Medicare for the Disabled

Medicare offers benefits for individuals under 65 years of age who have become disabled. If you have been receiving disability benefits from Social Security for more than two years (24 months), you are eligible to enroll in Medicare Part A and Medicare Part B.

How do I enroll?

Individuals who are eligible for Medicare due to having been on disability for 24 months are automatically enrolled in Medicare Parts A and B on the first day of the 25th month.

The Social Security office will send a package containing your Medicare card, as well as some information on how Medicare works. (If you have been receiving disability annuity checks from the railroad, your package will come from the Railroad Retirement Board.)

What does it cost?

Medicare Part A will require no monthly premium from you if you have met the requirements set by the federal government. If you have worked for 10 years or 40 quarters, you have paid enough in Medicare taxes that Part A is “free.”

However, Part B does come with a monthly premium. In 2021, that monthly premium is $148.50. Since those receiving Medicare benefits are enrolled automatically, this premium will be deducted from your monthly Social Security check (or railroad disability check). This will begin on your first month of Medicare coverage.

You may choose to not enroll in Part B. However, you will want to make sure that you have other insurance in place if you turn down this option. If you do not enroll and do not have creditable coverage elsewhere, you will incur a penalty that will apply to future coverage. This penalty is added to your monthly premium and is never removed.

If you are disabled, it is likely you do not have other insurance coverage. However, if you are married, you may be enrolled on your spouse’s plan. If your spouse’s group health plan is creditable, not enrolling in Medicare Part B may be an option to consider. 

Your spouse should speak to his or her HR department to find out if their coverage is creditable.

On the other hand, if you can afford the monthly premium for Part B and you are also enrolled on your spouse’s insurance, Part B will become your secondary insurance and you will have more benefits than you would with just one insurance policy.

What benefits are offered?

Medicare benefits are the same for everyone enrolled.

Part A

Part A is considered hospital insurance. It helps pay for things like inpatient hospital stays, skilled nursing facilities, hospice, and home health care.

Part B

Part B is considered medical insurance. You’ll use Part B coverage for things like doctor’s visits, outpatient care, durable medical equipment, and many preventive services.

What happens if I am no longer disabled?

If you are able to return to work and no longer meet the eligibility requirements to receive Social Security Disability Insurance (SSDI), you may stay enrolled in Medicare for up to 8.5 years (102 months). 

A disability is life-changing. It can cause hardship and pain. While Medicare is not always easy to understand, it is important to take the time to research your benefits or seek help from an insurance agent. Make sure you know your options to help make a hard time a little less difficult.

As always, John is here to help answer all of your Medicare and insurance questions! Call  801-637-4420 today.