Disability and Medicare- how does it work

You may have heard that it takes two whole years after you get Social Security Disability to receive Medicare coverage, and, to some degree, this is a true statement.

However, there are other things to consider when discussing the two-year wait for Medicare coverage. For instance, your date of entitlement (the true point at which you actually become entitled to receive Social Security Disability) may be several months or even years in the past. This can easily be the case if you claimed on your disability application that you become disabled years ago.

What does this mean as far as your entitlement to Medicare? It may mean that you will be entitled to Medicare as soon as you receive your Social Security Disability approval, instead of having to wait two years.

Here's another reason why a person who has been approved for disability may not have to wait for their medicare coverage to begin. Many individuals who receive their disability allowance from an administrative law judge at a hearing have already been waiting for disability two years or more.

Consequently, when they get approved by a judge, the twenty four month Medicare wait period has already passed and they are entitled to Medicare.

There are two major entitlements involved with Medicare, Part A and Part B. More recently, Medicare Part C and Part D have been added.

Medicare Part A is free coverage that covers some of the expense of hospitalizations. Part B covers some of the expense of doctors' visits and various types of testing. Part C and D involve prescription and Medigap coverage (health insurance companies offer policies to help pay the twenty percent gap in coverage left by Medicare) and are provided at a cost to qualified Social Security beneficiaries.

Note: Social Security will deduct all Medicare premiums from your monthly Social Security Disability benefit.

Although Parts B, C, and D have a premium, some disabled individuals will qualify for a subsidy to help offset the cost of the premiums of Parts C and D. Of course, to qualify for the subsidy, you must meet the income and resource requirements of the Medicare subsidy program. Some individuals may also qualify for help with paying Medicare Part B premiums, through their local Department of Social Services.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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