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Are You Eligible for Medicare?

Are You Eligible for Medicare?

How do you know if you’re eligible for Medicare? Read on to learn if you’re eligible for Medicare and what you need to do when you become eligible.


Who is eligible for Medicare?

Both U.S. citizens and qualified legal residents have to be one of the following:

  • Age 65 or older
  • Younger than 65 with a qualifying disability
  • Any age with a diagnosis of End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s Disease)

To qualify as a legal resident, you must have lived in the United States for at least 5 years in a row before applying for Medicare

Who is eligible for Medicare Advantage plans?

You may be eligible to enroll in a Medicare Advantage plan if you answer ‘yes’ to these questions:

  1. Do you have Medicare Parts A and B?
    • You’re at least 65 years old, or you’re under 65 and qualify on the basis of disability or other special situations and
    • You’re a United States Citizen or a legal resident who has lived in the United States for at least five consecutive years
  2. Do you live in RMHP’s CareAdvantage service area?
    • You must live in Delta, La Plata, Mesa, or Montezuma counties to qualify for this plan. A licensed sales agent can help answer your questions about the service area.

Who is eligible for a Dual Special Needs Plan?

You may be eligible to enroll in a Dual Special Needs Plan if you answer ‘yes’ to these questions:

  1. Do you qualify for Colorado Medicaid benefits?
    • You are under age 65 and qualify on the basis of disability or other special situation
    • You are at least 65 years old and receive Extra Help or assistance from your state
    • You must have full Medicaid benefits to qualify for RMHP DualCare Plus. A licensed sales agent can help answer your questions about eligibility.
  2. Do you have Medicare Parts A and B?
    • You’re at least 65 years old, or you’re under 65 and qualify on the basis of disability or other special situations and
    • You’re a United States Citizen or a legal resident who has lived in the United States for at least five consecutive years
  3. Do you live in RMHP’s DualCare Plus service area?
    • You must live in Delta, La Plata, Mesa, or Montezuma counties to qualify for this plan. A licensed sales agent can help answer your questions about the service area.

What if I work past age 65?

You still have a Medicare enrollment decision to make.

Even if you have coverage through your employer or your spouse’s employer, you'll still need to consider Medicare. Depending on your situation, you may or may not be able to delay Medicare enrollment. Your Initial Enrollment Period (IEP) happens when you’re turning 65 whether you’re still going to work or not. Be sure to know your IEP dates and plan ahead.

Learn how Medicare works with your employer coverage.

Depending on you employer coverage or your spouse's employer coverage:

  • You may be required to enroll in Original Medicare (both Part A and Part B) by your/your spouse's employer, or
  • You may be able to enroll in only Original Medicare Part A during your IEP, then enroll in Original Medicare Part B and/or Part D later during a Special Enrollment Period

Contact your employer's benefits administrator to learn more about your personal options.

What do I need to do when I’m eligible for Medicare?

Most people are automatically enrolled in Original Medicare (Part A and Part B) once they're eligible, but not everyone is.

When will I be automatically enrolled in Original Medicare?

You will automatically be enrolled in Original Medicare if:

  • You're receiving Social Security or Railroad Retirement Board benefits when you turn 65, or
  • You're eligible for Medicare because of a disability or medical condition.

When will I need to enroll myself in Original Medicare?

If you are not receiving Social Security benefits when you become eligible for Medicare, you will need to enroll yourself in Original Medicare.

How do I enroll myself in Medicare?

There are three ways to enroll yourself in Medicare:

  1. Online at www.SocialSecurity.gov.
  2. Call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7AM to 7PM.
  3. In-person at your local Social Security office.

What are my coverage choices after I have Medicare?

Once you’re enrolled in Original Medicare Part A and/or Part B, you’ll start to receive coverage from the federal government. At that point, you can also choose additional coverage from private insurance companies like RMHP.

Review coverage choices
 

Enroll with RMHP

RMHP is here to help! Here’s how you can enroll in an RMHP Medicare Advantage or Dual Special Needs Plan.

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Choose a plan and enroll online.

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Call 866-568-3706 (TTY:711), and speak to a licensed agent.

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Find a meeting in your community.

 

Medicare Disclaimer

This page was last updated: 10/01/2020. Please call to confirm you have the most up to date information about our Medicare plans.

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Important Disclaimers: RMHP is a Medicare-approved Cost plan. Enrollment in RMHP depends on contract renewal. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare. Other pharmacies, physicians, providers are available in our network. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult http://www.medicare.gov.   Every year, Medicare evaluates plans based on a 5-star rating system.  If you need help finding a network provider, please call 800-346-4643  (TTY 711) or visit www.rmhpMedicare.org to access our online searchable directory. If you would like a provider directory mailed to you, you may call the number above, request one at the website link provided above, or email customer_service@RMHP.org

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Let's Find A Medicare Plan That's Right For You

Since 1977, Colorado retirees like you have trusted RMHP to get the most out of their Medicare benefits. Enjoy easy enrollment, flexible options, and a large provider network when you choose RMHP. Let us help you enjoy your retirement.

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