Understanding Medicare Eligibility Requirements

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Understanding Medicare Eligibility Requirements

As individuals age, it’s important to maintain a healthy oral care regimen to avoid tooth loss and other oral care complications. However, dental appointments can be costly depending on how many annual visits are necessary and if any procedures are required. For those who are no longer working but are still in need of dental services, applying for Medicare would be the best option.

How to Know If You Qualify

Understanding Medicare Eligibility Requirements

Individuals over the age of 65 qualify to apply for Medicare if they are:

  • A U.S. citizen or have lived in the country for at least five years as a permanent legal resident.
  • Have worked enough years to qualify for Social Security or railroad retirement benefits, which consists of earning 40 credits as a result of 10 years of work in any field.
  • A government employee or retiree who has paid into Medicare payroll taxes throughout their career, even if they have not paid into Social Security.

It’s important to remember that if an individual earned 40 credits from payroll taxes throughout their career, they will not have to pay premiums for Part A benefits, which typically covers inpatient hospital care. Individuals also don’t need work credits to qualify for Part B and D benefits, which mainly consist of doctors’ services and outpatient care, and prescription drug coverage respectively.

For individuals who are 65 and have spouses who are at least 62, they can be included on their spouse’s work record and qualify for premium-free Part A benefits. They could still qualify even if they’re divorced from their ex-spouse, or if their spouse is deceased.

What if I Am Not 65 but Still Need Benefits?

Individuals who are not yet 65 but still need coverage for dental care may qualify for Medicare if they:

  • Were entitled to Social Security disability benefits for a minimum of 24 months, even if not consecutively.
  • Were injured and received disability from the Railroad Retirement Board.
  • Have certain diseases, such as Lou Gehrig’s disease, which is amyotrophic lateral sclerosis. Under this circumstance, individuals qualify for benefits immediately.

Depending on each individual’s needs, buying all parts of Medicare plans aren’t necessary. For example, it’s possible to enroll in Part B without enrolling for Part A. However, those who purchase part A are required to purchase Part B. For those who have more questions about what they’re eligible for, they can check their Social Security statements on their work records.

San Diego General & Family Dentistry

At McBride Dental, we are passionate about helping all age groups, especially our elderly patients because we believe having a beautiful and healthy smile is an important way to help improve one’s confidence and the quality of their lives. We believe it’s possible to still have healthy teeth, gums, and overall oral health at any age. However, it’s very important for our patients to take advantage of our preventative care services, cosmetic dentistry, teeth whitening, denture services, and much more. If you are in the San Diego area and would like to schedule an appointment with us, contact our office today at 760-471-1003.

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