How do I buy  Medicare Part A Hospital if I don’t have 10 years of working?

• Estimate my Medicare eligibility & premium

• the medicare family.com/calculators/part-d-penalty/ 
• medicare.gov/part-d-late-enrollment-penalty 

Visit Our Web Pages on:

• Part B & D Rx Premium Surcharge if you have High Income?
• Part B Late Enrollment - Penalties
• Enroll ONLINE for Medicare Part A Hospital & B Doctor Visits

Qualification for FREE Part A Hospital 

More Information on Medicare & FAQ’s

You cannot buy additional coverage through #Covered California
if you have premium-free Medicare Part A Hospital

Medicare complies with Health Care Reform, so you do NOT need to get a an Individual policy or a subsidized one from Covered CA.  It fact, it's illegal for anyone to sell you a policy!  ^{Kaiser Health News * Covered CA Medicare Fact Sheet * Medicare.Gov Medicare & Market Place #11694  * CMS.Gov FAQ Medicare & Marketplace * HealthCare.Gov when - how to change from Covered CA to Medicare  * Social Security §1882  * Health Care.Gov}

NOTE: This information also applies to people younger than 65 whose benefits begin the first month they receive disability benefits because they have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s Disease, and to people younger than 65 who have Medicare because of a disability and are receiving SSDI Social Security Disability Insurance.

There are a lot of ands, if or buts in this complex issue.  Please refer to the source material below.  There are some exceptions, but they are very complex.  Don't even think of getting a 1/2 correct answer over the phone. If you have to pay for Part A Hospital, then are options, like subsided Covered CA Plans. Email us [email protected] or ask a question below.

Video about Covered CA – if no Premium Free Part A – jump to 2:30  Medicare & the Marketplace (Covered CA

Medicare vs Covered CA - Publication 11694

Links & Resources 

• Medicare Publication # 11694 Medicare & Covered CA
• Covered CA Medicare Fact Sheet 
• InsureMeKevin.com

Sec. 1882. [42 U.S.C. 1395ss]

(3)(A)

(i) It is unlawful for a person to sell or issue to an individual entitled [no premium] to benefits under part A or enrolled under part B of this title (including an individual electing a Medicare+Choice plan [MAPD] under section 1851)—

(I) a health insurance policy with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled under this title or title XIX,

(II) in the case of an individual not electing a Medicare+Choice plan, [aka MAPD Medicare Advantage] a medicare supplemental policy with knowledge that the individual is entitled to benefits under another medicare supplemental policy or in the case of an individual electing a Medicare+Choice plan, a medicare supplemental policy with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled under the Medicare+Choice plan or under another medicare supplemental policy, or

(III) a health insurance policy (other than a medicare supplemental policy) with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled, other than benefits to which the individual is entitled under a requirement of State or Federal law.

(ii) Whoever violates clause (i) shall be fined under title 18, United States Code, or imprisoned not more than 5 years, or both, and, in addition to or in lieu of such a criminal penalty, is subject to a civil money penalty of not to exceed $25,000 (or $15,000 in the case of a person other than the issuer of the policy) for each such prohibited act. ^{Sec. 1882. [42 U.S.C. 1395ss]} 

Our webpages that touch on this Issue:

• Part B – Doctors – How to sign up – Benefit
• Part B Late Enrollment Penalt
• End Stage Renal – Kidney Failure
• Age 65 – Tax Credits?
• Part A Hospital rules for zero premium
• Employer Plans vs Medicare - over or under 20 employees?

FAQ’s

• Question I am 65 with insufficient credits for Social Security benefits. My younger husband is 60 and both covered under his group health insurance, including a “credible” Part D.
  • #1) My understanding from various call and office visits to Social Security is that I do not sign up for Social Security until my husband applies at 65.
  • #2) Since I am fully covered by his group health insurance, I do not apply for Medicare until he applies for his Social Security at which time I would apply for spousal benefits?
  • Is there something I should be doing before I turn 65 to avoid penalties later?
    .
• Answer  Thanks for your question. It prompted us to spend several hours updating our website to be more helpful to the public.
  • How many employees are at your husbands work?
  • More or less than 20?
  • This new webpage  should answer your questions.  If not, post your question in the comment section at the bottom of the most relevant webpage.
  • See the other faq’s.  You can qualify for Medicare on your husbands account, once he turns 62.
    .
• Question My father and mother have had Covered CA Silver 94 PPO plan, with APTC since ACA went into effect. Their income is below FPL but through two years of consecutive appeals hearing, the Judge had ordered Covered CA that they are eligible for APTC since they are not eligible for non-MAGI Medi-Cal (since both my dad and mom are above 65, and have assets more than Medi-Cal limits, and they cannot spend down).
  • Both my dad and mom have been legal permanent residents (green card) at the time of the appeals in 2016 and in 2015. They are eligible for Medicare but are not eligible for premium-free Medicare, and Covered CA did send them a letter stating that people who are not eligible for premium-free Medicare and who don’t enroll in Medicare could be eligible for APTC.
  • Just like last two years, again for 2017, Covered CA has told them that we are not eligible for APTC for 2017 coverage. My dad became a US citizen late 2016. But they continue to be ineligible for Medi-Cal, or premium-free Medicare. And without APTC, they cannot afford to get an affordable minimum qualified health plan.
  • They have filed for an appeal, but if you can point us to any sections of the ACA, or Federal Code of Regulations or California regulations, or special rules/clarifications, or IRS notes that we can represent to the judge during our hearing, it would be really helpful.
  • It is strange that while they would be eligible for APTC as non-citizen aliens (as decided by the Judge last 2 years), their becoming a citizen makes it worse for them.
    .
• Answer  See our page on Covered CA over 65 if not eligible for premium Free Medicare
  • Medicare vs Covered CA – Publication 11694
    .
• Question Steve,
  I have a few questions that I have numbered below for convenience.
• Regarding the sign up on the Social Security site, I understood from your email last week that I should sign up for:
  • 1. Medicare parts A and B.
  • 2. But should I also sign up for part D?
  • 3. What about Medigap?
  • 4. When do I sign up for part C (Advantage)?
  • 5. Once I sign up for Medicare can I start my coverage with the Blue Shield 65 Plus (HMO) plan effective April 1, 2016? If not, when will that coverage start?
  • 6. Once that coverage begins, do I pay for it until Bruce turns 62 in October?
  • 7. Also, have you heard from Blue Shield yet?
    • Please try to answer today if you can so that I can try to sign up today.
      .
• Answer
  • 1 That’s correct
  • 2 No, as you were getting the Blue Shield Medicare Advantage Plan. It includes Part D, Rx. Use the menu above to learn more about the Blue Shield and other plans.
  • 3 Medicare Advantage is pretty comprehensive and highly regulated. It’s my understanding an agent can go to jail if they sell you a Medi Gap plan in addition to a Medicare Advantage plan, as you don’t need the additional coverage.
  • 4 As soon as you get Part B, that should give you a new enrollment period into Medicare Advantage – Part C. OOPS!!! One has to check every rule, I don’t see that in Publication 11219 Understanding Medicare C & D Enrollment periods. It’s if you get Part B during the general enrollment period then you get a Medicare Advantage enrollment period. So, if you get your Part A & B NOW, then you can apply by the end of March for a April 1 start date. This MUST be done by the 31st as your 65th birthday was in December. We have your Blue Shield application, just give us your Medicare #.
  • 5 Yes. Sign up TODAY and get us the number. At least some PROOF that you’ve signed up and will be effective in April!
  • 6 The Blue Shield Medicare Advantage plan has no premium, other than the optional dental. Use the menu above to get the details and disclosures.
  • You will always pay for Part B Medicare – Doctor Visits.
  • It’s my understanding that once your husband turns 62 then you won’t have to pay the Part A premium of $426/month. Everything I have on buying Part A is on the page above or in the links to Medicare, Social Security and CMS websites.7 I just reemailed them and they agreed that you can pay for Part A or wait till your husband turns 62. If there are Part B late enrollment penalties, Blue Shield doesn’t do that. Social Security assesses them. The late enrollment penalty calculator also shows Part A premium and when one is eligible.
    .
• Question  My 82-year-old mom came to live in the United States this year and got her green card in July 2013.
  She is not eligible for Medicare since she has never worked/paid taxes in this country.
  • How much will it cost to insure her?
    .
• Answer  Most immigrants who are “lawfully present,” including people with permanent resident status (also known as green card holders), can buy coverage on Covered CA.  No extra charge to use an agent. Just like citizens, they are also eligible for premium tax credits and cost-sharing assistance if they meet the income requirements. (In fact, most legal immigrants must have coverage by 2014, unless they qualify for an exemption.)
  • See our page on Covered CA over 65 if not eligible for premium Free Medicare
  • As a green card holder, your mother will be eligible for Covered CA , but will need to live here for five years to qualify for Medi-Cal. Since she is not eligible for Medicare, however, she can apply for a premium tax credit, said Lynn Quincy, a senior policy analyst at Consumers Union. ^{New York Times
    .}
• Question I have less than 40 Social Security quarters and I will have to pay a premium for Part A, Part B and Part D.
  Can I buy a health plan from Covered California?
  .
• Answer   See our page on Covered CA over 65 if not eligible for premium Free Medicare
  .
• Question   How long must one live in the USA to be able to buy into Medicare?
  .
• Answer  An individual must be a U.S. resident and either a citizen, or an alien lawfully admitted for permanent residency who has resided in the U.S. continuously for at least 5 years as of the time the application is filed.  persons desiring Premium-Part A can only file for coverage during a prescribed enrollment period (see the discussion under Medicare Part B) and must also enroll or already be enrolled in Part B.  ^CMS.Gov
  • Medicare Eligibility Calculator 
  • Don’t have 5 years?  ACA/Obamacare Quotes
    .
• Question  I’m self employed and haven’t filed taxes for years.  What is the procedure to file late returns so I can show my 40 quarters? What do I do?
  .
• Answer   file an extension it’s October 15th? Turbo Tax
  • In 2019, you receive one credit for each $1,360 of earnings, up to the maximum of four credits per year Publication 10072 How you earn credits
  • Well, 1st of all, I’m not a CPA and not allowed to give tax advice.  Here’s research though, make your own interpretation and check with your CPA, Attorney and/or competent tax counsel.
  • There’s a time limit for reporting Social Security earnings and getting credits towards future Social Security benefits. The time period is 3 years, 3 months, and 15 days following the end of the calendar year in which you earn the income. If your earnings are not reported within this time period, you will not accumulate any Social Security credits for the unreported income.  Colvin Hallett Law
  • The Social Security Administration no longer mails out an annual Social Security Statement. In order to view your Social Security Statement, you must register on the Social Security Administrations website.
    • The Balance.Com

  • You earn work credits on the minimum $1,360 of earnings no matter when or how frequently you earn them. Theoretically, you could earn four work credits in a single month in which you make $5,440. That would max out your work credits for the year, however. Zacks.com

    • Social Security Self Employed 10022