Medicare Mistake #1: Assuming you Don’t Qualify

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Medicare Mistake #1:

Assuming You Don’t Qualify

Many people assume they do not qualify for Medicare coverage, but the qualifications are actually very simple. In the U.S., every registered citizen automatically earns Medicare credits by participating in the workforce and paying payroll taxes. Earning 40 credits ensures you will not have to pay premiums for Part A hospital services when you join Medicare.

You do not need work credits to qualify for Part B (doctor services, outpatient care, medical equipment) and Part D (prescriptions), provided you are 65 or older and a U.S. citizen. If you are not a citizen, you can still qualify if you are a legal resident who has lived in the U.S. for at least five years.

You may also qualify for Part A benefits on your spouse’s work record, or you can pay premiums for them. There are lots of avenues to receive these benefits!

Please be advised: If you are approaching 65, are 65, or older than 65 and still working, do not wait to sign up until you have earned 40 credits. If you wait, you may end up paying permanent late penalties to the government. It is always the best option to sign up during your recommended window.

If you are confused about deadlines, policies, and how Medicare applies to you, it is a good practice to seek out the advice of a professional. A state-licensed insurance agent can guide you through the regulations and help you plan ahead, avoiding any pitfalls.

Each case and each instance– including yours– is different and worthy of special care. You could be subject to:

  1. Yearly law and regulation changes
  2. Qualifications may depend on multiple criteria
  3. Your evolving financial situation
  4. Plans are added and removed over time
  5. Licensed agents may have different views on the same topic

Reach out to us. We will get you the answers you need.



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This article was updated on 2/26/24.

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