Medicare is a social security program that provides health insurance to those who are also receiving Social Security Disability Insurance (SSDI). It is meant to benefit those who are 65 years of age and older and who have worked for years and paid into the Social Security system.
People younger than 65 can qualify if they have certain disabilities or have permanent kidney failure. It helps SSDI recipients by covering a portion of their health care costs. It is a great benefit to many who are elderly and/or permanently disabled in some way.
There are four parts to Medicare: Part A (Hospital care), Part B (Medical care), Part C (Medicare Advantage- Medicare that has been obtained through an approved organization) and Part D (Prescription drugs). Part A is the most accessible part. Those who are eligible for Part A can pay a premium for Part B. Those with A and B can also obtain C (may have to pay a premium). Those with A and B can also obtain D for an additional premium.
There is a significant waiting period that exists for those who have been approved for SSDI and are applying for Medicare. The wait time is 24 months, or 2 years. There are an estimated 1.8 million Americans who are in that window at any given time. Many people are without any medical coverage during all or part of those two years.
Some people are fortunate enough to take part in their spouse’s health care plan. Others have been able to take advantage of policies offered under the Affordable Care Act. Still, others who are economically challenged may be able to receive Medicaid during the waiting period.
It is important to note that the date that one is eligible for Medicare is two years after their date of SSDI eligibility. If a person is filing significantly after he or she is eligible for benefits, the wait will be shorter. Those who suffer from end-stage renal disease or Amyotrophic lateral sclerosis will not have to wait nearly as long for Medicare.
The two year waiting period exists for a reason. The two year wait generally keeps the cost of providing coverage down. Also, when Congress made the stipulation, they thought that many disabled workers would still be covered under a private insurance plan, and two years would be a sufficient amount of time for a private plan to end. Lastly, they thought that this would be a good amount of time to determine if a disability would permanently affect a person’s ability to work or not.
Individuals have several options when filing for SSDI benefits. They can seek out the help of a disability attorney or advocate, or they can file on their own. However, an attorney or advocate with experience in SSDI is the best option. The reasons are many. An attorney or advocate can:
- get a faster hearing or eliminate the need for one
- get you a higher approval probability
- provide knowledge and guidance
- keep information about your case confidential and private.
Although you can apply on your own when seeking SSDI, it is greatly to your advantage to retain the services of a professional disability advocate or attorney.
