Wise Insurance Logo

Call Us



What Is Medicare?

Medicare is a health insurance program created by the United States Government to subsidize healthcare services to people that have reached the age of 65 who didn’t have health insurance coverage. Medicare is overseen by the Centers for Medicare and Services (CMS), an agency within the U.S. Department of Health and Human Services. This program also extends coverage for individuals with particular disabilities, and those who have Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease.

Medicare Eligibility

Medicare eligibility depends on specific criteria. Anyone who has lived in the United States for at least five years and is about the age of 65 qualifies for Medicare coverage. People under the age of 65 may qualify for Medicare if they receive Social Security Disability Insurance. However, those who receive Social Security disability benefits need to wait for two years after receiving their first check before being eligible for this program.

Anyone with kidney failure or ALS automatically qualifies for Medicare, no matter the age of the applicant. If you are insured, or your spouse has contributed to Medicare for ten years or more through payroll taxes, they can get premium-free Medicare Part A. However, the other parts of the Medicare program require you to pay for premiums.

Medicare is funded through several different sources. For example, United States taxpayers contribute to the Medicare program through the Federal Insurance Contributions Act (FICA). This goes towards Medicare deductions and Social Security. As of 2020, workers contribute a total of 7.65 percent of their paychecks to the Federal Insurance Contributions Act: 1.45 percent to Medicare, and 6.2 percent to Social Security. In addition, employers pay the same percentage of money on behalf of the employee.

While Medicare offers consumers more choice in terms of coverage and costs, it also introduces complexity for the people looking to sign up. The decisions surrounding this program can become overwhelming without the right help.

Enrolling In Medicare

Medicare can be challenging. Many worry that they don’t have enough information as they prepare to enter Medicare and feel tense about this process. For some people, enrolling for Medicare is automatic, while for others, it depends on certain factors, and we are here to help. The steps you take before enrolling in Medicare will depend on whether you are still getting your retirement benefits when you start the Initial Enrollment Period.

Anyone that is receiving SSRB or RRB can automatically enroll in both Medicare Part A and Part B, but for the people that are not receiving these benefits, they’ll need to actively enroll in Medicare. If you are eligible for automatic Medicare enrollment, you will get a parcel in the mail three months before your health coverage starts with your new Medicare card.

Moreover, you’ll get a letter that explains how Medicare works. You can automatically enroll in both Medicare Part A and B. As for the people that get Social Security Retirement benefits, their card and package will come from SSA. In contrast, those that get Railroad Retirement benefits will get their card and package from the Railroad Retirement Board.

You shouldn’t turn down Medicare Part B unless you or your partner still have job insurance that gives them coverage. If you turn down Medicare Part B without having insurance from your current employer, you may suffer a premium penalty if you want to enroll in a Medicare plan in the future.

Moreover, if you become eligible for Medicare while still receiving coverage from your job-based insurance, you can enroll in Medicare to pay less for your care and have primary coverage. If you are 65 years old and not receiving Railroad Retirement benefits or Social Security benefits, you’ll need to actively enroll in a Medicare plan.

Signing Up For Medicare

If you need to enroll in Medicare, the steps below can be your guide. If you are considering Medicare enrollment during your IEP, you can sign up for Medicare Part A or B as follows:

  • Go to your local social security office
  • Mail a dated and signed letter to a Social Security that includes your name, SSN, and the date you want to enroll in Medicare, you can apply online.
  • If you are eligible for RRB, enroll in Medicare by contacting your local Railroad Retirement Board or calling RRB.
  • To protect yourself from incurring a Medicare Part B premium penalty in case your application is lost, ensure to keep proof when you tried enrolling in Medicare.
  • Ensure to take note of the Medicare agent you talk to, along with the date and time of discussion.

Table of Contents

Still Have Questions?

We strive to educate and empower our clients to make the best decisions for their health insurance coverage.

Still Have Questions?

If you’ve enrolled in Medicare and want to learn more about your coverage, then we’re here to help. Feel free to reach out to us today and we will find a time to talk more about your specific coverage and the ways you can use it.

Let Wise Insurance Help!

If you have any questions about Medicare, please don’t hesitate to reach out to us. Our team of licensed and experienced Medicare agents are well-equipped to help you with your needs or questions.