When a serious injury or illness prevents you from working for a year or longer, you may be eligible to collect monthly Social Security Disability Insurance (SSDI) payments to help make ends meet. Unfortunately, when you have a disabling medical condition, loss of income may not be the only concerning issue you're facing. You may have questions about how you'll afford health insurance coverage so that you can pay for the medical treatment you need.
Fortunately, it is possible for disabled individuals to receive both SSDI benefits and Medicare coverage. Here's what you should know, and how the skilled legal team with O'Connor Law PLLC can work to ensure you receive the benefits and coverage you deserve.
What Is Medicare?
Medicare is a federal health insurance program that provides coverage for people who are 65 years of age or older, as well as for some disabled individuals younger than 65, regardless of income.
What Does Medicare Coverage Include?
Medicare coverage is comprised of two main parts:
- Part A – Hospital Insurance. This includes inpatient care in a hospital or skilled nursing facility, hospice care, lab tests, surgery, and home health care. Most people who collect SSDI benefits don't have to pay for Medicare Part A coverage, as it is financed by taxes you paid while working.
- Part B – Medical Insurance. Coverage includes health care providers' services and outpatient care, as well as durable medical equipment, home health care, and select preventive services. Most people must pay monthly premiums to receive Medicare Part B coverage.
Medicare also includes two additional parts:
- Part C – Medicare Advantage. Sold by private insurance companies, Part C Medicare Advantage plans offer supplemental coverage for deductibles, co-pays, and more. If you're eligible for Medicare, you have the option of enrolling in a Part C plan.
- Part D – Prescription Drugs. SSDI beneficiaries who have Medicare Part A, Part B, or Part C coverage are also eligible to purchase a Part D plan the covers prescription drugs.
SSDI and Medicare Eligibility
People who are disabled aren't required to wait until they're 65 years old for Medicare eligibility to begin. Generally, SSDI beneficiaries are eligible for Medicare coverage after receiving disability payments for 24 months (or in the 30th month after becoming disabled), even if they're younger than 65. After this two-year waiting period, your Medicare coverage benefits should begin automatically, with no action necessary from you unless you would like to purchase a plan for supplemental coverage.
Exceptions That May Warrant Expedited Eligibility
Though most SSDI recipients have to wait 24 months after their disability benefits begin before they're eligible for Medicare coverage, there are some rare exceptions to this rule. For example, if you're suffering from end-stage renal disease (permanent kidney failure treated with dialysis or a transplant) or are receiving SSDI benefits for Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease, the two-year waiting period will be waved so you're eligible for Medicare coverage much sooner.
Medicare Coverage and Returning to Work
Just because you go back to work doesn't mean you'll lose your Medicare coverage. As long as you have a disabling impairment, you can continue to receive hospital and medical insurance coverage for at least 93 months. During this time, you can receive hospital insurance without paying a premium. If you're still disabled after the 93-month period ends, you can buy Medicare hospital and insurance coverage.
Confused About SSDI Benefits and Medicare Eligibility and Coverage? Let Us Help!
Navigating life while dealing with a disabling injury or illness is challenging enough without trying to wade through administrative red tape without assistance. Fortunately, you don't have to go it alone. At O'Connor Law PLLC, our accomplished Social Security disability attorneys can help you understand your rights, benefits, and coverage options. Contact us today to schedule an appointment for a free initial consultation.