Can Ssi Recipients Receive Medicare
People who receive disability benefits through the Supplemental Security Income program don’t qualify for Medicare insurance coverageâat least until they reach the age of 65 years old. Upon turning 65, SSI recipients can receive Medicare based on age. Learn more about the Medicare and Medicaid that comes with disability benefits.
Medicare Eligibility Due To A Disability
If you have been receiving SSDI benefits for more than 24 months, often known as the two-year waiting period, you may be eligible for Medicare as a result of your disability. The two-year waiting period begins the month you receive your first SSDI payment. At the start of the 25th month, following the receipt of an SSDI check, you will be automatically enrolled in Medicare.
If you receive SSDI as a result of Amyotrophic Lateral Sclerosis or ALS, Medicare coverage begins the month automatically after your SSDI benefits begin. You do not have to wait two years.
Not Medicare, but Social Security determines whether you qualify for SSDI benefits and runs the program that distributes them. It is recommended that you contact your local Social Security Administration office for additional information about the Social Security Disability Insurance program.
Railroad employees should contact the Railroad Retirement Board for information on disability annuities and eligibility for Medicare.
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How Much Will Ssi Checks Be In 2021
Generally, the maximum Federal SSI benefit changes yearly. SSI benefits increased in 2021 because there was an increase in the Consumer Price Index from the third quarter of 2019 to the third quarter of 2020. Effective January 1, 2021 the Federal benefit rate is $794 for an individual and $1,191 for a couple.
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What Medicare Benefits Are Available For People With Disabilities
Medicare disability benefits are similar to the coverage benefits that Medicare members who qualify based on age receive. This means that you will receive:
- Medicare Part A coverage covers hospital care, skilled nursing facility, hospice care, and home health
- Medicare Part B coverage covers doctor visits, certain medical equipment, outpatient services, home health services, and other specified medical services.
Medicare recipients who qualify on disability also have the option to go for Medicare plans offered by private insurance companies including Medicare Part C and Medicare Part D which offers prescription coverage.
Medicare Part C And Part D
There are two parts to Medicare: Part A and Part B.
Part A is hospital insurance, while Part B is medical insurance.
Part C and Part D are offered by private companies, such as insurance companies or HMOs. You must have Parts A and B in order to enroll in a Part C or D plan.
Some companies offer a premium for their plans, while others have no premium or a free plan. You will have to contact your insurance company in order to deduct your premiums from Social Security. This can take a few months, so you might be asked for a large payment at first. Your monthly deduction will occur after all the details are set up with your insurance company and plan provider
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Keeping Medicare And Medicaid When You Work: Additional Work Incentives Available To People With Disabilities On Ssdi
Additional Work Incentives for SSDI Beneficiaries
SSDI recipients may be able to take advantage of one or more of the following incentives:
Earning-related Incentives
- Establishing a Plan for Achieving Self Sufficiency
Health Coverage Incentives
- Medicare for People With Disabilities Who Work
- Obtaining Medicaid Coverage While Employed
Earnings-Related Incentives
What is a trial work period?
A trial work period allows you to test your ability to work for 9 months. During this time you receive your full SSDI payment regardless of how much you earn as long as you continue to be disabled. The 9 months does not need to be consecutive. It will last until you accumulate 9 months within a rolling 60-month period. Certain other rules apply. Back to the Top
What is the extended period of eligibility?
If your disability benefits stop after successfully completing the trial work period because you worked at the substantial gainful activity level, SSA can automatically reinstate your benefits without a new application for any months in which your earnings drop below the SGA level.
So, for example, if after you complete the trial work period you may need to spend more on personal assistance or other impairment related work expenses for a particular month. This, in turn, may reduce our earnings below the SGA level for that month. SSA will provide you a SSDI check for that month.
Health Coverage Incentives
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What If My Income Is Too High For Ssi
Some people worry that their income will disqualify them for SSI and Medicaid. Usually, you will continue to qualify for Medicaid if the following remains true:
- Youre blind or disabled and
- Except for your income, you meet SSI eligibility rules and
- You qualify for at least one month of SSI payment before meeting SSAs Section 1619 and
- You met Medicaid eligibility in the month before qualifying for Section 1619 and
- To be able to work, you need Medicaid
The last rule is that your work income cant replace the value of your assistance. This includes Medicaid or SSI cash benefits. Your earning cant cause the loss of publicly funded personal care related to your income.
Even if your earnings exceed the threshold, you may still qualify for help. For example, you may get Medicaid for special work or medical expenses.
Always notify the funding authorities if you accept a job or become self-employed. Theyll want to know when your job starts and stops and how many hours you plan to work.
Based on this information and your disability, theyll grant you a trial work period for up to nine months. Be sure to tell them if you have expenses related to your disability, such as medications or a wheelchair. Make sure you tell them if these charges change as well.
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Medicare & Social Security Disability Benefits
We have mostly discussed thebasics of Medicare as it relates to retirees and Social Security retirement benefits. However, you can also qualify for Medicare when you receive Social Security disability insurance benefits from the Social Security Administration . When receiving disability benefits, you will be automatically enrolled in Medicare once you have received disability benefits for a 24-month period. There is a 24-month waiting period before your Medicare benefits begin. However, that waiting period does not apply to some individuals with certain conditions.
If you have been diagnosed with end-stage renal disease , you will qualify for Medicare benefits right away. Similarly, those with amyotrophic lateral sclerosis or Lou Gehrigs disease will be eligible for immediate Medicare benefits. These diagnoses will qualify you for immediate benefits, but you must still apply for the benefits. You will not be automatically enrolled in coverage. You can contact your local Social Security office or Centers for Medicare & Medicaid Services office to apply for coverage. You can alsoapply for Medicare online through Medicare.gov, or you can call Social Security at 1-800-772-1213.
Medicare Disability Requirements List
You can qualify for Medicare disability benefits only if you meet either of these set criteria for disability.
- To qualify for Medicare on disability, you need to have received Social Security Disability Insurance benefits for at least 24 months. These benefits are only paid to those who work in jobs covered by Social Security and have a qualifying medical condition that meets the set criteria for a disability.
- You have end-stage renal disease : You are eligible for Medicare disability benefits if you have ESRD. Your Medicare coverage will begin 90 days after your dialysis treatment begins. If you get a kidney transplant, your Medicare coverage will last for up to three years after the transplant surgery. If the transplant is successful your Medicare coverage will cease after three years.
- You have amyotrophic lateral sclerosis : If you have ALS or Lou Gehrigs disease you immediately qualify for Medicare disability coverage. There is no waiting period for this eligibility criteria and you can apply for Medicare coverage immediately after your diagnosis.
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How Much You Will Receive
The amount of your monthly SSDI benefit is based on your lifetime average earnings covered by Social Security.
If you donât already have an estimate, you can get your Social Security Statement online with your personal mySocial Security account or use our Benefit Calculators to determine how much you could get if you became disabled right now.
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Enrolling In Medicare Past Age 65
There is nothing that prohibits you from enrolling in Medicare after age 65. You may have chosen to opt out of Medicare upon reaching age 65, but you decided later to enroll in coverage. First, you need to determine whether you qualify for a special enrollment period. If you were still employed and covered through a group health plan upon reaching age 65, then you will generally qualify for a special enrollment when your group plan ends. This means that you can sign up for coverage without any late enrollment penalties. You can also sign up for supplemental Medicare coverage without paying higher premiums or going through full medical underwriting.
If you do not qualify for a special enrollment period, you will need to sign up for coverage during a general enrollment period. There is an annual enrollment period each year during which you can sign up for Original Medicare, prescription drug coverage, or Medicare Part C Medicare Advantage plans. Signing up during this period after your 65th birthday means that you will likely pay a late enrollment penalty and higher premiums.
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What Happens When You Turn 65
When you turn 65, you essentially lose your entitlement to Medicare based on disability and become entitled based on age. In short, you get another chance to enroll, a second Initial Enrollment Period if you will.6
If you decided not to take Part B when you were eligible for disability under 65, when you do turn 65, youll now be automatically enrolled in Part B. Your Medicare card will then be mailed to you about 3 months before your 65th birthday.
You can also decide during this time to enroll in a Medicare Advantage or Part D prescription drug plan. Additionally, once you have Part B, you can enroll in a Medigap plan if you so wish.
How The Waiting Period Works
The Social Security Administration counts each month in which you are entitled to receive an SSDI payment toward the 24-month Medicare qualifying period.
There is also a waiting period for SSDI payments to begin, lasting five full calendar months after the month in which the SSA determines that your disability began . That means, in most cases, you become eligible for Medicare 29 months after what Social Security terms the onset of your disability.
Remember, though, that your onset date can be well before you filed for SSDI or were approved to collect it . In fact, Social Security can pay up to 12 months of retroactive benefits if it determines, based on the medical evidence, that your disability predated your application.
And those months when you were medically entitled to SSDI but had not yet been approved to receive it count toward the Medicare waiting period. Say you applied for SSDI on Sept. 10, 2021, eight months after a chronic illness sidelined you from your job. Social Security approves your claim in February 2022 and denotes Jan. 10, 2021, as the start date of your disability.
Your benefit entitlement, then, began in July 2021, the sixth calendar month after your onset date. You would get seven months of retroactive payments and become eligible for Medicare in July 2023, 17 months after you got a decision from the SSA.
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How Do People Under Age 65 With Disabilities Qualify For Medicare
People under age 65 become eligible for Medicare if they have received SSDI payments for 24 months. Because people are required to wait five months before receiving disability benefits, SSDI recipients must wait a total of 29 months before their Medicare coverage begins. People under age 65 who are diagnosed with end-stage renal disease or amyotrophic lateral sclerosis automatically qualify for Medicare upon diagnosis without a waiting period.5 Of those who were receiving SSDI in 2014, 34% qualified due to mental disorders, 28% due to diseases of the musculoskeletal system and connective tissue, 4% due to injuries, 3% due to cancer, and 30% due to other diseases and conditions.6
Is It Mandatory To Sign Up For Medicare After Age 65
No, it isnt mandatory to join Medicare. People can opt to sign up, or not.
If you don’t qualify for Social Security retirement benefits yet, you may need to manually enroll in Medicare at your local Social Security office, online or over the phone when you turn 65. You can also apply online for your Medicare coverage at www.medicare.gov.
Enrolling in Medicare as soon as youre eligible ensures you get the subsidized health care you deserve without waiting periods or financial penalties.
If you continue to work for a company employing 20 or more people after you turn 65, you could delay your Medicare enrollment. Your employee group plan provides enough medical coverage while youre working, meaning you may be able to wait to sign up for Medicare once you retire without incurring any late penalties.
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Medicare Eligibility For Those 65+
When you reach the age of 65, you become eligible for Medicare if you meet the following criteria:
- Social Security retirement cash benefits are available to those who receive or qualify for them.
- Alternatively, you now reside in the United States and are one of the following:
- A citizen of the United States,
- or a permanent resident of the United States who has been in the United States for a continuous period of five years previous to applying
If you are currently receiving Social Security retirement benefits or Railroad Retirement benefits at the age of 65, the method by which you enroll will be determined by this factor. Additionally, there are scenarios in which someone may become Medicare-eligible at age 65 but may choose to defer enrollment in Medicare without incurring any future fines, such as if the individual receives qualifying health insurance via his or her workplace.
The amount of money you have to pay toward your Medicare coverage is determined by your job history . Everyone is required to pay a monthly payment for their medical insurance coverage . The majority of Medicare beneficiaries do not have to pay a premium for their hospital insurance .
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Contact Social Security To Sign Up For Medicare
You can either:
Know when to sign up for Part BYou can only sign up for Part B at certain times. If you dont sign up for Part B when you turn 65, you might have to wait to sign up and pay a monthly late enrollment penalty. Find out when you can sign up. How much is the Part B late enrollment penalty?
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What Are The Differences Between Medicare And Medicaid
Medicare and Medicaid are both government-funded health insurance programs that cover eligible individuals. They provide different types of benefits, and people with disabilities can qualify for either program.
Medicare is for people who have a disability before the age of 65, while Medicaid is for people with disabilities at any age. Medicare provides a link to help you find your local Social Security office and other organizations in your state at http://www.medicare.gov/contacts/. It covers eligible individuals for premiums, cost-sharing, and prescription drug benefits.
Medicaid is available to individuals who have an income of at least 100% of the poverty line in 2022. If you apply for and receive Marketplace coverage and subsidies, your eligibility for those subsidies will end. If you keep both Medicare Part A and Part B, Medicare will be the primary payer. Medicaid also provides help with premiums, cost-sharing, and prescription drug benefits like Medicare does.
Both programs are important resources for people with disabilities, but they offer different types of coverage depending on each persons needs
Importance Of Dental Care
Visiting a dentist on a regular basis is vital to maintain oral and general health. Lack of dental care increases your risk of mouth infections and cardiovascular disease.
Poor oral hygiene can also impact your professional and personal interactions. Mouth infections cause halitosis which interferes with communication. Dental-related illnesses can result in lost time at work and reduced income.
Its best to start routine dental cleanings and preventative services at a young age. Yet, statistics show that low-income families often lack access to dental care. Thus, theyre more prone to develop long-term dental problems.
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Health Coverage For People With Disabilities
If you have a disability, you have three options for health coverage through the government.
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Medicaid provides free or low-cost medical benefits to people with disabilities. Learn about eligibility and how to apply.
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Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease . Learn about eligibility, how to apply and coverage.
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Affordable Care Act Marketplace offers options to people who have a disability, dont qualify for disability benefits, and need health coverage. Learn about the .