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Medicare and You: Part I

Healthcare is a vital topic confronting our nation.  And because it is crucial, it has maintained a prominent position in everyday conversation and presidential campaigns alike.  Unfortunately, we sometimes hear disheartening stories like the one in which an older woman in a barely-heated flat faces the difficult decision in choosing between the medications that make her healthy or the groceries that keep her fed.  Or, perhaps, we learn about the elderly gent who yearns to join his peers at the local coffee shop but declines the offer because there is little money left over after purchasing prescriptions for his heart ailment.  These instances cause us to pause and wonder why such circumstances exist.  Still, there is a health plan in place for people age 65 and older, so let’s briefly examine what Medicare is and how people become eligible.

Medicare is a federal healthcare insurance program.  It was enacted in 1965 under Lyndon Johnson and is partially funded by payroll taxes.  The plan has four parts: A, B, C, and D.  The Original Medicare Plan consists of Part A and B.  Part A helps pay for hospital services, and Part B contributes to physician services.  The text below touches upon the qualification guidelines for Medicare Part A.

  1. Age and Credits. A person must be at least 65 and have earned 40 credits.  The credits are determined by the number of quarters employed and earnings.  For example, $920 equals one credit (four credits are allowed per year).  Theoretically, if an individual earned $1,000 a quarter for 40 quarters (ten years), he or she would have accrued 40 credits, the required number to qualify for Medicare Part A.  If a person has fewer than 40 credits, then a cost (premium) might apply.  NOTE: An exception to the “age” requirement is disability (where a person may be eligible before age 65).
  2. A Covered Spouse.  The spouse of a covered worker is eligible when the couple has been married for at least one year and the spouse meets the required minimum age.  In the case of divorce, a former spouse will still be eligible if he or she is at least 65 years of age and the marriage lasted a minimum of ten years.
  3. Widow or Widower Benefits.  The widow or widower is eligible for benefits under a covered spouse if he or she is at least 65.

People who qualify for free benefits under Medicare Part A (hospital insurance) can enroll in Medicare Part B (physician insurance) by paying a premium.  Yes, this may all seem somewhat complicated, so it is wise to stay informed.

Next week we will examine the steps an age-appropriate, covered individual must take in order to activate Medicare; the insurance does not automatically kick in at age 65.  We will also touch upon the different parts of Medicare and what they mean to the subscriber.  But, in the meantime, have a wonderful week (and stay warm!).

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