Approaching age 65 - Medicare Eligibility

What to expect from HPRS when turning age 65:  Approximately 90-120 days prior to your birthday month of turning age 65, you will receive a letter to remind you to enroll in Medicare Part A (hospital) and Medicare Part B (medical).

How to apply for Medicare Part A and B:  You may sign up for Medicare online at www.socialsecurity.gov/medicareonly or call your local Social Security Administration (SSA) office.

 ·         Apply for Medicare Part A (Hospitalization), either based on your or your spouse?s work history.

Eligible spousal work history includes:

ᵒ     if you are currently married and your spouse is eligible for Social Security benefits (either retirement or disability).  In addition, you must have been married for at least one year before applying.  When your spouse turns age 62 you may qualify for Medicare Part A at no cost.

ᵒ     if you are divorced and your former spouse is eligible for Social Security benefits (either retirement or disability).  In addition, you must have been married for at least 10 years and you must be single. 

ᵒ     if you are widowed and you were married for at least nine months before your spouse died.  In addition, you must be single.  If your deceased spouse was age 62 or older you may qualify for Medicare Part A at no cost. 

·     Purchase Medicare Part B (Medical) coverage (required).  There is a monthly premium you pay directly to Medicare, not HPRS.

Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition.

Please refer to www.medicare.gov for more information.  

Medicare Part A

In general, Part A covers:

• Hospital care

• Skilled nursing facility care

• Nursing home care (as long as custodial care isn't the only care you need)

• Hospice

• Home health services

Please note even if a beneficiary is not eligible for Social Security benefits, he or she may be eligible for Medicare Part A. If Part A is available at no cost, a beneficiary must enroll in it to be eligible for HPRS health care benefits.

Medicare Part B

In general, Part B covers two types of services:

• Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

• Preventative services: Health care to prevent illness (like the flu) or detect it an an early stage, when treatment is most likely to work best.

• Part B covers things like:

• Clinical research

• Ambulance services

• Durable medical equiment (DME)

• Mental health

• Second opinion before surgery

• Limited outpatient prescription drugs

All beneficiaries are eligible for Medicare Part B at age 65. The cost of Part B is either deducted from your Social Security check or you have to make a direct payment to Social Security. All beneficiaries who are eligible for Part B must enroll in it to be eligible for HPRS health care benefits.

Medicare Part D

In general, Part D covers prescription drugs.

Medicare Advantage

Medicare Advantage programs are sometimes referred to as Part C. This is a plan offered by a private company approved by Medicare that incorporates Medicare Parts A, B, and D coverage into a comprehensive plan.

For a brief explanation of other benefits, click on any item listed below:

HRA	Dental
Vision	Long-Term Care
Life Insurance