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Understanding Eligibility and Enrollment for Medicare in 2022

 Overview:  Learn what Medicare requirements are needed, and if you have to pay a premium for coverage in 2022

“When the calendar flips to 2022, certain Medicare costs will creep higher.” This is what CNBC says about 2022 Medicare costs.

Generally, Medicare eligibility takes into consider three main factors: age, ability, and health. This is still the case for 2022 coverage. People age 65 or older, younger people with disabilities, and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) have automatic access to Medicare.

You’ll automatically qualify for Medicare Advantage (Part C) once you qualify for Part A and Part B coverage. Advantage plans are sold by private companies to cover some of the out-of-pocket costs Medicare does not cover.

For individuals who don’t fall under any of the categories listed above, eligibility and enrollment would differ.

What to Know About Medicare: 

Medicare has two parts, Part A and Part B (Medicare Insurance). You are eligible for premium-free Part A (Hospital Insurance) if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: 

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board.

  • You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.

  • You or your spouse had Medicare-covered government employment.

You can read more about general Medicare eligibility here.

Though the eligibility criteria remains the same for Medicare, there are some small changes to the plan for 2022 if you want to get full Medicare benefits at age 65 or older, especially if you do not qualify on your own or through your spouse’s work record but are a U.S. citizen or have been a legal resident for at least five years.

 Changes to Part A in 2022: 

Part A deals with work credits and Income and covers hospital insurance. The amount of income it takes to earn a credit changes each year.

  • In 2022 you earn one work credit for every $1,510 in earnings, up to a maximum of four credits per year.

  • If you have accrued fewer than 30 work credits, you pay the maximum premium — $499 in 2022.

  • If you have 30 to 39 credits, you pay less — $274 a month in 2022.

  • If you continue working until you gain 40 credits, you will no longer pay these premiums.

Changes to Part B: 

Part B covers doctor visits and other outpatient services, as other people who enroll pay.

  • In 2022 the amount is $170.10 for individuals with a yearly income of $91,000 or less or those filing a joint tax return with $182,000 in income or less.

  • Rates are higher for people with higher incomes.

“You can enroll in Part B without buying Part A. But if you buy Part A, you also must enroll in Part B,” according to AARP.

Keep in mind that the government uses your tax return from two years earlier to determine whether you’ll pay those monthly adjustments. So for 2022, it would be your 2020 return.

To request a reduction in that income-related amount due to a life-changing event such as retirement, the Social Security Administration has a form you can fill out.

Advantage Plan Changes:

Also, while Advantage Plan premiums vary among plans — the average for 2022 is $19 monthly, down from about $21 this year — any charge would be on top of your Part B premium. And, some of those options either have no monthly charge or will pay your Part B premium. (If you don’t like your Advantage Plan, you can switch or drop it in the first three months of the year.)

Related: Here’s What to Know About Your 2022 Medicare Costs

Changes to Part D in 2022: 

For people with high prescription costs, be aware that the amount that Part D enrollees pay out of pocket before qualifying for “catastrophic coverage” will jump to $7,050 in 2022 from $6,550 this year (manufacturer discounts count toward that amount). In that phase of coverage, your share of prescription costs drops.

 The Bottom Line: 

Many Americans rely on medicare during their retirement as a means of subsidizing or paying for their healthcare. “This year is more critical than ever as changes hit medicare payments because the U.S. is seeing a spike in inflation that eats at retirement funds and might put many in a bind,” says FINSUM, a market leader in financial news summaries.

With the huge change in healthcare costs, retirees need to address them in their portfolio given spiking prolonged inflation. Read the full article here.

For more information or guidance on Medicare eligibility, enrollment, and costs, reach out to us here or call us at (909) 792-5100.

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