Medicare coverage and Social Security Disability can be difficult to navigate. What are the benefits of being on Medicare with or without Social Security Disability benefits?
Recently a client sent us this question; “I am 58 and do not qualify for ss disability. I just received my Medicare award letter to take effect 11-2020 due to my disability. It didn’t explain what Medicare will do for me. Do you know?”
If you recently began receiving Medicare benefits, you may be asking the same question. What exactly will Medicare do for you? How will it work hand in hand with your SSDI benefits if you receive them, and how does it work if you aren’t on Social Security?
As we all know, the cost of medical treatment can be quite costly, and your health care expenses can add up quickly. These expenses could easily devour your monthly social security benefits. Fortunately, if you qualify for Social Security Disability benefits, you’ll also qualify for Medicare benefits.
There are things to be aware of when it comes to what types of coverages are available to you and when your coverages would be available.
The Medicare Breakdown
Medicare is a form of health insurance that’s available for individuals who are 65 years or older, and for individuals who are under 65 years old but who may be disabled or suffer from end-Stage Renal Disease.
Part A, which is a patient’s hospital insurance and Part B which is a patient’s medical insurance.
Fortunately for patients, there aren’t any existing health conditions or illnesses that could disqualify a patient for Medicare coverage.
The Parts of Medicare
- Part A Coverage: As hospital coverage, this will help to cover any form of inpatient care, such as hospital stays, and nursing home facility stays.
- Part B Coverage: This coverage is for any outpatient care. It helps to cover any doctor’s visits, surgeries needed, medical equipment, or labs.
- Medicare Advantage Part C Coverage: This can be considered a Medicare Advantage plan and works to help in replacing Medicare Parts A and B.
- Part D Coverage: This works as a patient’s prescription drug coverage or can also be called pharmacy benefits. With some of the incredibly high costs of medications, this can come in handy for patients.
Medicare Coverage with Social Security vs Medicare without Social Security Disability
You may be questioning the difference between Medicare coverage with SSDI benefits and Medicare coverage without SSDI benefits.
Coverage is essentially the same for individuals who qualify because of age rather than disability.
Available coverage helps cover nursing home facilities, hospital visits and stays, physician appointments, and home health care. The covered services do not necessarily need to be directly related to a patient’s disability.
Medicare Coverage and Social Security Disability
As the question stated above, there are individuals who are younger than 65 years old that qualify for Medicare because of a disability. To receive Medicare, they should have received SSDI benefits for 2 years, already have End-Stage Renal Disease, or ALS (Lou Gehrig’s Disease).
After an individual proves disability, they will have a five-month waiting period to begin collecting their SSDI benefits. However, if a patient has either ESRD or ALS, they don’t have to wait to collect benefits for 2 years in order to be considered Medicare-eligible.
There are a couple of different requirements for patients with ALS and ESRD. ALS patients are eligible once they start receiving SSDI benefits. However, ESRD patients are typically eligible after 3 months of consistent dialysis or a kidney transplant.
Once the requirements are met, patients have usually enrolled automatically into Medicare Part A and Part B.
Social Security Disability Application for Medicare Coverage
Individuals who are eligible for Social Security Disability benefits usually receive their Medicare card via mail.
If you find that you have not received your card, you may contact your local Social Security office.
An individual can enroll in Medicare during several periods. Medicare enrollment must be done through Social Security.
- Initial Enrollment Period – When an individual is advised of the end of their health insurance, and up to seven months after.
- General Enrollment Period – This is from January 1st – March 31st every year.
- Special Enrollment Period – If an individual is covered under their employer’s health coverage.
The Waiting Period for SSDI
More than likely, your Medicare benefits will not take effect immediately after receiving your Social Security Disability payments.
The waiting period is two years from the date of your Social Security entitlement. In the meantime, you may be eligible for Medicaid services.
If you find yourself wanting to know more about Medicare supplemental plans, please give us a call at the number listed above.
Our agents are here to help you. You may also complete an online rate form to find your best plan today.