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Who can get Medicare and how does the Initial Enrollment work?


The Suzie @ Wenatchee Insurance is asked about Medicare a lot. We help people understand and enroll. If you are looking for PEBB information then go to the HCA and request customer service and if you don't like their options request that they contract with brokers. Once they contract then we get access to the specialized training and can effectively assist PEBB retirees. We work with plans that contract out with licensed producers. 

Who can get Medicare?

Medicare is the federal health insurance program in the United States that provides coverage to individuals who are 65 years or older and certain groups of people including:

1.       Individuals who are 65 years or older: If you are a U.S. citizen or a legal permanent resident and you or your spouse have worked and paid Medicare taxes for at least 10 years, you are eligible for Medicare at age 65.

2.       Individuals with certain disabilities: If you have a qualifying disability and have received Social Security Disability Insurance (SSDI) or Railroad Retirement Board disability benefits for at least 24 months, you may be eligible for Medicare. Set a reminder once the benefits have started so that you can get ready for Medicare!

3.       Individuals with End-Stage Renal Disease (ESRD): If you have permanent kidney failure that requires dialysis or a kidney transplant, you may be eligible for Medicare, regardless of age.


4.       Individuals with Amyotrophic Lateral Sclerosis (ALS): If you have been diagnosed with ALS, also known as Lou Gehrig's disease, you are eligible for Medicare as soon as your disability benefits begin.


It's important to note that eligibility requirements for Medicare may vary depending on your individual circumstances, and some individuals may be eligible for Medicare before age 65 if they have certain medical conditions or disabilities.

How does the Initial Enrollment Period (IEP) work?

When you become eligible for Medicare, you have an initial enrollment period (IEP) of seven months to enroll in Medicare. Your IEP starts three months before your 65th birthday month, includes your birthday month, and ends three months after your 65th birthday month.


During your IEP, you can sign up for Original Medicare, which includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). You can also enroll in a Medicare Advantage plan (Part C), which is an alternative to Original Medicare, and provides additional benefits such as prescription drug coverage, vision, and dental services.


If you choose to enroll in a Medicare Advantage plan during your IEP, you will need to have Medicare Part A and Part B, and your coverage will begin on the first day of the month after you enroll. If you only enroll in Original Medicare during your IEP, you can also enroll in a Medicare Part D plan, which provides prescription drug coverage.


It's important to note that if you miss your IEP, you may face late enrollment penalties, and you may have to wait until the next Medicare enrollment period to enroll in coverage.

We have people setting appointments as far as 5 years out to enroll in Medicare. We can do the appointment in our office in Wenatchee. We do service Washington State, including Chelan, Douglas, Okanogan, and Grant counties. It is not a problem to screen share or a telephone appointment. 

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