A person with a debilitating health condition that hinder one’s ability to work, diving into the complex world of government assistance programs can be intense and complicated, and you might need some help. There are two systems that offer substantial support to individuals in need: the Social Security Disability Benefits (SSDI) and the Medicare.
Both SSDI and Medicare programs are federal-run, and they’re intended to tackle the financial problems of those individuals who are unable to work due to a severe disability. If you want to apply and qualify for one of these programs, you must meet certain requirements. But, could you request and get approved for both?
Could I get SSDI and Medicare benefits at the same time?
The amount of SSDI benefits one receives is based on their average lifetime earnings before becoming disabled. These benefits provide a stable income to cover daily expenses and ensure a basic standard of living despite the challenges posed by disability. Medicare offers healthcare coverage to Americans aged 65 and older or individuals under 65 with certain disabilities. The Medicare is divided into parts A, B, C, and D, anyone with different coverages and benefits.
If you are still asking if SSDI and Medicare could be approved to the same person, at the same time, the answer is yes, but let’s explain better. is an essential aspect of the comprehensive support system for disabled individuals. Generally, individuals who receive the SSDI become eligible for Medicare after a waiting period. This waiting period typically lasts 24 months from the date of entitlement to SSDI benefits.
During this waiting period, beneficiaries can maintain their healthcare coverage through other means, such as employer-sponsored insurance, COBRA, or Medicaid, if eligible. Once the waiting period concludes, they automatically become eligible for Medicare, ensuring uninterrupted access to vital healthcare services.
How the Medicare complements the SSDI assistance, for a better quality of life. It assists in covering doctor visits, hospital stays, prescription medications, and various medical procedures, thereby relieving the financial burden associated with healthcare expenses.
Understanding Medicare: Who’s eligible, what are the requirements and more
As you should know by now, Medicare is a federal-run program that aims to cover medical expenses for qualifying individuals in certain circumstances. Medicare consists of four primary parts: Part A, Part B, Part C, and Part D, and you should know which one you qualify for.
Medicare Part A, also known as Hospital Insurance, covers inpatient hospital stays, skilled nursing facility care, hospice care, and limited home healthcare services. Most individuals do not have to pay a premium for Part A coverage, often referred to as “premium-free Part A.” However, if you do not qualify for premium-free Part A, you have the option to purchase it for an affordable price. If you don’t qualify for the free plan, the costs vary from $278 or $506 each month.
The Part B covers doctor visits, outpatient care, preventive services, and medical supplies and, unlike Part A, it has a monthly premium payment. Medicare deducts the premium automatically from Social Security or other benefit payments. If you do not receive these payments, you will receive a bill for your Part B premium.
The Part C is popularly known as Medicare Advantage Plans, offers an alternative way to receive Medicare benefits. These plans are offered by private insurance companies approved by Medicare. Medicare Advantage Plans provide all the benefits of Part A and Part B, and often include additional coverage such as prescription drugs, vision, dental, and hearing services. The monthly premiums for Part C plans can vary based on the specific plan you choose.
The last is the Part D, which is known as Hospital Insurance. It covers healthcare services received as an inpatient, and you should know what does it cover in your state or city you’re living in, because the costs are different for every person depending on their health situation.
Take a look at all the costs, deductibles, and values in the official Medicare website.
Waiting for the Medicare: What to do in the meantime
There are potential solutions available to navigate the often challenging 24-month waiting period for Medicaid coverage. According to Healthcare.gov, individuals receiving SSDI payments and undergoing this waiting period may still be eligible for Medicaid coverage by following these steps:
- Establish or log into a Medicaid account to initiate the application process. When prompted about having a disability, kindly respond with a “yes.” Your application will then be forwarded to your state Medicaid agency for further review.
- Alternatively, you can directly apply to your state Medicaid agency. On the Medicaid page, you can conveniently select your state from the menu, providing you with the necessary contact information to proceed with your application.
Medicare vrs. Medigap: What is the difference?
Medigap, also known as Medicare Supplement Insurance, is part of the American healthcare system. It’s designed to fill the gaps in coverage left by the original Medicare program, providing individuals with additional financial protection and peace of mind.
In the Medigap program, there are several standardized options available, labeled with letters from A to N. Yes, that’s a lot of options, and we’ll try to simplify the thing for you. For example, the Medicare Part A (A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up) is covered by all the plans, from A to A. Now, in the Parte B (coinsurance or copayment), it’s covered by the plans A to G, M and N, while the Medigap plan K just covers 50%, and the 75%.
Furthermore, you could check what your needs are and how those are covered within the Medigap system, when the original Medicare system is not in that gray area. The website medicare.gov has a comprehensive and complete guide you could check here.