If you are receiving SSDI payments, can you still get Medicare benefits?
The answer is yes. However, there is a waiting period involved that may
hinder your ability to obtain Medicare payments right away.
You must wait 2 years (24 months) to receive Medicare after becoming entitled
to SSDI benefits.
In reality, you may have to wait up to 30 months to start receiving Medicare
payments from the month you become eligible for SSDI. This is because
there is a 5-month waiting period to begin receiving SSDI payments from
the time you initially apply. For example, if you are injured and apply
for SSDI benefits in January of 2015, you may become entitled for SSDI
sometime around May of 2015, and will then become eligible for Medicare
in May of 2017. The bottom line is that you will most likely have to wait
between 24 and 30 months from the date you apply and become entitled to
SSDI to get Medicare coverage.
The ALS Exception
For patients who suffer from Amyotrophic Lateral Sclerosis (ALS), also
known as Lou Gehrig’s disease, there is no waiting period to receive
Medicare benefits. This means, if you have ALS, you can start receiving
Medicare coverage in the same month you become entitled for SSDI benefits.
Typically, you will have to wait 4 weeks until you receive your Medicare
card in the mail, but you will not have to wait for the full 2 years that
is required for other SSDI and Medicare recipients.
Understanding Medicare Coverage
There are 4 parts of Medicare coverage. Part A covers general hospital
bills, hospice care, home health care, skilled nursing facility (SNF)
care, and inpatient medical expenses. Typically, SSDI benefit recipients
do not have to pay for Part A Medicare coverage. Part B covers doctor’s
visits, medical supplies, outpatient care, and medical/surgical supplies
and services not covered in Part A. Part B also covers certain preventative
health care services, therapies, mental health services, and diagnostic
testing. It is important to note that you may opt out of Part B if you
are covered under a private insurer or under a family member’s work
Part C coverage includes Medicare Advantage (MA) Plans. Medicare-approved
private insurers, including HMOs and PPOs, provide coverage for Part C.
You may have to use hospitals and doctors in your plan, and you can typically
receive all the Medicare-covered services of Part A and B through this
coverage. Depending on the situation, you may also combine Part D under
Part D is known as Medicare Prescription Drug Coverage. It helps pay for
outpatient drug treatments. Part D is available to everyone with Medicare,
and you must enroll in a Medicare-approved plan to receive coverage. Furthermore,
extra help is offered to those with chronic medical conditions who need
extensive, long-term medication and drug treatment.
If you are receiving SSDI benefits, you are still able to receive all parts
of Medicare. This can provide much needed financial assistance to help
with the medical costs of your disability. It is important to keep the
waiting period in mind when applying for SSDI payments, and to understand
your options for receiving coverage under Medicare programs.
Knowledgeable Assistance for Social Security Issues in Detroit
Goodman Acker P.C. has guided hundreds of clients through various Social
Security legal issues. Whatever your situation, we can talk with you and
help determine effective legal strategies as you pursue a beneficial outcome.
We know you are going through a stressful time. That is why we strive
to handle the complex issues so you can focus on healing.
Contact us today to discuss your situation with our experienced Detroit Social Security
attorneys. We provide free consultations to all prospective clients.