifying home health care. Generally, medically essential services and equipment (e.g., nurse services, a semi-private room, prescription medicines, etc.) are reimbursed if they are part of an inpatient beneficiary's treatment.

If a patient is diagnosed with a terminal illness and has less than six months to live, hospice treatment is also covered. Included are physician/nursing services, hospice aide services, physical/occupational therapy, prescription medications, and caregiver respite care.

Long-term nursing home and care facility benefits are not covered under Part A. Coverage is restricted to institutions where assistance with personal care, such as eating and bathing, is not the sole service a beneficiary receives.


Eligibility

Those who paid Medicare taxes while employed for at least ten years are automatically enrolled in free Part A coverage when they turn 65. (40 quarters). You might be eligible for premium-free Part A benefits if your spouse is. If they are, then you might be as well. If you or your spouse are currently receiving or are eligible for Railroad Retirement benefits, you may also be eligible for free benefits. Even if the applicant's spouse passed away or got divorced, this benefit is still available.
Even if you don't have a job, you can still enroll in Part A, but you'll have to pay a monthly premium.

In order to be eligible for Medicare Part A benefits if you are under 65, you must:

Meet the requirements for the Social Security disability program. You may be eligible if you have end-stage renal disease (ESRD) or permanent kidney failure that necessitates ongoing dialysis or a transplant, receive disability benefits due to Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig's disease), are the child or widow(er) of a worker who worked in a government job for a sufficient amount of time to have paid Medicare taxes, are 50 years of age or older, After receiving one of these disability benefits for 24 cumulative months, you are automatically enrolled in Parts A and B. These months don't have to be one after the other.


Enrollment

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

In either instance, you will receive a Welcome to Medicare packet containing your Medicare card and comprehensive information on how Medicare operates.

You can enroll in Medicare during the Initial Enrollment Period if you do not meet these conditions (IEP). Your IEP is the seven-month period beginning three months before your 65th birthday and ending three months after it. If you qualify, you may enroll in Medicare Parts A and B during a Special Enrollment Period following the conclusion of your IEP. You may also enroll during the Medicare General Enrollment Period (January 1 through March 31 each year), but this may result in higher costs and delayed 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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