By SYLVIA GORDON
Guest Columnist
If you are disabled and apply for Social Security Disability, your chances of being denied on your first attempt are astronomical (think 90 percent depending on which state you apply in). If you do persevere and finally get accepted, you’ll be shocked to find out that Medicare coverage won’t begin for two years. This seems cruel to make disabled people wait so long for help with their health care.
When Social Security began in 1935, there was no provision for the disabled. It was strictly considered an “old age and survivors” benefit. In the 1950s, Congress fought over adding disability and the cost was contentious. The compromise that brought us a SSDI benefit came with the cost-saving measure of a two-year wait for Medicare.
Some serious conditions are an exception to this rule. Lou Gehrig’s disease (ALS) can get Medicare immediately. But the majority of people have to wait. There are a few options for health insurance prior to Medicare: Spousal group health, COBRA, VA, Medicaid and Affordable Care Act (ACA). The ACA can be very Unaffordable; it’s based on your income. You might pay $0 per month or up to $500 plus a high deductible.
Most people are eager to get to Medicare only to find out that insurance laws don’t guarantee the same rights to those on disability as to those 65 and over. In Indiana, like most states, insurance companies are not required to sell Medicare Supplements to those under age 65. Many people know Medicare Supplement Plan G is the “Cadillac” plan. When they call any insurance company to purchase a plan, they are told it’s not available to those on SSDI. Most people stop looking at that point, not realizing Medicare Advantage (MAPD) plans are available. MAPD may be a great option forever, or only until you reach age 65. At age 65 – even if you’ve been on Medicare for years – you can start over as if you were just turning 65! This is a critical time to choose the Medicare Supplement Plan G you need. You can’t be turned down due to your health and the insurance company cannot charge you more.
Contact your Medicare insurance specialist three months before your Medicare eligibility begins. For most people that will be 21 months after your first disability payment begins.
Sylvia Gordon is co-founder of The Medicare Family, headquartered in Noblesville, where she educates thousands on Medicare and Social Security in all 50 states. You can learn more at themedicarefamily.com.