So once you are on disibility, is your insurance the same as if you were on medicare or is it more like Access or medicade? I am not sure if I am making sense LOL, but just what type of medical care do you get on disibility????

Hi

24 months after your official onset date, you are entitled to Medicare. Until then, you are on your own.

My official onset date is October, 2006, so I will be eligible for Medicare in November 2008. I am not sure if we MUST take it??? I have a good private plan now and want to stay on that until 65.

good questions Georgio.. my husband just asked me about my insurance coverage tonight. I am now able to get insurance because of my disability through SS. I feel terrible ... I have done nothing about it yet and I know so many people are eagerly awaiting their coverage. The problem is : I DON'T UNDERSTAND IT !! I do have insurance through my hubbies work. However as of the last couple years we have high co-payments and percentages of my testing at the hospitals, and very poor perscription coverage. I am just so confused as to how to get my Medicare started ( they send me info saying I am able to start it now)and am very confused as to the different levels they make you choose from and their monthly charges. I also dont' know how to use two insurances at once I always just had one which is my husband's from work. Is the coverage worth it if you don't pay for the different levels ?? I am sorry if this seems like I am jumping in on your post but your concerns and my questions seem very similiar. if any one has any experience with Medicare insurance please inform us ... thanks and take -care, :angel:

I'm here for you guys...I understand it fairly well....Ask away, if needed. As some of you know, I'm an ex university faculty member so this is one way I can still help people or teach. Unfortunately, my disability caught up to me and I was forced into early retirement or whatever you want to call it....I receive disability....Both through my work plan and SS.

Georgi....Reach is correct in that you are eligible 24 months after your disability onset date...NOT your award. Thus, when your disability is backdated, so is your medicare qualification. Anyone applying for SSD has an "onset" date. This is the date everything kicks in.

Reach....You don't have to accept it if you don't want it. However, it can also serve as a "back up" or "secondary" insurance. I'd recommend getting it. When you have secondary insurance, you usually don't have any medical co-pays...Your primary picks up the co-pay and anything left gets billed to medicare. You could always sign up for one of the basic plans that doesn't cost much.

If you decline medicare, you can get it later during "open enrollment" which is each Fall....Like most insurance policies.

Queenee....As far as the different plans....There are TONS! This is what makes it so confusing, IMO. To make matters worse, each region or part of the country has different approved plans & etc. Thus, if you live in one part of the country, and a friend or family member lives in another part, you may not be able to get the same plan.

When you are eligible to enroll, you log on to their site and type in all your information and a list of plans pop up that you are eligible for...There may be 20+. They are sorted from least expensive to most expensive. You can compare / contrast any of them. Some have higher monthly premiums and lower drug co-pays, while others have lower monthly premiums and higher co-pays. Some have the infamous "donut hole" while others do not. You will pick a plan that is best for your particular situation. This process will also tell you which of your meds are covered and how much they will cost. Some don't cover many of the expensive drugs, while others will.

You can always get help via your local resource center...Your county or town / city gov't also typically offers help. I would use this resource.

Hope this helps.

Ex

wow Executor you are a very fast typer!! I no sooner logged out and when I went to my e-mail you already had a reply !! I have many times took your advice on this forum so thank you in advance. now I am still wondering if you could answer these questions:
am I automatically enrolled or do I have to fill out forms? ( sorry I didn't even open up the mail from medicare I wasn't ready to study it at the time)

since I do have my hubbies coverage would it be worth it to enroll even if I choose not to have the benefits that I would have to make a payment on ??

and lastly I promise (LOL)....how does one use two insurances....for instance would I show both cards at the hospital and or doctor's office.. does one over ride the other ??

sorry if If these questions sound simple to you .... I really am educated except when it comes to insurance and TAXES ....Thanks again , take-care, :angel:

my eyes are crossing so I am going to bed. I imagine your response will come VERY QUICKLY, but I will have to check it in the morning... lol..nite

now I am still wondering if you could answer these questions:

am I automatically enrolled or do I have to fill out forms? ( sorry I didn't even open up the mail from medicare I wasn't ready to study it at the time)

You automatically qualify...You have to enroll by telling them which plan you want....It's really simple, actually.

since I do have my hubbies coverage would it be worth it to enroll even if I choose not to have the benefits that I would have to make a payment on ??

That just depends. I don't know anything about your other plan, or what coverage you have & etc. It just depends on how often you go to the Doc, get meds, & etc. I suppose if you have a great plan through him, you may not need it. I would call SS and talk to them. The simple 800 number will direct you through prompts to a specialist for medicare....I'd talk to them just to make sure.

and lastly I promise (LOL)....how does one use two insurances....for instance would I show both cards at the hospital and or doctor's office.. does one over ride the other ??

When you sign up, you tell Medicare (either over the phone or on line when you do it) that you are covered by other insurance. This automatically makes your Medicare "secondary." When you go to your Doc, yes, you give both cards. This will then let you have no co-pay. Also, when you have procedures done, tests, or whatever, same deal...No co-pay....Or a very little one.

sorry if If these questions sound simple to you .... I really am educated except when it comes to insurance and TAXES ....Thanks again

No problem....It can be overwhelming, and it's not set up to be easy to understand, that's for sure.

Regards,

Ex

Whoa!!!
You mean to tell me that I wont have health care for 2 years after I am accepted on disibility??????????????????? And the "on set date" is the date you are accepted or the date you could no longer work. This whole thing is freaking me out.
Thanks Executor for the info.
georgi

Yes, that is the way it works. Before I became eliglible for Medicare, my family had an individual health plan and my premium alone was horrendous ($800+ per month just for me because of my medical condition). I had to maintain that for almost two years until I was eligible for Medicare. I ended up going with a Medicare Advantage plan through Anthem Blue Cross/Blue Shield. Anthem accepts the standard Medicare monthly premium and I have a separate Part D (prescriptions) which costs me another $44 per month. While I have out-of-pocket costs associated with this, the way we figured it, I was still coming out ahead by NOT paying $800+ per month in insurance premiums.

This is all horribly confusing and I can't say that I didn't make an error or two through all of this. For example, had I decided to pursue a powerchair on my old insurance, my total out of pocket expenses would have actually been less than they were on the Medicare Advantage plan I'm on. And I also realized afterwards that while my overall coverage is better than straight Medicare, durable medical equipment was only covered at 70%, whereas straight Medicare would have covered 80%.

I think it stinks that they make you wait two years, but I guess there is some logical reason for the waiting period, although for the life of me I can't figure it out.

Hi All

Just an FYI:

I am going through some turmoil right now because of insurance coverage. I am too tired to explain it all now, but in researching, it seems we can decline medicare when we come to the pouint of eligibility if we choose to stay on another plan. However, there is a catch to it... if we decline to accept Medicare when first eligible and then later decide to take it, there is a 10% hike in the cost for every 12 month period for which we declined when eligible.

I have a great plan for free now as a retirement benefit. My dilema is that if I decline Medicare when I become eligible in 6 more months and instead wait until I am 65 in 7 years, I will pay a 70% hike for the premium! I sure don't want to do that, but neither do I want to give up a great, free health plan. I am just weighing out the pros and cons now.

For all those who think we on SSD have it "made" in life, they sure don't understand what difficulties there can be.

Sigh
reach

I am going through signing up for Medicare, Part B right now. I declined it two years ago, because I was on my wife's insurance at her work. The way it works, if your insurance you are on at the time is as good or better than Part B, you don't pay a penalty of 10% a year. All you need to do is either call SSA or do it on-line and tell them you want to sign up for Part B. I have had Part A for two years now, which is free.

They will send you a simple form to fill out and in my case, another one that my wife's employer (HR Dept.) has to fill out. This will show Social Security you have been insured since you were eligible for Medicare and there won't be a penalty assessed.

My wife retires on September 1st, so I am going through this process now, so I will have everything in place when she retires. I will be getting a secondary insurance through her employer, which will cost $66 a month, but covers prescriptions.

I hope this helps everyone understand all this Medicare stuff better.

Hi

Director is so correct about the 10% penalty deal! I continued researching today and discovered that it is okay as long as you have other equal or better coverage.

I never even thought to call Social Security and ask.... duh! I spent hours researching instead of going to the source. Lesson learned. Chuckles.

I have spent hours on the phone with retirment personnel concerning insurance and they just can not accept that being on Social Security Disability does NOT mean immediate enrollment into Medicare. This is really impacting me as I get full paid medical insurance benefits in retirement. These ding-dongs are trying to cut me off as of July 1st. I am sure it will get resolved, but like many processes with powers to be, it can get long and complicated. Oy.

Take care all
reach

Whoa!!!
You mean to tell me that I wont have health care for 2 years after I am accepted on disibility??????????????????? And the "on set date" is the date you are accepted or the date you could no longer work. This whole thing is freaking me out.
Thanks Executor for the info.


Yes, you must wait. However, you have to remember that it is back dated just like our overall disability and back pay. So, if you have to wait two years for approval, you then get everything backdated, including the Medicare. So, the clock is ticking from your "onset date"....This is on your application.

Regards,

Ex