Most people will qualify for Medicare coverage when they turn age 65, there are situations where an individual may be eligible for these benefits before they reach this age based upon a qualifying disability. In many cases, this can be a big relief, as those who have disabling conditions typically have a difficult time finding affordable health insurance coverage.
Who Can Qualify for Medicare Based on a Disabling Condition?
Medicare assists those with disabling conditions by providing health insurance coverage in three key areas. These include individuals who:
- Have received Social Security disability payments for a minimum of two years
- Have amyotrophic lateral sclerosis, or ALS (also referred to as Lou Gehrig’s Disease)
- Have permanent kidney failure, or End Stage Renal Disease (ESRD)
Typically, for those who qualify for Medicare due to a disability, benefits will last as long as they are receiving Social Security disability payments – or possibly even longer. If, for example, an individual loses his or her Social Security disability income payments because they have returned to work, their Medicare benefits can still continue for up to another 93 months in some situations.
If a person’s employer offers health insurance benefits, the individual is required to accept them. This coverage will become the primary insurance payor, and Medicare will become the secondary payor.
If after 93 months have passed and the individual still has a disability – even though they are working – their Medicare benefits may be able to be continued. However, the person will likely be required to pay for Medicare Part A , as well as for Medicare Part B, unless they qualify for assistance through their state via a Medicare Savings Program.
If the person’s Medicare benefits are continuing when he or she reaches age 65, then the individual will simply continue to receive them. However, at that time, the benefits will be received based on the person’s age versus their disability.
At that time, the individual will be eligible for his or her Medicare Initial Enrollment Period. This means that they may be able to change their Medicare plan choices if they wish to do so. They may also buy a Medicare Supplement Insurance plan.
This can be an especially good time to purchase a Medicare Supplement plan, as during an individual’s Medicare Supplement open enrollment period, a person cannot be turned down for coverage or receive higher premiums.
If, however, they wait to enroll in Medicare Supplement after open enrollment, they will go through underwriting. This being the case – and if the person is still disabled – they will run the risk of being turned down or charged a higher premium rate for their Medicare Supplement Insurance coverage.
Why Consider Purchasing Medicare Supplement Insurance If You Are Disabled?
Medicare Supplement Insurance can be an ideal way to help reduce some of the out of pocket charges that are left by Medicare. While Medicare pays for a number of both hospitalization and doctors’ services, there are “gaps” this program leaves in terms of its deductibles, copayments, and coinsurance. Oftentimes, these expenses can make health care cost prohibitive.
For those individuals who may have an adverse health issue and who require regular visits to a health care professional, Medicare Supplement Insurance could essentially save a great deal in health care expenses each year.
If you want to buy a Medigap plan, there are ten different choices. Each of them has different protection areas.
Plan A is the smallest, and Plan F is the biggest. One important note is these policies are regulated by the government. The require carriers to offer the same coverage. A Plan F from one carrier is the same as a Plan F from another one.
Medigap Plan A offers:
- Medicare Part A coinsurance, as well as coverage for an additional 365 days after Medicare benefits end.
- Medicare Part B coinsurance. This is typically 20 percent of Medicare approved expenses, or copayments for hospital outpatient services.
- The first three pints of blood each year.
- Medicare Part A coinsurance for hospice care.
By having a Medicare Supplement Insurance plan, the money that can be saved in out of pocket expenses each year can be substantial. Anyone who is enrolled in Original Medicare should consider also owning this type of coverage.
Having a Supplemental Insurance policy is a great way to offset the costs. Each of the ten different plans covers various expenses as we mentioned, but it’s important that you decide which plan works best for you.
Before you decide, you need to consider your health and family history. If you’re in good health, you can buy a smaller policy.
Next, review your finances. Sure, everyone would rather purchase a Plan F and have the most supplemental coverage that they can get, but not everyone can afford the inclusive plans.
No Medicare enrollee, regardless of age, should have their savings drained because of medical bills and hospital costs. Jave questions or concerns about enrolling before 65? Or need quotes on any type of plan from Medicare Supplement Plan A to Medicare Supplement Plan F, we can help!