September 16, 2019

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Getting Medicare After Receiving SSDI Benefits

Worried Man

Financial assistance from the government can be a huge help when you’re dealing with an injury or a disease. The process of coping and adapting can be arduous and stressful, therefore it’s imperative to have proper coverage to ensure that you are able to get the medical help you need and deserve. To that end, it is important to understand the intricacies of Social Security Disability (SSDI), Medicare and how the two converge. If you’ve already applied for SSDI, you may be wondering whether you are eligible for Medicare. The short answer is, yes you are, but there are some important points to consider.

Waiting Period

To begin with, once you apply to the SSDI program – not long after you’ve been injured – it will take a few months before you are actually entitled to the benefits. Once you are entitled, you are then automatically put in a queue for Medicare. The waiting period, from the moment of entitlement, is about two years. But after including the few months spent waiting for SSDI to kick in, you could end up waiting a total of 30 months before receiving Medicare benefits.

Type of Coverage

Once you’ve made it through two years of waiting, you can start using Medicare. There are a few different types of coverage offered through this service. The first primary forms are: Part A and Part B.

A and B

Part A refers to hospital insurance, meaning it partially covers treatment given in inpatient facilities. It also covers part of follow up visits. Since this plan is funded via taxes you’ve already payed, there is no monthly charge.

Part B does require a monthly payment. This covers outpatient services and other medical treatment not given in a hospital.

The Social Security Administration automatically enrolls benefit recipients in Part A and B, but there are other types of coverage available to you if you wish to explore those options. These are Part C and D.

C and D

Part C is also known as a Medical Care Advantage plan. This type of coverage links you up with a private insurance company approved by Medicare. You must continue to pay for your Plan B coverage while on Plan C. Through the Medicare-approved private company, you can continue to have access to the benefits of Plan B, but you can also choose to pay for other benefits relating to vision, dental, hearing and prescription drugs. In general, you can save money in out-of-pocket costs with a Medical Care Advantage plan, though this will depend on the type of plan you buy through Plan C. You can choose between various HMOs, PPOs, private fee-for-service plans, and special needs plans.

Everyone who is eligible for Medicare is also eligible for prescription drug coverage via Plan D (sometimes called a PDP plan). It’s important to know that Plan D may be affected if you already own another drug plan through an employer or some other benefits program. For instance, having Plan D might force you (and potentially your family members) to forfeit your employer-sponsored health coverage.

Exception

It should be noted briefly that if you have Amyotrophic Lateral Sclerosis (ALS), then you don’t need to wait two years before receiving Medicare benefits. The moment SSDI becomes available to you, you will be given Part A and B of Medicare. Within a month of getting disability, you will receive a red, white and blue Medicare card.  

It can be rather complicated dealing with the rigmarole of SSDI and Medicare. This can be frustrating, especially if you are trying to return to some semblance of normalcy. For this reason, it can be very helpful to retain an attorney to help you choose the optimal coverage and to avoid any unnecessary roadblocks.

About Sean Lally

Sean Lally holds a BA in Philosophy from Temple University where he also studied theatre for several years. Between 2007 and 2017, he worked as a professional actor for several regional theater companies in Philadelphia, including the Arden Theatre Co., EgoPo Productions, Lantern Theater and the Bearded Ladies. In 2010, Sean co-founded Found Theater Company, an avant-garde artist collective with whom he first started to cultivate an identity as a writer.

Over the past few years, Sean has been working as a content writer, focusing primarily on the ways in which unequal power distribution can negatively affect consumers, workers and “everyday people,” more broadly. He writes for a number of websites including AccidentAttorneys.org, PersonalInjury.com, AmericanLegalNews.com and others.