Is Medicare Eligibility Based On Income?

Medicare is the United States federal health insurance program that provides health coverage for people who are older than 65 or those younger than 65 with a disability. Medicare helps contain the medical care costs that naturally rise as you get older, keeping you healthy and protected.

What Are The Different Parts of Medicare?

There are four different parts of Medicare. Each of the four parts gives you different coverage: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. Together, Medicare Part A and Medicare Part B make up what is known as Original Medicare. Additionally, you have the option to get Medicare Supplements, or Medigap, to cover gaps in your Medicare coverage.

Who Is Eligible for Medicare?

You are eligible for Medicare if you: 

  • Are 65 years or older, or you are younger with a disability 
  • Have End-Stage Renal Disease or ALS
  • Are a citizen of the U.S.
  • Get benefits from Social Security
  • Get benefits from the Railroad Retirement Board
  • Are a government employee

Some people can be automatically enrolled in Medicare, but others have to sign up, which usually occurs during your initial enrollment period. After your initial enrollment period, when you first become eligible, there are certain times of the year when you can enroll or change your coverage. These times are known as special enrollment periods (available based on your personal circumstances), the general enrollment period (January 1st to March 31st), and the annual enrollment period (October 15th to December 7th).

Is Medicare Eligibility Based On Income?

Medicare eligibility is not based on income. Anyone who meets the above qualifications can get Medicare, regardless of how much money you make. However, you may pay higher or lower premiums for Medicare based on your income.

For low-income Medicare recipients, there are programs like the following to reduce your Medicare costs:

  • Qualified Medicare Beneficiary (QMB) Program helps pay for Part A premiums Part B premiums, deductibles, coinsurance, and copayments. To qualify in 2021, you must make below $1,094/month for individuals and $1,472/month for couples, as well as fall under the $7,970 individual resource limit and the $11,960 married couple resource limit. 
  • Specified Low-Income Medicare Beneficiary (SLMB) Program helps pay for Part B premiums for people who have Medicare Part A and limited income and resources. To qualify in 2021, you must make below $1,308/month for individuals and $1,762/month for couples and fall under the $7,970 individual resource limit and the $11,960 married couple resource limit.
  • Qualifying Individual (QI) Program helps pay Part B premiums for people who have Part A and limited income and resources. To qualify in 2021, you must make below $1,469/month for individuals and $1,980/month for couples and fall under the $7,970 individual resource limit and the $11,960 married couple resource limit.
  • Qualified Disabled and Working Individuals (QDWI) Program helps pay the Medicare Part A premium. You may qualify if you’re a working disabled person under 65, you aren’t getting state medical assistance, you meet your state’s income and resource limits, or you lost your Social Security disability benefits and premium-free Part A because you returned to work.

Medicaid is also available in combination with Medicare for certain income-qualifying individuals. 

Higher-income Medicare recipients may have to pay a higher Medicare Part B premium. In 2021, the standard Part B premium is $148.50. If you make over the income limits, you’ll pay more for your premium. In 2021, higher premium amounts begin when you make more than $88,000 a year.

Wondering What You’ll Have To Pay For Medicare?

At Temmen Insurance, we get you the coverage you need so you can get back to what really matters: enjoying retirement. We specialize in simplifying the Medicare process and making suggestions based on your needs, so give us a call today.

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