Who qualifies for Medicare in New Hampshire?
Most people are eligible for Medicare in New Hampshire when they reach age 65 or suffer from disabling conditions that prevent them from working. For people who are 65 or older, they can receive Medicare in New Hampshire when they meet the following eligibility requirements:
- Natural born or naturalized U.S. citizen, or
- Lawful permanent resident who has lived in the U.S. for at least five years, and
- Recipient of Social Security or Railroad Retirement Board benefits, or
- Eligible for Social Security or Railroad Retirement Board benefits but have not begun receiving them, or
- Government employees/retirees who paid FICA taxes for Medicare but not Social Security through payroll deductions
Certain people in New Hampshire who are younger than 65 might still be eligible to apply for Medicare coverage from the federal government. However, they must meet one of the following requirements:
- Have been eligible for or received Social Security disability benefits or Railroad Retirement Board benefits for at least 24 months
- Have end-stage renal disease, received a kidney transplant, on dialysis, and have paid Social Security/FICA taxes for an age-specific time through employment
- Have a diagnosis of amyotrophic lateral sclerosis (Lou Gehrig’s disease) for automatic eligibility for Medicare
Lawful permanent residents and U.S. citizens who are not otherwise eligible for full Medicare and who have lived in the U.S. for at least five years can still receive Medicare when they turn age 65 by buying into the program and purchasing Medicare Part A and Part B. However, Medicare Part A will not be premium-free and instead will require them to pay premiums based on the number of work credits they have. The lowest premiums are available for people who have between 30 and 39 credits. If people continue working until they reach 40 work credits, the premiums for Medicare Part A will end.
In addition to paying premiums for Part A, people who buy into Medicare at age 65 will also be required to pay the same monthly Part B health plan premiums that others with similar incomes pay. In 2021, the standard Part B premium is $148.50 per month for individuals earning up to $88,000 and joint filers earning up to $176,000.
It is possible to enroll in Part B at age 65 for outpatient care without buying Part A. By contrast, people who buy Part A hospital coverage must also enroll in Part B. Beneficiaries who are enrolled in both Parts A and B can also apply for Part D to receive prescription drug coverage.
People must be enrolled in Original Medicare Parts A and B before they can enroll in Medigap Supplements or Medicare Advantage plans through private health insurance companies. People who enroll in these health insurance plans have additional options for coverage.
Is Medicare in New Hampshire free?
People in New Hampshire pay into the Medicare program through payroll tax deductions during their careers and earn benefits by earning 40 or more work credits. While people can receive premium-free Part A hospital coverage through earning enough work credits, they must pay monthly premiums for Medicare Part B. People will also be responsible for deductibles and copays associated with the different Medicare parts or plans before their benefits will start paying for their care.
How Much is Medicare Part A?
In 2021, people do not have to pay a Part A premium as long as they have earned at least 40 work credits. People will have to pay Part A premiums when they have earned fewer credits in the previous 10 years as follows:
- From 30-39 credits – $259
- Less than 30 credits – $471
All people are responsible for paying deductibles for inpatient hospital stays of $1,484. Required hospital coinsurance will be assessed based on the number of inpatient overnight days as follows:
- First 60 days – $0
- Days from 61 to 90 – $371
- Days 91 and above up to 60 additional days – $741 countable as a part of the lifetime reserve days
- Days after 60 lifetime reserve days are used – 100% of inpatient stay costs
How Much is Medicare Part B?
In 2021, the standard Part B premium for individuals earning $88,000 or less or joint filers earning $176,000 or less is $148.50. Under the Medicare program, people with higher incomes pay higher Part B premiums. However, most people only have to pay $148.50 per month for the standard premium.
The deductible for outpatient health services under Medicare part B is $203. After reaching that, people must pay copayments of 20% for their outpatient services.
How Much is a Medicare Part D prescription drug plan?
Prescription drug coverage is available through Medicare Part D. The premiums people will have to pay will vary based on their incomes. The weighted average monthly premium paid by people in New Hampshire for Part D is $38 for prescription drugs. People with Part D plans also pay a standard deductible of $447. On average, Medicare beneficiaries pay copayments of under $10 for generic drugs and maximum copayments of 33% for branded prescriptions.
What if I choose a $0 Premium Medicare Advantage Plan?
Medicare Advantage plans are also known as Medicare Part C health plans. These plans are insurance plans with different premiums based on the plan. Some Medicare Part C plans offer $0 premiums. However, people cannot enroll in Medicare Advantage plans unless they first pay Medicare Part B premiums. Medicare Advantage plans include PPO or HMO plans that offer additional coverage options, including wellness, hearing, dental, fitness, and vision benefits. Some also include Part D prescription drug coverage. Insurance agents can explain the coverage options and wellness benefits offered by different Medicare Advantage plans.
How Much is a Medicare Supplement plan?
Private insurance companies offer Medicare Supplement medical insurance plans with premiums depending on which plan out of 10 standard medical insurance plans you select and your age, gender, and location. In addition to paying a premium for your Medicare Supplement plan, you will also have to continue paying your Part B premiums. Most Medicare Supplements or Medigap plans do not have Part D coverage for prescription drugs included. People often choose Medigap plans because of the robust coverage options they offer and the fact that they do not require enrollees to participate in health coverage networks. Medicare Supplements also make it easier for people to accurately predict the costs of their medical care.
What Medicare plans are available in New Hampshire?
Best for network freedom: Medicare Supplement
Medigap/Medicare Supplement plans have higher monthly costs from $125 to $250. However, in exchange for paying a higher monthly premium, you will not be restricted to a specific service area and will instead enjoy nationwide coverage. Since you will not be restricted to a service area, this means that you can be covered when you must go out of state for care from a specialist. Referrals are not required, and Medicare Supplement plans do not have annual changes. However, the monthly premium might change.
Best for lowest premiums: Medicare Advantage
Medicare Advantage PPO plans do not require referrals and feature larger networks. They charge monthly premiums ranging between $0 to $100.
Medicare Advantage HOM plans have smaller networks. If you need care from a specialist, you will be required to get a referral from your primary care physician. In most cases, Medicare Advantage HMOs have $0 monthly premiums.
Best for low-income or health conditions: Medicare Advantage D-SNP
The Centers for Medicare & Medicaid Services offer Medicare Dual Eligible Special Needs Plans or D-SNPs for low-income people. These plans are also a good choice for people who suffer from chronic conditions, including Lou Gehrig’s disease or end-stage renal disease. You can apply for a Medicare Advantage D-SNP plan if you are eligible for both Medicaid and Medicare. These plans allow you to dual enroll in Medicaid and Medicare to lower your out of pocket costs for copays and premiums.
New Hampshire Medicare FAQs:
What is the income limit for Medicare in New Hamphire?
There is no income limit for Medicare enrollment in New Hampshire. However, higher earners must pay higher premiums for Part B health coverage based on their annual incomes as described below:
- Individual filers earning between $88,001 and $111,000/joint filers earning between $116,0001 and $222,000 – $207.50 monthly premiums
- Individual filers earning between $111,001 and $138,000/joint filers earning between $222,001 and $276,000 – $297.50 monthly premiums
- Individual filers earning between $138,0001 and $165,000/joint filers earning between $276,0001 and $333,000 – $386.10 monthly premiums
- Individual filers earning between $165,001 and $499,999/joint filers earning between $333,001 and $749,999 – $475.20 monthly premiums
- Individual filers earning at least $500,000/joint filers earning at least $750,000 – $504.90 monthly premiums
How do I apply for Medicare in New Hampshire?
You will likely first become eligible for the Medicare program when you reach age 65. To apply for Medicare Part A and Part B, your Medicare enrollment steps will depend on whether you are already receiving Railroad Retirement Board or Social Security benefits when your initial enrollment period begins.
If you are already receiving Railroad Retirement Board or Social Security benefits, enrollment in Medicare Part A and Part B should be automatic. If you are not receiving retirement benefits when you turn 65, you will have to apply for Medicare Part A and B Medicare benefits and health care coverage.
If you are automatically enrolled, the Social Security Administration will send a package to you in the mail three months before the start date of your health care coverage.
If you are not receiving retirement benefits yet, you can apply for Medicare Part A and /or Medicare Part B by doing one of the following things:
- Going to your local Social Security office to apply in person
- Applying by phone with the Social Security Administration by calling 1-800-772-1213
- Applying online by going to www.ssa.gov
- Applying by mail by sending a signed, dated letter that explains the date you want to enroll and includes your name and Social Security number to the Social Security Administration
People who are eligible for Railroad Retirement Board benefits can apply for Medicare at their local Railroad Retirement Board offices or by calling them to enroll.
Regardless of the method you choose for applying for Medicare, make sure to keep documentation of the date that you try to enroll in Medicare in New Hampshire to avoid being charged a Part B premium penalty.
When can I apply for Medicare in New Hampshire?
The initial enrollment period for original Medicare starts three months before you reach age 65 to three months following the month you turn age 65 for a total enrollment period of seven months. If you fail to enroll during the initial enrollment period, you might have to wait to enroll in Medicare and be assessed a Part B premium penalty. If you are not eligible for premium-free Part A, you might also have to pay a Part A premium penalty.
Where do I apply for Medicare?
People in New Hampshire can apply for Medicare benefits by doing one of the following things:
- Applying in person at their local Social Security or Railroad Retirement Board offices
- Applying online by going to ssa.gov
- Applying by telephone by calling 1-800-772-1213 or 1-800-325-0778 for people with hearing loss
Mailing a letter to the Social Security Administration is also a way to enroll, but since letters can get lost in the mail, it is best to choose one of the other methods to apply for Medicare benefits.
What should I bring when applying for Medicare?
Bring the following documents with you if you plan to apply in person, or have them available to refer to if you apply online or over the phone:
- Proof that you are a U.S. citizen or lawful permanent resident who has lived in the U.S. for at least five years
- Birth certificate
- Income tax returns/W-2s for the past two years
- Proof of current health insurance if you have any coverage
- Any records of military service, if applicable
Is enrollment in Medicare mandatory at age 65?
At the time that you enroll in the Social Security retirement program, you are required to enroll in Medicare Part A since these two programs are linked. Enrollment in the other Medicare Parts, including Part B, C, and D, is optional. This means that you can delay your enrollment in these parts as long as you have creditable insurance coverage.
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- In New Hampshire, Medicare Advantage & Medicare Supplement plans are the most popular choices
- Your initial Medicare enrollment period begins three months before your 65th birthday and includes the entire month
- In New Hampshire, apply for Medicare online, by phone or at a Social Security office in your service area.