Jeffrey Wade
Medicare is a federal health insurance program for people aged 65 and over. Those under 65 may be eligible if they have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). Medicare Part A covers hospitalization, home or skilled nursing, and hospice, while Medicare Part B covers medical insurance. To apply for Medicare in Maryland, you can do so online at marylandbenefits.gov or in person at one of the state's 24 local departments of social services.
| Characteristics | Values |
|---|---|
| Medicare Part A | Hospital Insurance |
| Medicare Part B | Medical Insurance |
| Medicare Advantage | Bundles Parts A and B under a single monthly premium |
| Medicare Advantage | Includes prescription drug and vision coverage |
| Medicare Advantage | Available in Maryland depends on the county |
| Medicare Savings Programs | Includes income and asset limits |
| Medicare beneficiaries under 65 | Eligible due to a disability that has lasted at least 24 months |
| Medicare beneficiaries 65 or older | Qualify for Medicare due to their age |
| Medicare Part A and Part B | Automatically received if receiving Social Security retirement benefits between age 62 and up to 4 months before turning 65 |
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What You'll Learn
Medicare Parts A and B
Medicare is a federal health insurance program for people aged 65 and over. If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
Medicare Part A is insurance for hospitalisation, home or skilled nursing, and hospice. Most people don't have to pay for Part A. It is based on your Medicare-covered employment, which the Social Security Administration determines.
Medicare Part B is medical insurance, which helps cover medically necessary services like doctor visits, outpatient care, durable medical equipment, certain home health services, and other medical care not covered by Part A.
To sign up for Part A and/or Part B, you'll need to contact the Social Security Administration. The easiest and fastest way to sign up is to apply online through your secure my Social Security account. You can also fill out form CMS-40B and send the completed form to your local Social Security office by fax or mail.
If you receive Social Security disability benefits, you will automatically begin receiving Medicare Parts A and B after 24 months. If you have Lou Gehrig's Disease (ALS) or End-Stage Renal Disease (ESRD), you will receive Medicare Parts A and B immediately upon enrolling in Social Security disability benefits.
In Maryland, you have several Medicare options to choose from. You can sign up for Original Medicare (Parts A and B) and decide whether to add Medicare Part D (drug coverage). Alternatively, you may enrol in a Medicare Advantage (Part C) plan, which covers the same services as Original Medicare, and sometimes prescription drugs, all under one plan. Many private insurance companies in Maryland offer Medicare Advantage plans.
Medigap plans (Medicare Supplement) are also available in Maryland. These policies can help you pay deductibles, coinsurance, and copayments.
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Medicare Savings Programs
Medicare is the federal health insurance program for people aged 65 and over. If you are under 65, you may be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
To qualify for a Medicare Savings Program, your income and resources must be below a certain limit. These limits vary by state and increase each year. Even if your income is higher than the federal limit, you may still qualify as some states do not count certain types or amounts of income or resources.
You can apply for Medicare Savings Programs through your state. When you apply, your state will determine which program(s) you qualify for. It is recommended that you apply even if you do not think you meet the qualifications.
In addition to helping with Part A and Part B costs, Medicare Savings Programs also provide Extra Help with the cost of prescription drugs. This means you will pay no more than $12.15 in 2025 for each drug covered by your Medicare drug plan.
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Eligibility criteria
To be eligible for Medicare in Maryland, you must meet specific criteria, which depend on your age and health status. Here are the detailed eligibility criteria for Medicare in Maryland:
Age-Based Eligibility:
- Age 65 or Older: The majority of Medicare beneficiaries in Maryland and nationwide are 65 or older. Turning 65 is typically the standard age requirement to qualify for Medicare.
- Under 65: About 9% of Maryland's Medicare beneficiaries are under 65. If you are under 65, you may still be eligible for Medicare if you have a qualifying disability.
Disability-Based Eligibility:
- Disability: If you have a disability that has lasted or is expected to last for at least 24 months, you may be eligible for Medicare before turning 65. In Maryland, about 9% of Medicare beneficiaries are under 65 and eligible due to a disability.
- End-Stage Renal Disease (ESRD): Individuals with ESRD may qualify for Medicare before the age of 65. Those with ESRD do not have to wait for the 24-month period typically required for other disabilities.
- Amyotrophic Lateral Sclerosis (ALS)/Lou Gehrig's Disease: Individuals diagnosed with ALS are eligible for immediate Medicare coverage upon enrolling in Social Security disability benefits. They do not have to wait for the 24-month period typically associated with other disabilities.
Enrollment Periods:
It's important to be mindful of enrollment periods to ensure timely sign-up and avoid potential late enrollment penalties:
- Initial Enrollment Period: The Initial Enrollment Period for Medicare begins 3 months before you turn 65 and ends 3 months after the month you turn 65, giving you a total of 7 months to sign up.
- Special Enrollment Period: If you are still working past the age of 65 and are not ready to receive Social Security benefits, you may be able to wait until you retire to sign up during a special enrollment period.
Income-Based Eligibility:
- Medicare Savings Programs: These programs provide financial assistance to Medicare enrollees in Maryland with low incomes. Income and asset limits determine eligibility for these programs.
- Maryland Senior Health Insurance Program: This program offers assistance with Medicare applications and provides information on eligibility guidelines in Maryland.
To confirm your eligibility for Medicare in Maryland, it is recommended to refer to official sources, such as the Maryland state government website and Medicare.gov, which can provide the most up-to-date and accurate information.
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Enrollment timing
The timing of your Medicare enrollment in Maryland depends on several factors, including your age, employment status, and health condition. Here is a detailed breakdown of the enrollment timing for Medicare in Maryland:
Initial Enrollment Period
The Initial Enrollment Period for Medicare is the first opportunity for individuals to enroll if they are not automatically enrolled. This period starts three months before you turn 65 and ends three months after your 65th birthday, giving you a total of seven months to enroll. During this time, you can research coverage options and find a plan that suits your needs. If you miss this enrollment period, you may have to pay a penalty.
Automatic Enrollment at 65
If you are already receiving Social Security retirement benefits or Railroad Retirement Board benefits when you turn 65, you will be automatically enrolled in Medicare Part A and Part B.
Enrollment with Social Security Application
If you apply for Social Security later in life, three months before you turn 65 or later, you can sign up for Medicare when you apply for Social Security.
Special Enrollment Period for Part B
If you or your spouse are working past the age of 65 and have group health insurance through an employer, you may elect not to receive Part B initially. However, you can enroll in Part B during a Special Enrollment Period that lasts eight months from the time your employer coverage ends. You will need to contact the Social Security office or complete specific forms to enroll during this period.
Enrollment with Disabilities or Chronic Conditions
If you are under 65 and living with certain disabilities or chronic health conditions, such as End-Stage Renal Disease or Amyotrophic Lateral Sclerosis (ALS), you may be eligible for Medicare. If you receive Social Security disability benefits, you will automatically receive Medicare Parts A and B after 24 months. Individuals with ALS will receive Medicare Parts A and B immediately upon enrolling in Social Security disability benefits.
Medicare Advantage Plans and Part D Enrollment
Medicare Advantage Plans (Part C) and Part D, which covers prescription medications, have specific enrollment periods. You can join, switch, or drop these plans during these designated enrollment periods. If you are already enrolled in a Medicare Advantage Plan, you have the flexibility to change to another Medicare Advantage Plan or switch to Original Medicare within the first three months of having Parts A and B.
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Medicare Advantage plans
Before signing up for a Medicare Advantage Plan, it is important to consider a few things. Firstly, talk to your employer, union, or benefits administrator about their rules, as joining a Medicare Advantage Plan might cause you to lose your current coverage. Secondly, research and compare different plans to find the best coverage and rate for you. The Centers for Medicare & Medicaid Services (CMS) awards each plan a star rating on a scale of 1 to 5, which can be a helpful guide in your decision-making process. Additionally, all Medicare-eligible individuals in Maryland have access to a $0-premium Medicare Advantage Plan, so be sure to explore all your options.
You can sign up for Medicare Advantage Plans online at Social Security, which is the easiest and fastest way to get enrolled and receive any financial assistance you may need. You will need to create a secure my Social Security account to sign up for Medicare or apply for benefits. Alternatively, you can call the Railroad Retirement Board at 1-877-772-5772 if you or your spouse worked for a railroad.
It is important to note that Medicare Advantage Plans can disenroll you for various reasons, such as moving outside of their service area or losing Medicare eligibility. In such cases, you will be eligible for a Special Enrollment Period, allowing you to review your options and ensure you maintain the desired coverage.
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Frequently asked questions
You can apply for Medicare in Maryland online, by phone, or by mail.
There are two main options: Medicare Advantage plans, where coverage is through private Medicare Advantage plans, or Original Medicare, where services are paid directly by the federal government.
Signing up online is the easiest and fastest way to apply for Medicare and get any financial help you may need.
Most people qualify for Medicare due to their age (65 or older). However, you may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
