Medicare Eligibility
You're eligible for Medicare if:
- You're age 65 or older
- You're under 65 with certain disabilities
- You have ESRD (end-stage renal disease, permanent kidney failure treated with dialysis or a transplant) or ALS (Lou Gehrigs disease), regardless of your age
What are the basic parts of the Medicare program now?
- Part A: (Hospital Insurance) is managed by the federal government to help pay for care in a hospital and skilled nursing facility, home health care, and hospice care - usually for no monthly premium.
- Part B: (Medical Insurance) is managed by the federal government to help pay for doctors, outpatient hospital care, and other medical services - usually for a monthly premium, which is deducted from your Social Security check.
- Part C: (Medicare Advantage Plans) is offered by private companies like Aetna, who contract with the federal government, to cover the same or more benefits than Original Medicare (Parts A and B). Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Some Medicare Advantage plans also include Medicare prescription drug coverage (MA-PD plans); others do not (MA plans).
- Part D: (Medicare prescription drug coverage) is offered by private companies like Aetna, who contract with the federal government, to help cover your prescription drug costs only. This coverage is available as a Medicare prescription drug plan (PDP) or as part of a Medicare Advantage plan (MA-PD).
- Medigap: (Medicare Supplement Plans) is offered by private companies like Aetna to help pay for certain benefits not covered by Original Medicare (Parts A and B). New Medicare Supplement policies no longer cover prescription drugs.
When can I switch Medicare health plans?
Generally, if you are age 65 and over or disabled and made your Medicare selections for the first time, you can make plan selections and/or changes to your current Medicare coverage any time of year. Advantage plans and prescriptions can only be changed from October 15 through December 7. During this time you can select a new Medicare health and/or prescription drug plan for the next calendar year.
Generally, you may not make any other changes during the year unless you meet certain special exceptions for a Special Election Period (SEP). These exceptions include moving out of the plan's service area or newly becoming eligible for Medicare.