When a disabling physical or mental health condition prevents you from working, monthly benefit payments through Social Security Disability Insurance and Medicare make life easier. It’s understandable that hearing or reading about anything affecting your SSDI and Medicare eligibility could be upsetting.
The Northern California disability professionals at Sackett and Associates have devoted 45 years to helping folks in California and throughout the country obtain and keep their Social Security disability benefits. The information in this blog explains changes to expect in Medicare and disability benefits after 65, and how those changes affect you and other beneficiaries.
Benefits Available To Disabled Workers
The Social Security Act, a federal law, created the retirement and disability benefits programs relied upon by millions of American workers and their dependents. You need a history of working at jobs or self-employment where you paid into the Social Security system through payment of Social Security or self-employment taxes to be eligible for retirement or SSDI benefits.
SSDI provides monthly benefit payments to eligible workers who become disabled before they reach full retirement age, which is not age 65 for all workers. Your full retirement age depends on the year of your birth. For example, if you were born in 1960 or later, your full retirement age is 67. You can apply for retirement benefits at 62, but the benefits you receive will be reduced by as much as 30% from what they would be at full retirement age.
You need not wait until full retirement age for Medicare benefits. Eligibility for Medicare insurance generally starts at 65 unless you have a disability and qualify for SSDI. If you qualify for disability benefits through SSDI, you become eligible for Medicare after a 24-month waiting period. The 24-month waiting period does not apply if you qualify for SSDI because of amyotrophic lateral sclerosis (ALS). SSDI claimants with ALS qualify for Medicare coverage as soon as their SSDI benefits begin.
Because of the relationship between SSDI and retirement benefits, you cannot collect both. When you reach full retirement age, your SSDI benefits automatically convert to retirement benefits.
SSDI And Medicare Benefits
Although you can continue receiving disability benefits after 65 until reaching your full retirement age, you may notice changes to your health insurance coverage when you get to Medicare transition age 65. When that occurs, your Medicare transitions from disability-based eligibility to age-based.
Workers with a long enough work history become eligible for Medicare at 65 rather than at full retirement age. If you receive SSDI benefits, also become eligible for Medicare 24 months after you start receiving disability benefits. At age 65, your SSDI benefits continue until full retirement age when they convert to Social Security retirement benefits, but the transition of Medicare coverage to age-based eligibility gives you a second initial enrollment period to change or add coverage.
Medicare Coverage At 65 When Receiving SSDI Benefits
The turning 65 Medicare rules make it easier for you by eliminating the need to reapply for coverage. Age-based coverage is continuous.
Another change you may see with turning 65 Medicare rules has to do with the coverage. The coverages available through Medicare include the following:
- Part A Hospital Insurance: Part A pays toward inpatient care provided in a hospital, care provided in a skilled nursing facility, hospice care, and home health care.
- Part B Medical Insurance: Part B coverage pays toward services provided by physicians and other healthcare providers, including outpatient services. It also pays toward home health care; wheelchairs, walkers, hospital beds, and other durable medical equipment; preventive screening services, including vaccinations, wellness examinations, and other preventative care.
- Part D Drug Coverage: Part D pays toward prescription medications and vaccines.
Private health insurance companies offer Medicare supplemental insurance, also called Medigap, to pay a patient’s share of medical costs not covered by Medicare.
Original Medicare, the coverage available under turning 65 Medicare rules, automatically includes Parts A and B. If you receive Medicare because of a disability that qualifies you for SSDI, you automatically receive Part A, hospital insurance, with the option of adding Part B coverage, provided you pay the premium.
The turning 65 Medicare rules give you a new initial eligibility period to add additional coverage to the Parts A and B included with the transition to age-based Medicare. If they did not do so when they received disability-based Medicare, this may be when a person decides to add Medigap or switch from original Medicare coverage to a Medicare Advantage Plan provided by a private health insurance company.
Learn More About Medicare and SSDI From Sackett Law
Medicare may not be your only source of medical benefits when a disability prevents you from working. Depending on your monthly SSDI benefits amount, you may be eligible for Medicaid health benefits, provided you meet the eligibility requirements of the state where you live. Get assistance with disability benefits from the disability professionals at Sackett Law. Contact us now for a free consultation and disability claim review.
Leave A Comment