Immigrating to the US focuses on the lives of US immigrants. The Worldway Group Los Angeles Customer Service Center has recently learned that the US medical welfare system is undoubtedly one of the most secure systems in the world. For some elderly groups among US immigrants, applying for federal health insurance (Medicare, commonly known as the red and blue card) after retirement is essential. The Worldway "US Immigrant Life" column will launch a series of special reports detailing issues related to US Medicare. In this issue, Worldway introduces the application conditions for US Medicare and the benefits you can enjoy:
Eligibility for Part A
Most US citizens or permanent residents aged 65 or older can obtain free federal Medicare hospital insurance (Part A).
◆ If you meet the following conditions, you will be eligible for free coverage at age 65:
‧ Currently receiving or eligible to receive Social Security benefits; or
‧ Currently receiving or eligible to receive Railroad Retirement benefits; or
‧ You or your spouse (living or deceased, including divorced spouses) have worked in a government agency and paid Medicare taxes for a sufficient period; or
‧ You are the dependent parent of a worker who has worked in a government agency and paid Medicare taxes for a sufficient period.
If you do not meet these conditions, you can also purchase Medicare hospital insurance by paying a monthly premium. Generally, hospital insurance can only be applied for during designated enrollment periods.
Note that even though the prescribed normal retirement age is no longer 65, you should still apply for Medicare three months before your 65th birthday.
◆ Conditions for eligibility under age 65
If you meet the following conditions, you can also obtain free Medicare hospital insurance (Part A) before age 65:
‧ Individuals with disabilities who have been receiving Social Security Disability Insurance (SSDI) for 24 months; or
‧ Those receiving disability benefits from the Railroad Retirement Board and meeting certain special conditions; or
‧ Patients with Lou Gehrig's disease (Amyotrophic Lateral Sclerosis); or
‧ Individuals who have worked in a government agency and paid Medicare taxes for a sufficient period and meet all Social Security disability benefit conditions; or
‧ Children of workers who have worked in a government agency and paid Medicare taxes for a sufficient period, who meet all Social Security disability benefit conditions, or widows and widowers aged 50 or older who meet disability conditions, including divorced widows and widowers.
‧ Patients with permanent kidney failure receiving maintenance dialysis or a kidney transplant must be: currently receiving or eligible to receive Social Security benefits or Railroad Retirement benefits; or have worked in a government agency and paid Medicare taxes for a sufficient period; or be the child or spouse (including divorced spouse) of a living or deceased worker who has worked and paid Social Security taxes or worked in a government agency and paid Medicare taxes for a sufficient period.
Medical services covered by Part A
Applying for Medicare Part A does not consider the applicant's assets and income. In other words, there are no restrictions on assets and income; regardless of how many assets or properties you have, you can apply as long as you meet the conditions.
Coverage of Part A:
‧ Inpatient hospital care
‧ Skilled nursing facility care
‧ Home health care and hospice care
Out-of-pocket expenses for Part A
Applicants can use Medicare Part A for free as long as they meet the conditions. However, you should also be aware of how much you need to pay out-of-pocket when using it. According to New York State regulations in 2016, the out-of-pocket expenses for Medicare Part A are as follows:
1. Deductible: $1,288 for the first 60 days (inpatient treatment)
2. Copayment: $322 per day for days 61 to 90; $644 per day for days 91 to 150 of hospitalization.
If you are discharged, a new benefit period will begin after 60 consecutive days (including the day of discharge). If you return to the hospital within 60 days, the original benefit continues.
3. Part A does not cover the first 20 days of skilled nursing home costs. The copayment for days 21 to 100 is $161 per day.
【Next Issue Preview】Worldway will introduce the federal Medicare situation in New York State in installments. The next issue will focus on answering key questions about applying for and using this Medicare card. Please stay tuned!
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Disclaimer: Some of the material in this article comes from the Medicare website, and the copyright belongs to the original author. The information or views in this article are for reference only. If there are any copyright issues, please contact the original author and us.