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Medicare is the federal health insurance program for people who are 65 or older. It is also available for certain people younger than 65 with disabilities or people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). There are different parts of Medicare that cover specific services like inpatient hospital stays, doctors' services and the cost of prescription drugs. Learn more about Medicare Parts A, B, C and D below:

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You can qualify for Medicare by age once you are 65 years or older. You will become eligible to enroll three months before your 65th birthday until three months after turning 65. This window is called the Initial Enrollment Period. You can apply for Original Medicare during this period if you are eligible. If you decide to delay your enrollment, you may face a late enrollment penalty whenever you decide to enroll for Medicare at a later time. However, you can avoid these late enrollment penalties as long you qualify and enroll during a Special Enrollment Period.

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People who receive Social Security Disability benefits can qualify for Medicare once they have received benefits for 24 months. Individuals in this category become automatically eligible on the 25th month. People who meet the requirements for Social Security Disability benefits should receive when the requirement time has passed. If this does not happen or you have more questions,  feel free to reach out to your local Social Security office.


Health Condition

People suffering from End-Stage Renal Disease and Amyotrophic Lateral Sclerosis may become eligible for Medicare even when under 65. Those with kidney failure who need a transplant or frequent dialysis qualify for Medicare automatically. Medicare will begin coverage after the first dialysis.

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Medicare Advantage

Medicare Part C is also known as a Medicare Advantage plan. As with SIMs, Advantage plans come from private providers. These plans include and replace Medicare Part A, B, and D coverage, with the exception of hospice care. Medicare pays the premiums for participants. Plans have a structure of health maintenance organization (HMO), preferred provider organization (PPO) plans, private fee-for-service (PFFS) plans and special needs plans (SNPs). The federal government forbids private insurers from selling Medigap policies to individuals enrolled in Medicare Advantage. To be eligible the individual must live in the plan’s service area, have Medicare Parts A and B, and not have an end-stage renal disease. These plans come from private providers who have government approval.

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