Social Security Disability And Medicare

Jul 10, 2011 Comments Off on Social Security Disability And Medicare by

We often hear from our clients that receiving Medicare or Medicaid is just as important to them as receiving cash disability benefits from Social Security. The only problem is that our clients can’t seem to tell the difference between Medicare and Medicaid. They sound so similar but they are different. Let’s start out today talking about Medicare. Look at tomorrow’s post for information on Medicaid.

Medicare is not a needs-based program. You don’t have to be poor to get it. You do have to pay one or more premiums to receive all the benefits of Medicare.

Medicare goes to those who have been on a Title II Social Security disability benefit for two years. Title II Social Security benefits are those based upon someone’s record of paying into the Social Security trust funds. There are three main types of Title II Social Security disability benefits:

  • Disability Insurance Benefits — the claimant must have worked for a significant length of time under Social Security.
  • Disability Widows and Widowers Benefits — the claimant must be the widow or widower of someone who worked a significant length of time under Social Security and be 50 or older and become disabled within a set length of time after their husband or wife died.
  • Disability Adult Child Benefits — the claimant must be the child of someone who is drawing Social Security benefits based upon their own earnings record or the child of a deceased parent who had earned enough to have qualified for benefits before dying. Also, the child must have become disabled before age 22.

Note that I said that there is a 24 month waiting period after cash disability benefits begin before a person becomes eligible for Medicare. That 24 month waiting period is on top of the 5 months waiting period for cash benefits. This means the waiting period is almost two and a half years! That’s brutal! Why so long? Because it saves money.  No other reason. I should say that there are exceptions to the long waiting period for those who need to get into kidney dialysis or who have amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig’s disease.

Medicare has three main parts.

  • Part A, which pays for inpatient medical care and kidney dialysis.
  • Part B, which pays for outpatient medical care.
  • The prescription drug benefit which helps pay for prescription medications.

You do not have to pay for Part A. For Part B there is a premium to be paid, currently $115.40 per month for most people. If you qualify for Part B, you will automatically be put on Part B. You can decline it but should not do so lightly. Having other insurance is not a good idea to decline Part B because your other insurance will almost certainly convert into a Medicare Supplement policy once your Medicare entitlement begins — and yes, they will know when you’re eligible for Medicare.

The premium for the prescription drug benefit depends upon which plan you choose. You can go online to see what is available in your area. Your pharmacy may also be able to help you choose the best plan for you. You will not be automatically enrolled in the Prescription Drug Benefit. You have to do that yourself.

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About the author

Charles Hall is the lead attorney for the Charles Hall Law Firm in Raleigh, NC. He has been practicing in the Social Security Disability law field since 1979, is published, and is ready to help new clients win their benefits in North Carolina.