Can You Be Forced to Take Medicare?

Medicare, an entitlement program for people age 65 or older as well as certain disabled Americans, is not mandatory. People automatically qualify for Medicare if they paid into the program with a percentage of their earnings during their working years and are entitled to Social Security or Railroad Retirement benefits. Medicare consists of four parts: Part A, hospital insurance; Part B, medical insurance; Part C, Medicare Advantage plans; and Part D, Medicare prescription drug coverage.

Part A

• Even though Social Security law does not require participation in the Medicare insurance program, entitlement begins at age 65, and coverage is automatically added if a former wage earner already receives Social Security or Railroad Retirement benefits. Part A covers a portion of inpatient care in a hospital or skilled nursing facility if the patient goes to the nursing facility following a stay in the hospital. The coverage also pays for some hospice care and some home health care. Those who desire Medicare coverage but are not receiving Social Security benefits should apply three months prior to their 65th birthday. The application covers both Part A and Part B. While there is no charge for Part A, a premium is associated with Part B; therefore, the recipient may decline the additional coverage.

Part B

• Medicare Part B pays for a portion of doctor's fees and many other medical services not covered under Part A. Part B also covers some medical supplies as prescribed by the recipient's attending physician. In 2011, the Part B monthly premium for most beneficiaries is $96.40 or $110.50. A newly enrolled recipient's 2011 premium weighs in at $115.40. A high-income wage earner pays the $115.40, plus an additional premium based on an income-related monthly adjustment.

Part C

• Medicare Advantage plans, or Part C, are available in certain areas of the country. Basically, Part C works much like a health maintenance organization, providing health care services through a network of approved providers in a plan that expands the coverage provided through Parts A and B. The premium for Part C is higher than Part B because of the additional coverage provided. The cost is specific to the individual plan. While a participant may choose a provider outside most plans, co-payments normally increase when treatment comes from a non-network health-care professional.

Part D

• Medicare Part D is insurance for prescription drugs.

  Prescription drug coverage, or Medicare Part D, comes at an additional cost. This coverage is offered through Medicare-approved health insurance companies. Each company's premium amount and approved-drug benefit varies depending on the company and the area of the country the insurer services.

Considerations

• A person age 65 who is still employed and receiving health care benefits through his employer should check his insurance provider to determine how his coverage might be impacted by reaching Medicare age. If a person fails to apply for Medicare when he reaches 65, he must wait for a specific enrollment period or file online during the general enrollment period, January 1 through March 31 of each year. Generally, a penalty of 10 percent applies to the Part B premium if the enrollee could have applied for Medicare but failed to do so during her initial eligibility.