Many questions arise regarding Medicare, let alone when you are under 65 and disabled. The steps of the things he needs to do or the things he knows are not as clear as he would like them to be. If he doesn’t log everything within a window the government provides, he could be penalized. The sanction will cost him more money than he expected. Someone who qualifies for SS disability income has a two-year waiting period before becoming eligible for Medicare A and B. This could be a long wait if you need insurance.
If you were in paid employment, you would be offered coverage through your job. If you were to take a leave of absence as a result of your qualifying disability, COBRA would be provided to you to extend the coverage you had from your previous employer. The COBRA option could allow you to pay for health insurance for up to 18 months, and in some cases, you can get 24 or 36 months, depending on the situation. That will give you some time to transition to Medicare for disability.
If you don’t meet premiums due to COBRA cash flow, you may be able to qualify for Medicaid. Medicaid is a health program available through the state. They have their own set of requirements to qualify. Check your state’s guidelines for applying. Then your medical care will be a nominal cost to you, paid for by the state.
Once you’ve met your two-year disability waiting period to be eligible for Medicare coverage, you have a window to do other things to comply. The government requires you to have Part D coverage; D is for drugs. Original Medicare does not provide this, except for drugs for hospital patients. They give you a window of about three to four months to buy Part D. This is usually the month Part B (provided by Original Medicare) starts and then 90 days after that month. If you don’t enroll in Part D, or its equivalent, during this time period, you will be penalized when you finally enroll. Medicare requires this to allow more people to pay to control the cost for everyone.
If your state requires insurers to offer Medicare supplement insurance for people with disabilities under age 65, then you can apply without the need to sign up during the same time period. You will notice that the premium is much higher for those under 65 than if she were 65 or older. Part of this is that she’s on Medicare early because she’s disabled, which means she’s more likely to have more claims. Either way, she has the opportunity to apply for a plan that she has to sign up for and take advantage of the lower rates without being screened for health condition. However, in some states, such as Indiana, insurance companies are not required to participate in the under-65 disability market.
If you continue to work and are able to maintain insurance through the workplace, becoming eligible for Medicare A and B doesn’t change anything. You can keep that coverage if you want. You will need to provide proof of qualifying coverage at that time, or when you apply for Part D or qualifying coverage in the future if you ever lose that health care coverage. Keep any supporting documents as needed.
Some programs combine Medicare Supplements and Part D into one program called Part C or Medicare Advantage. There are advantages and disadvantages to these. You need to do your homework before jumping into the program. Many can be restrictive and possibly more out of pocket expenses for the year. However, it can be a good option and save you money.
The transition to Medicare A and B and all the other elements attached to it can be confusing, but in the end it can be clear. Taking the right steps and getting the right help can make all the difference in the world and save you time and money.