Medicare Eligibility Verification

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eSolutions’ Medicare Eligibility Verification also features real-time change reporting. When you submit a new transaction, the tool will compare the new transaction to the patient’s most recent transaction processed in the last 90 days. Each field on the Coverage Detail Report is analyzed in real time. When there’s a change, the changed item(s) displays with light gray shading. Additionally, the date of the previous transaction (the one that the new transaction was compared to) is displayed in the header row of the report.

Original Medicare (Part A and B) Eligibility and Enrollment

To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required is dependent on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person’s working years. Most individuals pay the full FICA tax so the QCs they earn can be used to meet the requirements for both monthly Social Security benefits and premium-free Part A.

Check Medicare Eligibility at

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NaviNet Medicare Eligibility

With NaviNet Medicare Access, unnecessary phone calls to Medicare IVR and tedious data reentry are issues of the past. Now you can link directly to the Centers for Medicare & Medicaid Services (CMS) to get all the answers you need. A premium low-cost, easy-to-use online solution, NaviNet Medicare Access delivers robust, detailed real-time benefits information for Medicare Parts A, B, C, and D coverage, as well as the current amount of annual deductible already met. NaviNet Medicare Access enables you to perform fast real-time transactions and searches, eliminating frustrating phone calls and unproductive wait times.

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