To make the most of Medicare, you need a comprehensive plan that takes into consideration not only what it covers, but when your coverage begins. To get started with your planning, read this guide to Ohio Medicare eligibility requirements in 2023.
While there haven’t been any changes in the eligibility rules for Medicare, it’s important that you understand when you’ll be eligible to enter Medicare.
The standard eligibility rules work in two parts: one part determines whether you meet the requirements to participate in the program at all, and the other part determines when you will actually be able to enter and begin using your benefits.
Medicare is restricted to citizens of the United States and permanent legal residents. You can get Medicare if you were born a citizen or if you’ve become a citizen through the naturalization process; there’s no distinction.
In order to meet the requirement for permanent legal residence, you must have been lawfully present in the country for at least five years.
These two criteria determine if you’ll get Medicare. The next criteria will help you understand when you can start using it.
This is the big question, and knowing how entry into the program works will give you a big leg-up in preparing for it. You’ll be allowed to enter Medicare when certain events “trigger” your entry. There are four potential triggers:
These are the only ways that you’ll enter Medicare. If you qualify due to illness or disability, you can enter the program at any age. However, it’s most likely that you’ll become eligible to start your benefits due to turning 65 years old.
When you enter due to turning 65 years old, you’ll have a standard enrollment window during which you can enroll. This eligibility window is called your Initial Enrollment Period, and it will last for a total of seven months:
As long as you enroll during this timeframe, you’ll be all-set. However, if you miss this window, you could be subject to late enrollment penalties.
When you become eligible to enter Medicare, you’ll also have the chance to enroll in a private Medicare Insurance plan if you so desire. The three main private Medicare plan options are:
The eligibility rules for Part D and Part C are identical to those for Original Medicare. As soon as you’re enrolled in Medicare Part A & Part B, you can get either prescription drug coverage or a Medicare Advantage plan. It doesn't matter how old you are.
The rule for Medicare Supplement (Medigap) insurance is a little different. There is a minimum age requirement to get Medigap in some states, and Ohio is one of them. In Ohio, you won’t be able to get Medigap coverage before you turn 65. So, if you enter Medicare early due to disability or illness, you’ll have to choose either a standalone drug plan or a Medicare Advantage plan. However, when you do turn 65, you’ll have an Open Enrollment Period to get Medicare Supplement Insurance at that time if you want to.
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