Who Is Eligible for Medicare Part B?

Medicare is a federal insurance program that provides for hospital care, medical care, and prescription drug benefits. It can be difficult to understand how eligibility is determined for the various Medicare plans as they do have set rules and eligibility requirements. Adding to the confusion is the fact that while it is the Social Security Administration that determines the eligibility for Medicare, the plan itself is actually administered by the Centers for Medicare and Medicaid Services (CMS). This article will help you in determining whether or not you qualify for Medicare Part B.

How does eligibility work?

When it comes to Medicare, you are generally eligible for both parts A and B if you meet the following criteria:
• You or your spouse has worked at least 10 years in Medicare covered employment
• You are a United States citizen (or lawfully admitted alien who has been living here at least five years)aged 65 or older
• You are under age 65 but have been receiving Social Security Disability Insurance for at least 2 years
• You have permanent kidney failure, or require either dialysis or a kidney transplant
• You have been diagnosed with Lou Gehrig’s disease

In addition, disabled children may also be eligible for Medicare, generally after a 24 month qualifying period.

What does Medicare B cover?

Medicare Part B is the portion of Medicare which pays for doctor visits, outpatient care, and some home health services such as physical therapy. Unlike Medicare Part A, which covers hospitalization, there is a monthly premium associated with Medicare Part B. There is also annual deductible for Medicare Part B. This deductible must be met before Medicare starts to pay its share. Once the yearly deductible has been met, Medicare recipients may also be responsible for a coinsurance amount. The plan is voluntary, and you can choose to opt out of Medicare B at any time.

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