Wondering how Social Security Disability Insurance and Medicare benefits might go together?
You’re not alone. Figuring out the healthcare part of your life on top of an already complicated SSDI claim gets confusing. But don’t worry! We’re here to help clear up some of your most pressing Medicare + SSDI questions.
Do All SSDI Recipients Also Get Medicare?
We get this question a lot from readers and the answer is a qualified yes. SSDI recipients can receive Medicare benefits, but they must wait for it. Everyone eligible for SSDI benefits, regardless of their age, may qualify for Medicare but only after a 24-month waiting period.
Why is this? Well, during the two-year qualifying period, many SSDI applicants are still able to get insurance through their former employer. Whether it’s COBRA or some other program, that coverage should be utilized by an SSDI recipient to bridge the gap.
Those without any coverage may wish to check into insurance options available through the Affordable Care Act. They may qualify for subsidies to help make health insurance more affordable until they are eligible to receive Medicare.
Is This Coverage Free for People on SSDI?
The answer here is yes and no. There are two parts to regular Medicare: Part A (hospital insurance) and Part B (medical insurance).
Most people do not have to pay anything for Part A. However, the majority of Medicare recipients pay a monthly premium for Part B.
While SSDI makes you eligible for coverage earlier than you would be otherwise (i.e. at age 65), it doesn’t pay your monthly premiums. If you’re receiving SSDI and then qualify for Medicare, your premium will likely be deducted from your monthly SSDI payment.
However, individuals who receive SSDI may also be eligible for state help paying their premiums through Medicare Savings Programs. It pays to check with your local social services office to see if you are entitled to these additional benefits.
Can My Spouse and Dependents Also Get Medicare Coverage?
Unfortunately, the answer here is no. Medicare is an individual healthcare policy, not a family insurance plan. Just because you qualify doesn’t mean it extends to spouses or children/dependents. This is different than other types of health insurance. Even if both parents qualify for Medicare, this does not mean their children will qualify.
We also had a reader ask if they could inherit their parents’ Medicare after they had passed away. Again, the answer is no. Medicare is non-transferrable and each person who qualifies must do so individually.
That said, a child may qualify for Medicare if their kidneys no longer function, or they undergo a kidney transplant. By law, anyone under age 20 with end-stage renal disease (ESRD) may become eligible for Medicare on their own.
If you need coverage for your family while you’re on Medicare, it would be smart to contact your State Healthcare Insurance Assistance Program (SHIP) to discuss your options.
Do I Lose My Medicare Benefits If I Go Back to Work?
No, you will not lose your healthcare benefits as soon as you return to work. However, that is contingent upon you still having a disabling condition that meets the rules set forth by the Social Security Administration.
If you meet those conditions, you may keep your Medicare for 8 ½ years (93 months plus the 9-month trial work period). This means that after returning to any substantial gainful activity, you have the reassurance of keeping health insurance while you readjust.
If you lose your monetary SSDI benefit payments, premiums will no longer automatically deduct from your monthly check. Accordingly, you will then start receiving a bill every three months for your Medicare insurance premiums. The Part A (hospital insurance) premiums will remain free, but there are still fees associated with Part B (medical insurance).
Do I Need an Attorney?
Qualifying for SSDI to begin with is complicated. While you don’t necessarily need an attorney just to get Medicare, speaking with a disability lawyer can help demystify the entire SSDI + Medicare application process.
A qualified disability attorney can also help you determine important dates, such as when your 24-month qualifying period actually begins. That way you’ll know when you become eligible for Medicare in addition to any other SSDI benefits you’re receiving.
Bottom line, it never hurts to have someone with knowledge of the SSDI process in your corner.
Ready to see if you may qualify? Complete your free online SSD benefits evaluation now!
Kimberly Dawn Neumann
Kimberly Dawn Neumann is a multi-published NYC-based magazine and book writer whose work has appeared in a wide variety of publications ranging from Forbes to Cosmopolitan. She graduated summa cum laude from the University of Maryland, College of Journalism. For more, visit: www.KDNeumann.com, Instagram @dancerscribe, and Twitter @KimberlyNeumann