Medicare Part A is one half of Original Medicare and it is hospital insurance. Part A offers coverage for inpatient hospital stays, hospice care, limited home healthcare, and short-term skilled nursing facility stay and care. But be aware that it does not cover all the hospital costs. Part A does not cover your first 3 pints of blood yearly, does not cover private rooms and long-term care needs.
In this blog, we will breakdown the requirements for eligibility and how to sign up for Medicare Part A.
Part A Eligibility
If you want to sign up for Medicare Part A, first you need to meet some criteria. First of all, you must be a U.S. citizen or a permanent resident who is living in the U.S. for at least five years in a row. If these criteria are met, then we can proceed with other eligibility requirements. So, to be able to apply for Medicare Part A, you must meet one of the following requirements:
- You are 65 years old or older
- You are receiving Social Security benefits for at least 24 months in a row
- You have been diagnosed with End-Stage Renal Disease (ESRD)
- You have been diagnosed with Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig`s disease)
When the time comes and you met the criteria for eligibility, you want to be informed about enrollment in Medicare Part A. There are several Medicare Enrollment periods that need to get to your attention.
Medicare Part A Enrollment
First, let`s talk about automatic enrollment because for some senior people their enrollment will be automatic. In a case where you are receiving Social Security benefits before age of 65, then when you come to your 65th birthday you will be automatically enrolled in Original Medicare – Part A and Part B. Exception from this is Puerto Rico. People in Puerto Rico who met the eligibility criteria for automatic enrollment will only be enrolled automatically in premium-free Medicare Part A. If you are not in these two groups and you are not receiving Social Security benefits, then you will not be automatically enrolled in Medicare.
If you are not meeting the criteria for automatic enrollment in Medicare, then you must apply through Social Security. In this case, you have three types of enrollment available: Initial Enrollment Period (IEP), Special Enrollment Period (SEP), and General Enrollment Period.
Initial Enrollment Period
The initial enrollment period happens for everybody once in a lifetime, around the 65th birthday, and you are expected to enroll in Medicare during this period. If you fail to do so you could be exposed to a late enrollment penalty fee. The duration of the IEP is seven months. It begins three months before your 65th birthday and lasts until three months after your 65th birthday. If you missed enrolling during this seven-month period then you will have to wait for General Enrollment Period (unless you qualify for Special Enrollment).
The Special Enrollment period is designed for cases when individuals failed to enroll in Medicare during their Initial enrollment period, but still want to enroll in Medicare Part A lately. The special enrollment period starts in the month after your employee health coverage ends and lasts for eight months. Not everybody is eligible for Special Enrollment. It is specifically for people who are getting coverage through their employer. Besides this, you can qualify for SEP if you are a volunteer serving in a foreign country or if you have TRICARE (active duty service members and their families, National Guard and Reserve members and their families). Important notice: if you qualify for SEP, then a late enrollment penalty will not be applied.
General Enrollment Period
The General Enrollment Period happens at beginning of every year and is designed for those who failed to apply during their IEP and have not qualified for a SEP. General Enrollment Period starts on January 1st and lasts until March 31st. If you enroll during General Enrollment Period, your Medicare coverage will become active the month after your application. But in this case, the possibility of a late enrollment penalty exists. During this enrollment period, you can also drop or change your existing plans, like switching back from Medicare Advantage to Original Medicare or vice versa.
Medicare Part A Online Application
The easiest and fastest way to apply for Medicare coverage is doing it online, on the Social Security webpage. You will be required to create a “My Social Security” account to be able to sign up for Medicare. After creating your account, find the blue button “Apply for Medicare”, read the page “Terms of Service” and check the “I understand and agree” box. On the next page, click on “Start new application” and type in all asked information. The next page will ask you if you want to apply only for Medicare or if you want to do so for Social Security retirement benefits. Check your options and proceed. The next screen will ask you if you want to enroll in Original Medicare – Part A and Part B, or only Part A. Check your options and proceed. The final page will be with questions about any health insurance coverage you have had and their duration dates.
After the finalization of the application, you will get a confirmation link where you can save a copy of your application. Within a few weeks, you will receive a confirmation letter of enrollment, and after that, the only thing left is to wait for your Medicare card in the mail.
What Documents Are Needed to Apply For Medicare?
Here is a list of documents needed for Medicare application:
- Social Security card
- Social Security statement or records of your earnings
- Original birth certificate or certified copy of it
- An alternate form of identification proving your age besides a birth certificate
- A W-2 or self-employment tax information
- Proof of U.S. citizenship (U.S. passport, Naturalization certificate, Certificate of Citizenship, or U.S. consular report of birth for those born outside the United States of America)
- Proof of your legal residency if you are not a U.S. citizen (including “Green card”)
- A record of your service or discharge papers if you had served in U.S. Military before 1968