Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market
The brief is based on interviews with senior executives at 13 large firms that contract with the Medicare and Medicaid programs and finds almost all of the insurers expect dually eligible beneficiaries will become more important to their business over time. The brief also looks at how insurers currently serve dually eligible beneficiaries, particularly through Special Needs Plans that are part of the Medicare Advantage program.
Video: Turning 65 Becoming Eligible for Medicare – 2011
Extending Social Security and Medicare Eligibility Ages
In light of the increase in life expectancy after age 65 and the decline in physically demanding jobs, it would be reasonable for the eligibility age for social security to rise to 68 or 70. The average age of retirement from the labor force for Japanese males is already only a little below 70, which shows that much higher retirement ages is feasible. Persons who are physically or mentally incapable of working would then opt for disability status. This is a rapidly growing category in most developed countries, despite the increase in physical and mental health of older persons, because of a weakening of qualifying standards. With more flexible labor markets for the elderly, such as reducing the fear of companies that they will be sued for discrimination against older workers, older men and women could retire from more demanding jobs, and take jobs that are less taxing. This is what happens to older men in Japan.
Who is Eligible for Medicare?
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months. If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration or visit their web site. The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A.
If I Win my SSDI Case, When do I Become Eligible for Medicare?
For many of my clients, Social Security disability income benefits are a lifesaver. The $1,500 to $2,000 per month typical in SSDI cases plus a $20,000 to $30,000 lump sum can mean the difference between living with dignity and not. However, monthly income benefits are not the only result of a favorable disability decision. SSDI claimants also become eligible for Medicare, although this eligibility is not immediate. There is a 24 month waiting period from the first date you become eligible to receive SSDI payments and the date you become eligible for Medicare. Here are a couple of examples that might help you better understand the 24 month waiting period: Example 1: Sue’s last day of work is August 10, 2010. She files for SSDI on August 11, 2010 using August 10 as her alleged onset date. Sue and her lawyer appear at a hearing in July 2012 and she is approved as of her alleged onset date. Sue first becomes eligible for SSDI payments as of February 1, 2011. This is because the five month waiting period for SSDI runs September, 2010 – January, 2011. Note that the five month waiting period refers to five full months – thus, August, 2010 does not count towards the five month waiting period. Sue becomes eligible for Medicare on the 25th month after her first SSDI payment, or March 1, 2013. Example 2: Tom stops working due to severe back problems on March 3, 2005. He does not apply for SSDI until July 18, 2008. Tom appears at a hearing in September, 2010 and receives a fully favorable decision using the March 3, 2005 onset. Tom first becomes eligible for SSDI payments in July 2007. His five month waiting period runs from April, 2005 through August, 2005, but he can only collect benefits one year prior to the date of his application, which is July 18, 2007. His Medicare eligibility begins as of September, 2008, which is during the 25th month after his first eligibility for SSDI payment. Here is a link to SSA’s page about Medicare eligibility – http://1.usa.gov/11CbEEW.
Question about calculating Medicare eligibility date
Hi, I have a question about how to calculate my Medicare eligibility date and I’m finding some conflicting information on the web so I’m hoping someone here can provide a better answer. I filed for disability in 9/2012. SS determined that my medical onset date is 9/2010. They have my entitlement date as 9/2011. I understand that there is a 24 month waiting period before one is eligible for Medicare. My question is do they start counting from the onset date (the first date they found I was disabled) or the entitlement date (which is the 1 year prior to my application date, which is apparently as far back as they can go)? I’ve seen some sites say they go from the onset date (in which case I would be eligible) but other sites say you actually have to receive benefits for 24 months (so using the entitlement date, basically). I was at the SS office today and the lady helping me thought it was calculated from the entitlement date, but she wasn’t certain. I’m hoping someone here has had experience with this issue and can shed some light on it. Thanks for any information!
Drug Savings Act Would Strengthen Medicare Without Harming Beneficiaries
Implementing Medicare drug rebates is not new law. Upon passage of the Medicare Modernization Act (MMA), millions of older adults and people with disabilities gained access to prescription drug coverage through private plans approved by the federal government, known as Medicare Part D. At the same time, the MMA severely limited the tools available to the federal government to control spending on pharmaceutical drugs in Medicare. In particular, the MMA eliminated rebates offered by pharmaceutical manufacturers for drugs provided to beneficiaries dually eligible for Medicare and Medicaid. Applying Medicaid-level rebates to Medicare drugs simply restores a practice that existed for dually eligible beneficiaries prior to the passage of the MMA.
Obscure Medicare Rule Creates Catch
First, for many, employer-based plans are cheaper, more comprehensive and more familiar than Medicare, so people want to keep that coverage. While enrollment for Medicare Part A (which covers hospital stays) is automatic and requires no premium, Medicare Part B (which covers outpatient care) costs $100 per month and some individuals may opt out. Once the employed spouse retires, then the other spouse signs up for Medicare Part B. Without this protection, late applicants for Medicare Part B would have to pay a penalty, like anyone else who signs up late.
Oklahoma Medicare Eligibility Requirements
You’re not alone if the term “Medicare eligibility” leaves you scratching your head, wondering if you qualify for the full package of benefits. It’s true, there are a few restrictions, but for the most part, as long as you’re 65 or older and a permanent citizen, you should be qualified for health care benefits through Medicare. In some cases, it’s possible to be eligible for Medicare even if you’re younger than 65. If you have End-Stage Renal disease or have been on Social Security disability benefits for over 24 months, you’re eligible at any age.
Know Your Medicare In Better Way
Medicare Eligibility: In order to be eligible for Medicare, there is an eligibility criterion that should be fulfilled. The guidelines for eligibility include age, nationality and various other factors. As far as age is concerned, people should be 65 years or above. Even people who are below 65 years of age can apply, but this is only when the applicant is disabled or suffering from end stage renal disease. As far as nationality goes, the applicant needs to be a U.S citizen in order to be eligible. Even non-Americans can be eligible if they have gained U.S citizenship at least 5 years before applying for the program. If an applicant’s spouse has worked for a minimum of ten years and has paid premiums into the Medicare program, it makes them eligible for coverage too. What Medicare Covers: The basic break down of Medicare coverage is divided into 4 parts. These include Part A, B, C and D, and each plan offers different benefits. Part A: This plan involves cover for expenses paid during hospital stays. For this reason, Medicare Part A is also called hospital insurance and it pays for expenses incurred for up to 90 days of hospital care. However, this requires the insured to pay a minimal annual deductable. The expenses covered under this plan comprise of: • Meals • Semi-private room • Medical tests • Medical supplies • Intensive care unit • Blood transfusion after the first three pints • Coronary care unit • Operating room • Medication supplied by the hospital