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What are the Different Medicare Guidelines?

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  • Written By: Autumn Rivers
  • Edited By: J.T. Gale
  • Last Modified Date: 17 April 2018
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Medicare is a United States government program that offers health insurance to certain citizens. It has two parts, referred to as Medicare Part A and Medicare Part B. For the most part, Medicare guidelines are pretty straightforward.

To be eligible for Medicare, one must be at least 65 years old. A person whose spouse worked 10 years or more in a Medicare-covered job also can receive coverage at 65. Those with end-stage renal disease, commonly known as chronic kidney failure, are eligible as well. The 65-year-old age requirement is waived for those applicants who have a disability.

Part A is hospital insurance which pays for care from a hospital, some nursing facilities, and hospice care. Medicare guidelines state that those with Part A do not have to pay for it since it comes out of their paychecks via taxes when they are employed. Some people did not pay enough Medicare taxes while working so they simply have to purchase Part A and pay a monthly premium.

General Medicare guidelines for Part A state that anyone age 65 or older can get the coverage without premiums as long as they either receive or are eligible for Social Security or Railroad Retirement Board disability benefits. Having a spouse who worked in a Medicare-covered United States government job is also a way to receive coverage. Those under age 65 can also get the same coverage if they have received Railroad Retirement Board or Social Security benefits for at least two years, which typically requires having a certain approved disability.

Part B is considered medical coverage which includes visits to the doctor, physical therapy, and outpatient care. In order for components of Part B to be covered by Medicare, they must be deemed medically necessary. Enrollment in Part B is by choice and typically costs about $100 US Dollars (USD) per month, though it could change at any time, particularly for those with a higher income.

Under nearly all circumstances, Part B is optional and must be paid for. Though the retirement age under Social Security rules is 67-years-old, those who are eligible can get Medicare at age 65. Those who did not pay enough into the Social Security fund while working might not receive Part A for free, but they can pay for it as long as they have been a legal resident of the United States for at least five years.

Medicare guidelines do not state that retirement is necessary to be enrolled in any of the programs. Those within three months of their 65th birthday should look into the benefits whether they are still working or not. Official Medicare guidelines and applications can be found on the US government's website.

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