Insights Into Common Insurance Requirements Your Clients Need to Know

Matthew Zelk
Matthew Zelk
Published on June 24, 2022

Insurance can be complex, and people have lots of concerns when it comes time to purchase coverage. One worry many people share is whether or not they will be eligible for the insurance policy they want to buy. 

You can help your senior clients and their families understand if they meet the requirements for various insurance products, helping them to be less worried as they plan their insurance purchases. 

Read on to learn more insights into some common insurance requirements your senior clients need to know about, then contact us at American Senior Benefits for more information. 

Common Insurance Requirements Your Clients Should Know About 

These common insurance requirements are important to know. 

Medicare Requirements

Many people have questions about Medicare eligibility as they age. Medicare is a government program for people who are age 65 or older. Medicare is also available for people younger than 65 who: 

  • Have end-stage renal disease or a kidney transplant, and the individual or their spouse has paid Social Security taxes for a certain amount of time
  • Have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Disease
  • Are eligible to receive a disability pension from the Railroad Retirement Board
  • Are entitled to Social Security Disability for at least two years

If your clients are aged 65 or older, they qualify for full Medicare benefits as long as they are: 

  • A U.S. citizen or permanent resident residing in the country for at least the last five years 
  • Eligible to receive Social Security or Railroad Retirement benefits 
  • A government employee (or has a spouse who is), or retiree who has paid Medicare taxes while working 

Clients Can Purchase Medicare

If your clients do not qualify for full Medicare benefits based on these criteria, they still may be able to get benefits. As long as your clients are U.S. citizens or legal U.S. residents of at least five years, they can purchase Medicare benefits if they are at least 65 years old. 

Clients can pay premiums depending on how long they have worked, or how many work credits they have earned. These work credits offset what your clients will pay for their Part A benefits. For Medicare Parts B and D, clients will pay what other Medicare enrollees pay, which changes from year to year. 

Clients do not have to purchase all parts. For example, they do not need to purchase Part D (prescription drug coverage). If your client enrolls in Part A coverage, however, they do need to purchase Part B coverage as well. A client could elect just Part B coverage, though. 

How to Help Your Clients Understand Insurance Requirements 

These requirements can get confusing, especially if your clients have other insurance or do not qualify for Medicare in a traditional way. Take time to review their personal situation to understand their needs. Once you know their circumstances you will be able to advise them on how to best qualify for Medicare. 

Because it can be complicated, you may need to meet with your senior client and their family more than once to best understand and help with their insurance needs. Agents can help provide a positive insurance experience and can advocate for their senior clients – once you understand their needs. 

How Do I Learn More?
To learn more about common insurance requirements for seniors, contact us at American Senior Benefits. Our affiliated experts will be happy to answer any questions you have.

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