Is My Senior Loved One Eligible for Medicare?

By Raz Silberman, 9:00 am on

Medicare is the federal health insurance program for people over age 65. It consists of four parts that cover stays in hospitals and skilled nursing facilities, as well as providing prescription drug coverage. Plano senior care providers can look to the following information to determine whether or not their loved ones are eligible for coverage.

Enrollment Is Usually Automatic

Most people qualify for Medicare upon reaching the age of 65. Your loved one should qualify if he or she:

  • Is a U.S. citizen or a legal resident
  • Has resided in the U.S. for at least five years
  • Has worked in Medicare-covered employment for a minimum of 10 years 

If all of the above is applicable, and your loved one has had social security deductions taken from his or her paycheck, then he or she should automatically receive a Medicare card in the mail prior to becoming eligible.

Instances Where Enrollment Is Not Automatic

Your loved one may have to apply for benefits if he or she:

  • Has not applied for Social Security or Railroad Retirement benefits
  • Was employed by the government
  • Has kidney disease

Additionally, U.S. citizens who are older than 65 but are lacking the 10 years of covered employment, as well as permanent resident aliens who have lived in the U.S. for at least five years prior to applying, are still eligible for benefits under Medicare.

Understanding Medicare Parts A and B

Individuals who fall into the above category must apply to be accepted. This is known as “voluntary enrollment” and participants must pay a monthly premium to be covered under Medicare part A and another premium for Medicare part B. Medicare part A covers hospital visits, as well as stays in a skilled medical care facility, and covers some home health care. Medicare part B covers certain doctor visits, outpatient care, medical supplies and some preventive services. 

While Medicare doesn’t cover non-medical home care, there are other types of aid seniors can apply for that cover home care agencies like Home Care Assistance of Plano. We are a leading provider of stroke, Alzheimer’s, and Plano dementia care that enables seniors to age in place while promoting physical and emotional wellbeing. Call us today at (214) 586-0120 to learn more about our services and customize a care plan for your loved one with help from an experienced Care Manager.