Services Offered
Linda Gordon Insurance Solutions offers expert guidance through Medicare, Medicaid, and Marketplace options, and steps to take, ensuring you understand your eligibility and receive personalized assistance.
Medicare Eligibility Overview
Medicare is a federal health insurance program in the United States that primarily covers people age 65 or older. It also provides coverage to some younger people with certain disabilities and people of any age with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease.
Here is a breakdown of the general eligibility requirements for the different parts of Medicare:
Residency and Citizenship Requirements
To qualify, you must be a resident of the state where you apply and meet citizenship or immigration status criteria. We guide you through these requirements to avoid common pitfalls.
Medicaid Eligibility Overview
Medicaid eligibility depends on factors like income, household size, age, disability status, and state-specific rules. Understanding these criteria helps you identify if you qualify for coverage.
Income and Household Size
Your income must fall within limits set by your state, which vary based on the number of people in your household. We help you assess your financial situation accurately.
Special Eligibility Categories
Certain groups such as seniors, pregnant women, children, and individuals with disabilities often have expanded eligibility options. We clarify how these categories affect your Medicaid access.
Residency and Citizenship Requirements
To qualify, you must be a resident of the state where you apply and meet citizenship or immigration status criteria. We guide you through these requirements to avoid common pitfalls.
Who is eligible for Medicare in Florida?
The eligibility requirements for Medicare are set at the federal level and are the same across all states, including Florida. The general criteria are as follows:
Primary Eligibility
Age 65 or older: This is the most common path to Medicare eligibility. You must be a U.S. citizen or a lawfully admitted noncitizen who has lived in the United States for at least five continuous years.
Younger people with disabilities: You may be eligible for Medicare if you're under 65 and have received Social Security Disability Insurance (SSDI) benefits for 24 months.
Specific medical conditions: You can also qualify for Medicare at any age if you have:
End-Stage Renal Disease (ALS): Permanent kidney failure that requires regular dialysis or a kidney transplant.
Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease: There is no waiting period for Medicare coverage for people with ALS; they are eligible as soon as they start receiving SSDI benefits.
Medicare Plans
Comprehensive Medicare options designed for those 65 and older or with qualifying disabilities, including Parts A, B, C, and D coverage.
Medicaid Coverage
State and federally supported Medicaid plans offering affordable health services for eligible low-income individuals and families.
ACA Marketplace Plans
Flexible Affordable Care Act plans providing essential health benefits with options to fit various income levels and health needs.
Dental Insurance
Affordable dental plans that cover routine checkups, cleanings, and major dental work to maintain oral health.
Vision Insurance
Vision coverage options including eye exams, glasses, and contact lenses to support clear and healthy eyesight.
Personalized Support
Guidance from an experienced advocate to help you select the right plan based on your unique health needs and budget.
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Gather Your Documents
The documents required for a Medicare application can vary slightly depending on your personal situation, but there is a standard set of information and paperwork that most people need to have ready.
If You Are Not Automatically Enrolled
This applies to you if you are not yet receiving Social Security or Railroad Retirement Board benefits when you are approaching age 65. You will need to apply for Medicare Parts A and B, and you should be prepared with the following:
Primary Documents:
- Your Social Security number and Social Security card. This is essential for all applications.
- Your original birth certificate or other proof of age. This verifies your eligibility based on age.
- Proof of U.S. citizenship or legal residency. This could be a U.S. passport, Certificate of Citizenship, or your Permanent Resident Card ("green card") if you are not a U.S. citizen. Legal residents must have been in the U.S. for at least five continuous years.
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Medicare Application Made Simple
The Medicare application process is simplified with Linda’s clear, written instructions on how to access and navigate the Social Security website. Linda also provides any additional forms needed to help ensure a smooth and timely approval.
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Submit and Follow Up
Applying for Medicare and following up is a focused process with distinct steps, as the system is managed by a government agency (the Social Security Administration). While a general "submit and follow up" principle applies, the methods and timelines are more standardized.
Medicare FAQs
How do I compare Medicare plans?
Comparing Medicare plans involves reviewing coverage options, premiums, deductibles, and provider networks. Consider your health needs and budget to select a plan that offers the best balance of benefits and costs.
What is the difference between Medicare and Medicaid?
Medicare is a federal program primarily for people age 65 and older or those with certain disabilities. Medicaid is a joint federal and state program for individuals and families with limited income. People who have both Medicare and Medicaid are eligible for a DUAL Plan that offers more benefits and lower or $0 copays, depending upon what level of Medicaid you have.
Can I switch my health insurance plan during the year?
You can switch plans during specific enrollment periods, such as the Annual Enrollment Period or Special Enrollment Periods triggered by qualifying life events. Outside these times, changes are generally restricted.
Can I have both Medicare and Medicaid in Florida?
Yes—dual eligibles often get added help with Medicare costs (e.g., premiums, drug coverage, Home health care in some situations and other benefits) via Medicaid programs.
