Can You Lose Your Medicare Benefits? Debunking Common Myths and Explaining the One Exception

Most people forget that they lose Medicare Benefits if they forget to pay their monthly bill.

There are two ways to get Medicare: because of a disability or because you turn 65.

If you’re disabled, there’s a special case where you could lose it, but if you’re just old, you won’t unless you miss payments.

Some other plans to get Medicare might have different rules, so check with them directly.

Having health insurance helps you get care without breaking the bank, so knowing how to keep your Medicare, who’s eligible, and what happens if you lose it is important.

An image illustrating Can You Lose Your Medicare Benefits
A photo of a woman visiting a therapist at the clinic, PHOTO CREDIT: Freepik.

 

Losing Medicare coverage

Turning 65 unlocks Medicare, your health insurance for life! Unless you miss the monthly fee for Part B (doctor visits and such).

If you have a disability, Medicare stays with you always for ALS, but if it’s for kidney failure and you’re not 65 yet, it ends after a year of dialysis or 3 years after a transplant.

Whether you have Original Medicare (hospital, doctor, some meds), Medicare Advantage (similar coverage with private companies, often with extras like vision or dental), or just prescription drug coverage (Part D), remember this is just a starting point.

Get the full scoop from Medicare or your plan provider to ensure you have the right coverage for your needs!

Watch out! You could lose your Medicare coverage if:

An infographic with Circumstances when you may lose your Medicare coverage, PHOTO CREDIT: InsuranceBlobs.com.

 

  • You skip paying your bills: This includes your Part B premium and any extras like Part C or Part D. They’ll send you warnings before dropping you, so make sure to pay on time!

 

  • You move away: Some plans only cover specific areas. If you move out of that zone, you might lose your coverage. But don’t worry, you’ll usually get a chance to choose a new plan for your new home.

 

  • Your plan disappears: Sometimes, plans get shut down by the government or the insurance company decides to stop offering them.

If you make any mistakes on your application:

  • You might get a Special Enrollment Period (SEP) to choose a new plan. This happens if you weren’t able to join a plan because of something you didn’t know or understand.

 

  • Don’t lie on your application. This is especially important for Medicare Supplement plans, where you need to be honest about your health. For example, if you say you don’t smoke to get a cheaper plan, you could lose your coverage. The same goes for lying about your address if the plan only covers people in certain areas.

 

  • If you’re caught lying, you could lose your coverage.

Don’t cheat Medicare:

  • If you do anything that breaks the rules, like letting someone else use your card, you could lose your coverage.

Can I still Get Medicare Coverage If My disability Benefits Stop?

Even if the Social Security Administration (SSA) stops your disability benefits, you might still keep your Medicare benefits. This happens if:

– You’re still dealing with the medical condition that made you eligible.
– Your benefits stopped because you can work now.

If you get better and the SSA tells Medicare you’re not eligible anymore, your Medicare coverage will stop because you’ve recovered from the disability.

Usually, your coverage ends about a month after the SSA notifies you.

Will I lose Medicare If I Return To Work?

If you get Medicare because of a disability before you turn 65, you won’t automatically lose it if you start working again.

The Social Security Administration says you can keep getting Part A (hospital insurance) and Part B (medical insurance) for up to 93 months if you still have a disabling condition.

During this time, you won’t have to pay for Part A.

After 93 months, if you’re still disabled, you can buy Part A and Part B coverage.

This includes a nine-month trial work period.

Even if you’re 65 and qualify for Medicare, you might still keep it even if you have health insurance from your job.

Usually, your job’s insurance pays first, and Medicare pays second.

Do I lose Coverage If My Medicare Card Is Lost, Stolen, or Damaged?

If you lose your red, white, and blue Medicare card, don’t worry.

Just call 1-800-MEDICARE (633-4227) or log into your mymedicare.gov account to get a new one.

You won’t lose your coverage while waiting for a replacement card.

But until you get the new one, it might be tricky to make sure your healthcare is covered.

Doctors and others usually need to see your card as proof of insurance.

So, it’s smart to keep a copy of it safe, just in case.

What Do You Do If You Lose Your Medicare Coverage?

If you lose your Medicare, you have choices.

1. If you don’t have other health insurance, you might get Medicaid. Medicaid is a state program. It gives medical care to people with little money. Every state has rules about who can get it and what it covers. But, part of it depends on how much money you make.

2. You can buy insurance from a private company. Look at different plans and see if you qualify online or by calling the plans directly.

Who can get Medicare?

People aged 65 or older, those with a qualifying disability, or those with End-Stage Renal Disease can usually get Medicare.

But the requirements vary depending on whether you’re signing up for Part A, B, C, or D, and they depend on your situation.

Who can get Part A and B of Medicare?

To be eligible for Original Medicare Part A and Part B:

1. You must be a U.S. citizen or a permanent legal resident who lived in the U.S. for at least five years.

2. You or your spouse must have worked and paid Medicare taxes for at least 10 years.

Additionally, you must meet at least one of these conditions:

Here are the eligibility criteria for Medicare enrollment:

An infographic with eligibility criteria for medicare enrollment, PHOTO CREDIT: InsuranceBlobs.com.

 

1. Age Requirement:

If you’re turning 65 or older and eligible for Social Security benefits, you can enroll in Medicare three months before your 65th birthday.

Even if you’re not receiving Social Security or Railroad Retirement Board(RRB) benefits, it’s essential to sign up for Medicare.

Automatic enrollment in Part A and Part B occurs if you’ve been receiving Social Security or RRB benefits for at least four months before turning 65.

2. Permanent Disability:

Individuals who are permanently disabled and have received disability benefits for at least two years (24 months) are eligible for Medicare.

Automatic enrollment in Part A and Part B occurs after receiving disability benefits for 24 months, starting from the first month of receiving a check from Social Security Disability Insurance (SSDI).

3. End-Stage Renal Disease (ESRD):

If you have permanent kidney failure requiring dialysis treatment or a kidney transplant, you must enroll in Medicare. Automatic enrollment does not apply in this case.

Additionally, eligibility criteria include meeting one of the following conditions:

  •  Having worked the required time under Social Security, RRB, or as a government employee.
  • Receiving or being eligible for Social Security or RRB benefits.
  • Being the spouse or dependent child of an individual who meets the work requirements under
  • Social Security, RRB, or as a government employee, or is receiving Social Security or RRB benefits.

Medicare costs

In 2024, here’s what you’ll pay for Medicare:

Part A:
  •  You usually don’t pay a monthly fee. (If you do, it’s either $278 or $505 per month).
  •  Deductible: $1,632
  • You pay a portion of the hospital costs after a certain number of days.

Part B:

  •  Premium: $174.40
  • Deductible: $240
  • You pay 20% of the costs after meeting the deductible.

 

Part C:

  • Costs depend on the plan.
  •  Deductibles and out-of-pocket expenses vary by plan.

 

Part D:

  • Costs vary by plan
  • Deductibles and out-of-pocket expenses vary by plan too.

How To Apply For Medicare

If you’re eligible for Medicare, you can apply in a few different ways:

An Infographic with steps on how to apply for Medicare, PHOTO CREDIT: InsuranceBlobs.com.

 

1. Apply online at www.ssa.gov.
2. Visit your nearby Social Security office.
3. Give Social Security a call.
4. Call the RRB (if you’ve worked for a railroad).
If you already have Part A and want Part B, you just need to fill out an Application for Enrollment in Part B.

Conclusion

Most people on Medicare only lose it if they don’t pay their bills each month.

You can get Medicare if you’re disabled or when you turn 65.

But if you don’t pay, you might lose it. If you move or your plan stops, you could also lose it.

Being honest and using it right is important.

But even if you stop getting disability benefits or start working, you might still keep Medicare.

You need to know if you qualify and how much it costs.

You can apply online, visit an office, or call.

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