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North Carolina Medicare Eligibility Requirements For 2023 Plans

Knowing when you’ll enter Medicare is one of the most important pieces of information you can arm yourself with as you approach your entry into the program. Once you know the details about the start date of your coverage, you can make a plan to use one of the private options available to save as much money as possible on health care. To help you understand your timeline, we wrote this article on North Carolina Medicare eligibility requirements for 2022.


North Carolina Medicare Regulations


Participation in the Medicare health insurance program is based on a two-pronged system of eligibility and entry. It seems simple, but you must first be eligible for the program in order to use it one day. Eligibility is based on one criterion: you are eligible for Medicare if you’re a U.S. citizen or a permanent legal resident. This is the only basis for determining whether you will have Medicare benefits at some point.


The second aspect is entry into the system. Obviously, you will only enter if you’re eligible. However, just because you’re eligible, you don’t get to enter until you’ve experienced a triggering life event. There are four major events that could trigger your entry into Medicare:


  • Receiving disability payments from Social Security or the Railroad Retirement Board for 24 consecutive months, no matter your age
  • Being diagnosed with ALS (Lou Gehrig’s Disease), no matter your age
  • Being diagnosed with End Stage Renal Disease (ESRD), no matter your age
  • Turning 65 years old


As you can see, it is possible to enter Medicare even if you’re younger than 65 years old.While this is true, most people get to enter only when they turn 65. When you’re eligible to enter Medicare at 65, you enter your Initial Election Period (IEP). This is your opportunity to enroll. Your IEP will last a total of seven months:


  • It begins three months before the month you turn 65
  • It continues during your birth month
  • It ends at the end of the third month after the month you turn 65


You can sign up for Parts A and B at any point during your IEP. As long as you do this, your entry is on-time and you won’t be subject to a late enrollment penalty. If you should miss this opportunity, though, your enrollment will be considered late and you could be subject to a permanent late enrollment penalty.


You can enroll in Part A and Part B online or at a Social Security office. You may not have to enroll manually, though. If you are already receiving Social Security retirement benefits when you turn 65, your enrollment will likely be automatic.


Whether you enter Medicare early, right at age 65, or years later (if you choose to delay your benefits), this will be your chance to add a private Medicare Insurance plan, too.


Private North Carolina Medicare Insurance Plan Eligibility


The eligibility requirements for private plans like Medicare Supplement Insurance, Medicare Advantage, and Prescription Drug Plans generally match those for Original Medicare, with just a few differences.


To get Part D drug coverage from a standalone Prescription Drug Plan, you need to be enrolled in either Part A or Part B. You don’t have to be active in both, and you also don’t have to be 65 or older. There are no restrictions of any kind.


The same is true for Medicare Advantage plans: there are no minimum or maximum ages. The only requirement is that you have to be actively enrolled in both Parts A and B.


For Medicare Supplement Insurance, you also have to be active in Part A and Part B. Technically, you can get Medicare Supplement Insurance at any age, even if you’re younger than 65. However, since federal regulations don’t require insurance companies to offer Medicare Supplement Insurance to people under 65, the premiums can be very high. Because of the high cost of the premiums, people who meet the North Carolina Medicare eligibility criteria before age 65 may find it easiest to hold off on Medicare Supplement Insurance until they actually turn 65.

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