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Starting the Dialogue with Your Aging Parents: Medicare Eligibility

September 23, 2013

Last week I wrote about Medicare Part D and what can be expected from now until December 7th with the open enrollment period. If you missed the post you can catch it in the archives. If you still have questions leave a message in the comments section and I’ll be happy to review anything with you.

This week I’d like to explore what the eligibility requirements are in order to be a Medicare beneficiary.  Just because you’ve had that paycheck deduction up until the time you retired doesn’t mean you are automatically enrolled in Medicare.

For the majority of people the enrollment period runs for seven months (three months before the month of your 65th birthday, the month of your 65th birthday, and three months after you 65th birthday).  In order to apply for Part A and Part B you need to contact your local Social Security office or you can go to  Of course this is a government program and that means there are exceptions which can be a bit confusing.

If your parent is receiving Social Security before they turn 65 then they should be automatically enrolled in Medicare Part A and Part B. Because part B requires premium payments and is not free your parents can opt out. Consider options carefully before opting out however.

When an individual is receiving disability benefits through the Social Security program they are automatically eligible for Medicare in the 25th month that they receive those benefits. Their Medicare card should come in the mail automatically. If it does not contact the Social Security office that serves the area your parents live in and inquire.

What does a Medicare Card look like?

The card is white with a blue and red strip at the top. It will state MEDICARE HEALTH INSURANCE somewhere along the top banner.

The beneficiaries name will be on the card exactly as their Social Security card reads. 

A medicare claim number will be assigned. This is usually the beneficiaries Social Security number followed by a letter, but not always. Railroad beneficiaries and spouses who never worked may have numbers other than their own Social Security number on the card and also have different letters designated various things.

There should be an eligible date indicating when the beneficiary became eligible for Part A and Part B (if applicable). This is usually the first day of the month of the 65th birthday, but not always depending on a number of factors we won’t explore in this post.

What if your parents didn’t enroll in the first three months of their eligibility period for enrollment?

If enrollment wasn’t done before the 65th birthday (or with enough time for eligibility to be established) the eligibility date may be delayed and their eligibility date on the Medicare card will not be the first day of the month of their 65th birthday.

If enrollment was not done during the eligibility period as mentioned above then there is an open enrollment period for Part A and Part B from January 1 through March 31 each year. Coverage will begin on July 1 and there may be monetary penalties for delaying enrollment in the program.

There are other scenarios that may delay enrollment in Medicare Part A and/or Part B beyond the age of 65. These are outlined in easy-to-read and understand language in the handbook Medicare and You. Once again, I encourage you to get a copy of this handbook and review it with your parents on an annual basis to be sure they are getting the most from their Medicare benefits and that they understand the various plans.

Next week we will focus on Part A and go into some detail on what Part A covers.

Is this information useful to you? Please let me know our thoughts and questions in the comments section.

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