Medicare Criteria

Medicare is a structured health insurance plan for retirees and individuals with certain illnesses. It is broken into four separate parts: A, B, C and D. The criteria for eligibility depends upon the plan you are enroll in. For example, each plan has its own age criteria requirements. You can apply for Medicare through the social security office.

Part A

• The official website for Medicare states that Medicare Part A, hospital insurance, covers inpatient hospital care, home health care, hospice and nursing facilities. Premium-free Part A is provided to individuals who meet the eligibility criteria. You must be a permanent United States citizen and at least 64 years and 8 months old. You and your spouse are eligible if either of you were employed a minimum of 10 years with a Medicare covered business. According to the Social Security Administration, individuals collecting disability benefits, railroad or social security retirement checks are automatically enrolled in Medicare Part A and Part B.

Part B

• Because of the premium you pay for Part B, medical insurance, you have the choice to opt out. Part B covers various medical necessities such as outpatient care and doctors' visits. The criteria for Part B coverage is straight forward: any person eligible for premium-free Part A can enroll in Medicare medical insurance. There is no premium-free Part B plan, you are required to pay a monthly fee. If you are a legal resident of the U.S and 65 years or older you have the option to purchase Part B coverage for a higher premium. Standard premium rates can be found at the Social Security Administration's website.

Part C

• Members of Medicare plans Part A and B meet the criteria for joining a Medicare Advantage plan. All Medicare Advantage Plans cover you for urgent care, along with all the provisions of Part A and Part B coverage, according to Medicare.gov. Part C plans are offered by Medicare approved private companies. Advantage plans encompass specialty plans, preferred provider organization, PPO, plans and other Medicare managed care plans. Part C providers have the right to appoint different pay requirements. Most Advantage plans include Part D coverage.

Part D

• You must have Part A and Part B plans to be eligible for Medicare Prescription Drug Plan, Plan D. Plan D covers generic and brand-name prescription medication. Plans vary and dictate which drugs it covers. PDPs are optional and require a separate monthly premium. The Initial enrollment period is November 15th to December 31st of each year. You have this time period to apply for Medicare Plan D.