I am very close to being approved for SSDI. I was talking to a social worker and she said be sure to come in and apply for Medicare! I would like the scoop in layman terms. How good is the coverage, how long until it goes into effect, what about prescriptions, would they consider my home, car, furnishings assets? I would be very grateful to any of you that have been through this process. Thank you - RoxyI am not sure but I think Medicare is not based on any assets you may have. That is good news Roxy! I no nothing about Medicare accept that it goes into effect 1 yr after SSDI starts.
The kind of medicare you get with Social Security is higher quality than what you get through state assistance. You will get something similar to what someone that is older and on Social Security. What you end up doing is buying one of the Supplemental plans. My ex-boyfriend has this and gets very good care. He also can get medical care from one state to another. Check out AARP's web site. I believe they cover information on this. I know they sell the supplemental plans but have no idea the quality of them. Almost all the pharmacies also have info available about these plans.
However, I think you have to be on Social Security for 2 years to get their Medicare. But that is from the time you apply. The quality of care from state assistance varies widely per state. For information on those plans, for instance if Brett loses his insurance and you have to go this route, ask everyone you know about their experiences with the different plan options. Since your new to the area, you could ask all your family members to ask around.
Also, if you must go on a state assistance program or when choosing a different insurer, always check their formularies. For example, some do not cover Remicade or Humaria. Also, look at which primaries and rheumys they have on the plan.
As far as prescriptions, I pay nothing on the state plan and only occassionally a dollar copay to some doctors and not others. All films, blood work, surgeries, ER visits are covered. The downside has been the quality of the doctors and the fact that the insurance is an HMO which operates in very strict confines. However, there are several HMO plans that compete against each other. Believe it or not, Julie was on two worse plans than I am on now.
I'm so glad you are getting closer. That's very good news.
Medicare will be a huge help to you IF your doctors will accept what Medicare pays and not go after you for the remainder. Some do, some don't. I am lucky that, living in a very rural area, they do settle for that and I only have to pay the 20%. Be aware that Medicare kicks in 2 years from the time that you are approved for SSDI---you don't get it immediately. It is not means tested and they do not take into account anything you own or what you have in the bank or stock market. You paid into it all of your working life and you will get an SSDI check for the same amount that you would have if you retired at age 62. Once you become 62, you will no longer be considered disabled, simply retired , and the SSDI check becomes a SS check. What you paid in will determine what you receive every month. I get about 00 but I believe the national average is 0.
You can still hold a job as long as it doesn't bring in more than 0 per month. If you make more than that, they figure you aren't all that disabled.
In conclusion, Medicare will pay for all your RA related blood work, doctors appointments, trips to the hospital and ER. Part D Medicare will help a lot with your drugs, how well depends on what plan you pick.
Mazel Tov---you sound like you could use the help.
Roxy, Check on the Social Security website.
I just went to a meeting on Secure Horizons yesterday. Medicare for those of us on Soc. Sec. Disability is exactly what it is for retirees on Social Security. It goes into effect 2 years from the date that Social Security determines was your date of disability. This is the not the date they say "okay you're approved", it is the date they determine you were originally disabled. Like if they go back and pay you for a year's back disability, that date is where you start counting for your two years until Medicare kicks in.
As I understand it, you don't have a choice. You automatically get put on Medicare at the two year point. I'm really excited about it, because right now I am paying 1526.00 per Month for insurance for my husband and myself! That's because we had our own business, and had to buy private insurance. We've paid high amounts like that for 12 years, just to have insurance.
The Medicare, Part A is provided for what we have already paid in, if I understand it correctly. If you want part B, which all of us really must have, I think they deduct a small amount from our Soc. Sec. Disability check for that. You have to sign up for all of this a few months before you are due to start getting it, just call Social Security and ask them.
I think all of us would benefit greatly by getting a secondary or Secure Horizons or a new one called Scan or there are many others. They cover so much more than just plain Medicare and for some plans there is no premium! They just take over your medicare, and that's how they're paid.
Now all of this is what I found out yesterday. I am due to go on Medicare in May, so I will be calling Social Security next week to ask about all this and verify it for myself. Then I'm going to check into the different secondary plans. I know that the kind of care, Rx's, if you will need hospitalizations, etc, make a difference in what plan you choose, so it helps to do your homework and really check out the different plans.
I'll try to let you all know what I find out. I do know it is VERY confusing!
Good Luck, Sweetie. My thoughts and prayers are with you.
Also, Deanna, I am still praying for you, too. Don't get discouraged if they say you have to have a hearing. If nothing else, I know you'll get approved there, I am sure.
Hugs and Blessings to all,
Nini
Roxy, congratulations. I know this has been terribly hard on you, but considering where you were a year ago, you have come a long, long, long way. Once you get all of this bureaucratic garbage out of the way, you can work on getting yourself a life again.
I work in a medical office and insurance's can be very confusing. The best advice is to go to Medicare's website, read it over, print it out, read it over again and again. Usually the answers are there.
roxy in ohio medicare starts 2 years after u become disabled,they also knock the first 5 months from the date u became disabled . me they said i became disabled in nov 27 2004 so after the 5 months i will get medicare this may now. they sent me my medicare card today and date said may 2007 on it.hope this helps u out.Medicare is what you get when you turn 65. It will kick in 1 to 2 years afterThe Medicare you get with disability is the same that you would get if you retired at the appropriate age. You are eligible for it once you have been considered disabled for 24 months. If you are approved for SSD the 24 month waiting period starts the month you became eligible for disability. Most people couple supplement their Medicare with another health ins policy. Medicare by itself doesn't pay a lot. If you don't have another ins policy you more than likely will have copays. All I keep hearing about Part D is about the donut hole people get stuck in. Found this on a website. It explains how the Part D works.
Premiums, Deductibles, and Co-Payments
Q: Is there a premium for new drug coverage?
A: In 2006, a monthly premium (0 for the year) will be charged.
Q: Will there be a deductible?
A: Yes, people will be required to pay the first 0 for drugs in 2006.
Q: What will the Medicare Part D insurance cover?
A: Medicare Part D will pay three-fourths of drug costs from 1 to 50.
Q: What happens when costs reach 50?
A: You will have to pay 100% of costs in the "doughnut hole" between 50 and 00. This will represent a total of ,600 for out-of-pocket costs (The Medicare Part D /month premium, 0, is not included in these costs.)
Q: What happens when I've paid total out-of-pocket costs totaling ,600.
A: Medicare Part D will again provide coverage. This 'catastrophic drug coverage' will pay 95% of all prescription drug costs.
I was looking around yesterday, for a site that would answer all my questions about Medicare and I came across www.Medicare.gov . It is a wonderful site and has , what looks like, answers to any question you can think of regarding Medicare.
On the left side of the first page , click on Plan Choices and you can find out about all the plans that you can choose, beyond just plain Medicare.
I was so excited to find this site. It will make things so much easier for me, as I need to sign up within the next few months for SSDI Medicare.
Hope it helps.
Nini
Hi again... I was just reading the site I mentioned. It says if you are disabled, you don't have to do anything to sign up. It is automatic.
If you are receiving SSDI, they will send you a card 3 months before you are entitled to benefits, which is the 25th month after your date of disability.
Great web site!!!
Nini
Medicare is automatic after the 24 month waiting period. Most of the time, for those of us who have applied for SSD, when it is approved are already Medicare eligible. That's because it has taken us longer than the 24 month Medicare waiting period to be approved by Social Security for SSD. I got my Medicare card about a week before I got my award check.