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Rhode Island Medicare Eligibility Requirements For 2023 Plans

Many people are intimidated by Medicare, fearing that a lack of understanding will cause them to miss out on the health insurance benefits they need. While there are many complexities to Medicare, if you start your enrollment journey by learning the basics of eligibility and the details of entry into the program, you will set yourself up for success. To help you get started, read this short guide to the Rhode Island Medicare eligibility requirements.


Rhode Island Medicare Eligibility Criteria


Since Original Medicare, Parts A and B, are the foundation for all private Medicare coverages, you’ll save yourself a lot of stress if you get a solid grounding in when you’ll qualify for this coverage. The rules for Medicare eligibility are very simple. You one have to meet one of these:


  • You are a United States citizen, or
  • You are a permanent legal resident who has legally lived in the country for five years


Assuming that you meet one of these two criteria, you can safely assume that you’ll be able to get Medicare coverage one day. The next question to get an answer to is, When will I get to enter?


Medicare is designed to provide coverage for people starting at age 65. While this is when most people get their chance to enter, it is possible to get started earlier than this. You can qualify for early participation if you meet any one of these three criteria:


  • You receive federal disability income benefits for 24 straight months
  • You get diagnosed with End Stage Renal Disease
  • You get diagnosed with ALS


These are the only ways that you can get coverage before you turn 65. In all other cases, you have to wait until you’re turning 65. If this is the case for you, you need to know that your entry into Medicare may be automatic. This will happen if you’re already signed up to receive Social Security retirement income benefits at or before age 65.


If you’re not taking Social Security by this time, you will have to sign up manually. You can do this online or at a Social Security office in your area. If you have to enroll manually, you will have a seven month enrollment period during which you can do so. If you fail to enroll during this enrollment window, your enrollment can be considered late and you can be subject to late enrollment penalties.


When you enter Medicare, whether early or on-time, you will also have an enrollment window for a private Medicare insurance plan. These private plans are designed to help lower your out of pocket spending when you use Parts A and B. Each of the different private plan types have their own, unique, eligibility rules.

Rhode Island Medicare Eligibility For Private Plans


You must be enrolled in both Medicare Part A and Part B in order to enroll in a Medicare Supplement Insurance plan. Whether you can get this coverage before age 65 depends on the state in which you live since there are no federal rules requiring insurance companies to offer Medicare Supplement to people under age 65. Federal law does require insurance companies to offer these plans to people age 65 and older.


Rhode Island is among the states that do not require insurance companies to offer Medicare Supplement insurance to people under 65 years of age. This means that it may be difficult and expensive to get this coverage if you meet the Rhode Island Medicare eligibility requirements before turning 65.


To get Medicare Advantage coverage, you must also be enrolled in both Part A and Part B. However, there are no age restrictions for these plans.


There are also no age restrictions or requirements for standalone Prescription Drug Plans under Part D. To get this coverage, you only have to be active in either Part A or Part B.

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