A serious concern for those who have been approved for Social Security Disability benefits is medical coverage. Often, people lose their major medical coverage after they have been unable to work for an extended period of time. While COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) does allow many workers to continue their coverage, many cannot afford to pay the full insurance premiums.
If your Social Security Disability claim has been accepted, whether you receive SSDI or only SSI, you will qualify for Medicare after you have been eligible for Social Security Disability benefits for 24 months. You will be advised when your period of eligibility is approaching regarding how you should apply for Medicare.
All Social Security Disability beneficiaries are eligible for Part A (hospitalization) of Medicare and are required to enroll, even if you have other insurance coverage. Medicare Part A is provided at no cost for qualifying recipients. Failure to enroll in Medicare Part A when it is offered to you can result in you having to pay back Social Security Disability benefits, therefore making it necessary to sign up. In other words, while you are eligible to enroll in Medicare after 2 years, you are also required to.
If you do have other major medical coverage, Medicare will be your secondary insurer. Basically, this means that your primary insurance will pay what they would normally pay while Medicare covers any existing gaps in your coverage.
Medicare Plan B is also offered to Social Security Disability recipients. Medicare Part B covers doctor’s visits. If you accept part B, you will need to pay premiums based on your income level.
Those who have both Medicare Part A and Part B are eligible to participate in Medicare Part C, also known as Medicare Advantage Pans. There are a variety of Medicare Part C Advantage Plans available to those who receive Social Security Disability benefits. The plans are similar to other health insurance plans, offering pay for service, PPO, and managed care plans. They are typically sold by private-for-profit and non-profit insurance companies.
You will also be eligible to enroll in Medicare Part D, which covers prescription drugs. If you opt for this coverage, you are better off enrolling in Part D when you first enroll in Medicare, as there is a penalty for joining later.
You should be aware that signing up for the optional Medicare coverages does sometimes include waiting periods for pre-existing conditions, just as other insurance programs often do. Also, you should know that through the COBRA program, you can continue your Medicare coverage even if you lose your SSD benefits or return to work.
If you have not been contacted regarding enrollment in Medicare after you have been eligible for Social Security Disability benefits for 24 months, contact your Social Security Administration for more information . Remember that the 24 months are counted from your date of eligibility, not the date that you actually started receiving Social Security Disability payments. This means that you need to be aware of the actual date that you applied for your Social Security Disability benefits as well as the date that your disability began.
Your eligibility for Medicare is not affected by whether you are collecting SSDI or only SSI. If you have been approved for any Social Security Disability benefits due to your disability, you will be eligible for Medicare after you have been on Social Security Disability for two years. Depending on your income level, you may have to pay premiums for Medicare Parts B, C, and D. The amount you will need to pay is income based.
