Medicare is a government program administered by the Social Security Administration. Medicare is for people who have been receiving disability benefits, people with End-Stage Renal Disease, people with Amyotrophic Lateral Sclerosis, and American seniors who are 65 or older. All of these demographics are eligible at the federal level, and that makes them eligible in New Jersey.
Medicare with Disability
Once you’ve received disability benefits from Social Security for 24 months or certain disability benefits from the Railroad Retirement Board for 24 months, you are eligible to receive Medicare benefits. You will receive your red, white, and blue Medicare card in the mail three months before your 25th month of benefits. You are automatically enrolled in Medicare Part A and Part B and your coverage starts on the first day of the 25th month of disability benefits.
End-Stage Renal Disease (ESRD)
If you have End-Stage Renal Disease (ESRD), you can choose to enroll in Medicare. You are not automatically enrolled but instead must sign up for yourself. You can begin receiving benefits during your fourth month of a regular course of dialysis treatments or during the first month of at-home dialysis if you have been trained at a Medicare-certified facility and approved to perform the treatments. Coverage can be retroactive for up to 12 months for people with ESRD, but cannot start earlier than the fourth month of dialysis.
Amyotrophic Lateral Sclerosis (ALS)
If you have Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease), you are automatically enrolled in Medicare Part A and Part B. Your coverage begins the first month you begin receiving disability benefits. You will receive your Medicare card in the mail during this same month.
Seniors Age 65 and Older
The majority, around 85%, of Medicare beneficiaries are eligible for Medicare because of their age. Unless you have been receiving retirement benefits from Social Security or the Railroad Retirement Board at least four months before you turn 65, you will not be automatically enrolled and will need to sign up for Medicare by applying through Social Security. To do this, you can sign up through Social Security’s website, visit your local Social Security office, or call Social Security at 1-800-772-1213 or TTY: 1-800-325-0778.
What Plans Am I Eligible For?
As long as you are enrolled in Medicare Part A and Part B, you can sign up for any plan during your Initial Enrollment. You can stick with Original Medicare (Part A and Part B) or join a Medicare Advantage plan. You can also add a Part D prescription drug plan. The one restriction is you can’t have both a Medicare Advantage and a Medicare Supplement plan.
In the six months after you’re 65 and enrolled in Part B, you can sign up for a Medicare Supplement plan without having to go through medical underwriting. If you have Medicare with a disability and are younger than 65, you may not be accepted for a Medicare Supplement plan or may be charged higher premiums.
For assistance with understanding Medicare eligibility and the enrollment process, please don’t hesitate to contact the experts at Jersey Medicare Solutions.
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
