Disability Planner: Medicare Coverage If You’re Disabled

Posted by:  :  Category: Medicare

Everyone with Medicare also has access to prescription drug coverage (Part D) that helps pay for medications doctors prescribe for treatment. For more information on the enrollment periods for Part D, we recommend you read Medicare’s "How to get drug coverage" page.
Source: ssa.gov

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.
Source: cms.gov

Does Medicare or Medicaid Come with Disability?

Do you get Medicare coverage if you were approved for SSI? Claimants who are approved for SSI only typically receive Medicaid coverage in most states. And like SSI, Medicaid is subject to income and asset limitations. Medicaid is a needs-based, state- and county-administered program that provides for a number of doctor visits and prescriptions each month, as well as nursing home care under certain conditions. Can you ever get Medicare if you get SSI? Medicare coverage for SSI recipients does not occur until an individual reaches the age of 65 if they were only entitled to receive monthly SSI disability benefits. At the age of 65, these individuals are able to file an uninsured Medicare claim, which saves the state they reside in the cost of Medicaid coverage. Basically, the state pays the medical premiums for an uninsured individual to be in Medicare so that their costs in health coverage provided through Medicaid goes down. 
Source: disabilitysecrets.com

Medicare Eligibility Requirements

By law, you’re allowed to sign up for any Medigap policy in your state as long as you enroll during the initial window, even if you have medical issues that would otherwise prevent you from getting covered. An insurer has to charge you the same premium rate as a healthy person, too, so enrolling during this initial period is essential if you need the extra coverage. Your guarantees under the initial enrollment window expire once that 6-month eligibility period ends. Outside of the initial eligibility window, you may not find Medigap coverage at all. And if you do, it will probably cost a lot more.
Source: medicare.net

Medicare Disability Coverage For Those Under 65

When your Medicare starts you will be eligible for both Medicare Part A – hospital and nursing home coverage – and Medicare Part B – doctor visits and outpatient services. You will get a Medicare card in the mail before your 25th month of disability. If you do not want Medicare Part B, you can send back the card. If you keep the card, you will keep Part B and will pay Part B premiums.
Source: verywell.com

Eligibility for Medicare Supplement (Medigap) Plans

Trial rights allow you to join a Medicare Advantage plan for a one-year trial period if you are enrolling in Medicare Part C for the first time. If you’re not happy with the plan, you can return to Original Medicare anytime within the first 12 months. Then, if you dropped a Medicare Supplement plan to enroll in your Medicare Advantage plan, you can apply for the same Medicare Supplement policy you had previously if it’s still offered by the insurance company you were with before. If your former Medicare Supplement plan is no longer available, you have a special trial right to enroll in any Plan A, B, C, F, K, or L that is offered by any insurance company in your state. You may want to have your new Medicare Supplement policy go into effect at the same time your Medicare Advantage coverage ends to avoid breaks in your coverage. You can apply as early as 60 days before your Medicare Advantage coverage ends and no later than 63 days after your plan coverage ends.
Source: medicare.com

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