Facing Disability? Medicare Benefits Can Help

Facing Disability? Medicare Benefits Can Help

Most people assume that they will need Medicare benefits at retirement, and do not consider the possibility that they may need it earlier due to disability. It may be surprising, but “studies show that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching retirement age.”1 If you are in the position of having to consider disability benefits, you may have many concerns regarding your health care coverage.  Thankfully, Medicare health care coverage is available to disabled individuals under the age of 65.

A great deal of attention goes to Medicare beneficiaries who are over the age of 65, but many Americans receive Medicare benefits under 65 due to a disability. If you are disabled, you automatically get Medicare Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the Railroad Retirement Board for 24 months.  If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you will automatically get Part A and Part B the month your disability benefits begin.

If you do not qualify for premium-free Part A, you may be able to buy it if you meet certain conditions.  If you are under 65, disabled, and your premium-free Part A coverage ended because you returned to work, you may be eligible to purchase Part A. Keep in mind that if you are under 65 and disabled, you can continue to get premium-free Part A for up to 8 1/2 years after you return to work.

There are situations in which you may have other insurance, as well, and may be confused by the coordination on benefits. If you are under 65 and disabled, but have group health plan coverage based on your or a family member’s current employment, and the employer has 100 or more employees, your group health plan pays first. If you are under 65 and disabled and have group health plan coverage based on your or a family member’s current employment, and the employer has less than 100 employees, Medicare pays first.  If you have End-Stage Renal Disease (ESRD), and are covered by group health insurance, your group health plan will pay first for the first 30 months after you become eligible to enroll in Medicare. Medicare will pay first after this 30-month period.

There are many options available to you as a Medicare beneficiary due to disability, and you should find the plan that best fits your needs. Comparing the options available can help you narrow your choices and find the health care coverage that is right for you.

1www.ssa.gov/dibplan/index.htm