A Summary Of Medicare Benefits For Residents Of Florida
|St. Lucie Medical Center
1800 SE Tiffany Ave
Port St. Lucie, FL 34952
Plus Code: 7PQ4+9C Port St. Lucie, Florida
Medicare is a federal health insurance program that is run by the Centers for Medicare & Medicaid Services. There are some small differences from state to state, but most of Medicare is the same everywhere in the U.S., so the coverage Florida residents get will be similar to Medicare coverage everywhere else in the country.Individuals 65 and older who are citizens of the United States or who have lived in the country legally for at least five years straight.
Individuals younger than 65 with certain qualifying illnesses or disabilities.
Medicare Part A
Medicare Is Available To Two Groups Of People.
Part A is sometimes known as Medicare hospital insurance, and it typically covers inpatient hospital treatment, skilled nursing facility care, hospice, and certain forms of qualifying home health care. Medically essential services and equipment (e.g., nurse services, a semi-private room, prescription medicines, etc.) are normally reimbursed if part of a beneficiary's inpatient treatment.
Hospice care is also covered if a beneficiary is diagnosed as terminally ill and has six months or less to live. Doctor/nursing services, hospice aide services, physical/occupational therapy, prescription medicines, and caregiver respite care are all provided.
Part A does not cover long-term nursing home or care facility benefits. Only institutions where assistance with personal care, such as eating and bathing, is provided are covered.
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.
In Florida, when you turn 65, if you are already receiving payments from Social Security or the Railroad Retirement Board, you will usually be enrolled in Medicare Part A and Part B automatically. If you are under 65 and disabled, you are eligible for both Part A and Part B of Medicare after 24 months of receiving disability benefits from Social Security or the Railroad Retirement Board.
In either event, you should expect to get a Welcome to Medicare
packet that contains your Medicare card and detailed information on the program. During the Initial Enrollment Period, you can enroll in Medicare even if you don't match these criteria (IEP). The seven-month Individualized Education Plan (IEP) period begins three months before to the month you turn 65 and ends three months following the month you turn 65.
If you are eligible, you can enroll in Medicare Parts A and B during a Special Enrollment Period after your IEP ends. During the Medicare General Enrollment Period (January 1 through March 31 each year), you can also enroll, although doing so may result in higher rates and a delay in coverage.
Part A coverage is free for those who qualify, with the exception of deductibles for hospital stays. If you do not qualify for free Medicare Part A coverage, you can still enroll and pay a premium if you meet one of the following conditions:
You are at least 65 years old.
You are enrolled in Medicare Part B, or you are in the process of enrolling.
You meet citizenship and residency requirements..
The cost of your premium will vary based on how long you have worked and how close you are to earning 40 Social Security credits.
If you enroll in and pay for Medicare Part A, you must often also enroll in and pay a separate premium for Medicare Part B.
Upcoming Article: Understanding Medicare Part B, C, and D.
Speaking with a true Medicare health insurance specialist will be the best way to sum up all the information you acquired, and turn it into a smart health plan choice. When it comes to choosing the right health care plan, knowledge and expertise are an irreplaceable necessity.
A good insurance broker can help you with all aspects of the health insurance plan purchasing process. Because their expert assistance is normally free, getting assistance from a licensed Medicare insurance professional is a smart, sensible step in any insurance purchasing decision.
Good to know: Just because your doctor writes you a prescription doesn't mean you can fill it. Expensive medications for treatment of certain cancers, diabetes, liver disease, and a host of other maladies can cost patients tens to hundreds of thousands of dollars if the insurer does not cover the drugs. But even if the drugs are covered, insurers have been known to try to stall, just to see if the patient will come up with the money to pay for the drugs rather than wait on the insurer's approval. What can we say? It happens.
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We understand how choosing the right plan for the needs of you and your family can be confusing. Plan benefits, physician networks, deductibles, Rx coverage, price, and more, are all aspects of a health insurance plan that should be well considered.
Our licensed Medicare insurance professionals are happy to help you sort through all of the particulars in order to find a high-quality health insurance plan that fits your needs and budget. Our services are free. Call now. (772) 200-4604