Is there any way that my Medicare can continue if my Social Security Disability benefit stops because of my work?

By / March 3, 2016 / After You’re Approved for Social Security Disability & SSI / 72 Comments

See how your eligibility for Medicare can continue after your Social Security Disability benefit has been suspended or terminated because of your work.

Medicare Continuation without Disability Benefit Checks
Your Medicare can continue when your Social Security Disability benefits have been suspended or terminated if you have not recovered medically and your benefits stopped because you were performing substantial work.

Medicare Return-to-Work Incentive
One of Social Security’s return-to-work incentives is the Extended Period of Eligibility which is thirty-six months long. During the Extended Period, your benefits will be suspended for months in which your work is substantial. During this Extended Period, your Part A Medicare will continue and, if you pay the premiums, your Part B and Part D Medicare will also continue even in months you do not receive a disability check. After the thirty-six months end, if you have not recovered medically, but your benefits have been terminated because of your work, your Medicare insurance will continue for another fifty-seven months.

For information about Medicare Parts A, B, and D, see If I am approved for Social Security Disability, will I be eligible for Medicare and Medicaid health insurance?For a discussion of Social Security’s return-to-work incentives, visit our article Can I Keep Getting Benefits When I Am Working on Social Security Disability?

Is there any way that my Medicare can continue if my Social Security Disability benefit stops because of my work?
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  • Dear Yvette,

    If you have been receiving SSDI for twenty-four months and you are still disabled, you are eligible for Medicare based on receiving SSDI long enough and your eligibility will not dependent on the condition of your kidney. If you return to work while receiving SSDI and you have not recovered medically from your disabling conditions, SSA has several work incentives. One of them is continuation of Medicare for 93 months after the end of a nine-month Trial Work Period if benefits have ended due to substantial gainful [work] activity. You can read about all of SSA’s work incentives at https://www.ssa.gov/redbook/documents/TheRedBook2017.pdf.

    Sincerely,
    Kay

    • Yvette De La Vega

      Thank you Kay!, So will my medicare automatically end 36 months after my transplant date? which will be in like 6.5 months from now. I am so confused.

      • Dear Yvette,

        If you have received twenty-four months of SSDI benefits, your Medicare will continue as long as you continue to be eligible for SSDI benefits. If you recover medically and are not medically disabled, Medicare will stop at that time. If your benefits stop because you work earning enough, long enough, Medicare will continue after benefits stop as I have described. You can read about the Trial Work Period during which benefits continue in Social Security’s Red Book in the online link I gave you.

        Sincerely,
        Kay

  • Dear Tammy,
    In order to respond to your inquiry, we need additional information:
    1. Was your son’s benefits terminal because he was considered no longer disabled or he has recover medically?
    2. Are your son’s benefits suspended because he has completed his trial work period and is earning above the substantial work.
    Your son’s Medicare can continue if his Social Security Disability (SSDI) benefits have been suspended or terminated, if your son has not recovered medically and your son’s benefits stopped because he was performing substantial work. If your son’s benefits were terminated because he was no longer considered disabled, he can reapply for benefits.
    Once you have provided more information, we can respond to your to your questions. We look forward to hearing from your.
    Sincerely,
    Jane

  • Dear Enid,

    In order to respond to your inquiry, we need additional information:
    1. Were you still in your 36-month Extended Period of Eligibility (EPE) when your benefits were stopped. If so, please find out from Social Security whether or not you have any months left in the EPE and if so how many.
    2. If, on the other hand, you had to apply for Expedited Reinstatement (ER) to get benefits started, how many months of benefits have you received since reinstatement.

    Once we have this information, we can respond to your questions. We look forward to hearing from you.

    Sincerely,
    Kay

  • Dear Carolina,
    Your Medicare insurance can continue for a length of time while working if you have not recovered from your disability. If you haven’t recovered, Social Security has several programs that can support your return to work. In some circumstances you can be working while on Social Security Disability and continue to receive full disability benefits. However, to avoid overpayments that you will have to repay, it is important to report to Social Security as soon you start work. It can also be helpful to talk to a Social Security representative about your work plans before you actually begin working, so that you can take advantage of Social Security’s return-to-work programs.

    A key concept in Social Security’s definition of disability and in its work incentive programs is “substantial gainful activity,” which is called SGA for short. Social Security generally defines substantial earnings as a certain dollar amount. In 2017, generally $1,170.00 earnings per month is substantial for non-blind workers and $1,930.00 is substantial work for the blind. These amounts refer to your gross earnings if you are an employee and your net profit if you are self-employed. However, Social Security looks at many factors when determining whether your work, especially self-employment, is substantial gainful activity.

    At any point in time, you may be eligible for Social Security’s free and voluntary “Ticket to Work.” This program connects you with a network of vocational specialists in state agencies and private companies. Some examples of services that are available through the Ticket to Work program are return-to-work planning, job search assistance, and other support services that you may need to obtain and keep a job. If you are using Ticket to Work, in some circumstances, your claim will not be reviewed for medical recovery.

    In addition to the Ticket to Work, Social Security’s work-support programs include a Trial Work Period, an Extended Period of Eligibility, and Expedited Reinstatement. There are also provisions for continuation of Medicare health insurance.
    In general, regardless of which work programs you participate in, if your work never reaches the level of substantial gainful activity, you can work and receive Social Security Disability indefinitely, as long as you do not recover medically. Additionally, your eligibility to Medicare health insurance will continue while you work and receive benefits. Even if you think that your work is not substantial, it is important to report your work activity to Social Security as soon as you start working and whenever you have changes in hours, pay, or duties.

    Whether or not you participate in the Ticket to Work program, your work activity will be evaluated through three work-incentive programs. The first that comes into play is the Trial Work Period. You are eligible for a Trial Work Period after you have completed your first twelve months of disability. A Trial Work Period consists of nine months, not necessarily in a row, during which you earn at or above the Trial Work Period earnings level, which in 2017 is $840.00 per month. Note that the monthly amount that defines a Trial Work Period month, $840.00, is less than the dollar guidelines for the substantial gainful activity. During your Trial Work Period, you will receive full disability benefits and continuation of Medicare, no matter how much you are earning, as long as you pay any required Medicare premiums.

    When your Trial Work Period ends, you enter into a thirty-six-month Extended Period of Eligibility. The extended period begins the month after the end of the Trial Work Period, whether or not you are working at that time. During the Extended Period of Eligibility, you will be paid for months in which you do not perform substantial gainful activity. On the other hand, your benefits will be suspended for any month that your work is SGA. The only exception is that you will be paid benefits for your first month of SGA in the Extended Period, plus the two following months as a grace period. During the full thirty-six months, your entitlement to Part A Medicare will continue whether or not you are receiving a benefit check. Part B and Part D Medicare will also continue, if the premiums are paid.

    At the end of the thirty–six-month Extended Period of Eligibility, if you are engaging in substantial gainful activity, your Social Security benefits will stop. However, if you are not working or your work is not SGA, your benefits will continue until the first month you perform SGA, at which time, your disability benefits will be terminated. If your cash benefits end because you continue to work at SGA level and you have not recovered medically, your Medicare insurance will continue for an additional fifty-seven months.
    Sincerely,
    Jane

  • Dear Alex,
    If you got Medicare with the first month of eligibility, you were most likely approved based on End-Stage Renal Disease (ESRD), but you can contact your local Social Security office and ask them to tell you for sure the reason you are receiving disability benefits.
    Medicare continues as described below if you have not recovered medically. Because you have a Ticket to Work, your medical condition may not be reviewed as long as you are making progress in your Ticket plan. If you were to have a medical review, your condition at that time would be evaluated, not what your condition might be in the future. If you think you have recovered but are not sure, then getting a Ticket to Work, as you did, and using SSA’s work incentives is an appropriate way to proceed.
    Full benefits are paid during the nine-month Trial Work Period (TWP) no matter how much you earn. If you continue to work after your Trial Work Period ends, you enter into another work incentive program, which is a thirty-six-month Extended Period of Eligibility. The extended period begins the month after the end of the Trial Work Period, whether or not you are working at that time. During the Extended Period of Eligibility, you will be paid for months in which you do not perform substantial gainful activity. On the other hand, your benefits will be suspended for any month that your work is substantial gainful activity (SGA). In 2017, generally $1,170.00 earnings per month is substantial. The only exception is that you will be paid benefits for your first month of SGA in the Extended Period plus the two following months. During the full thirty-six months, your entitlement to Part A Medicare will continue whether or not you are receiving a benefit check. Part B and Part D Medicare will also continue if the premiums are paid.
    At the end of the thirty–six-month Extended Period of Eligibility, if you are engaging in substantial gainful activity, your Social Security benefits will stop. However, if you are not working or your work is not SGA, your benefits will continue until the first month you perform SGA, at which time, your disability benefits will be terminated. If your cash benefits end and you continue to work and you have not recovered medically, your Medicare insurance will continue for an additional fifty-seven months. If you became disabled again due to the same condition or a related condition within five years of termination, you could request an Expedited Reinstatement.
    On the other hand, if you are certain that you have recovered and can sustain employment at the SGA level (monthly earnings of $1,170 gross after reduction for Impairment Related Work Expenses), then you are responsible for reporting your recovery., which will cause benefit payments and Medicare to end even though you signed up for a Ticket to Work.
    Sincerely,
    Jane

  • Dear Jason,
    Medicare is not continued when your claim closes for medical recovery after a continuing disability review (CDR). You might be eligible for Medicaid and can apply at your local state or county social services office. Another alternative is to apply for insurance under the Affordable Care Act (ACA) also known as Obamacare; however, to apply outside the general (usual) open enrollment period, you must apply within sixty days of losing your Medicare insurance or within sixty days before the date you know it will end. Otherwise, you have to wait to enroll at the end of the year during the open enrollment period. Depending on your income, you might be eligible to receive a subsidy to help pay for the premiums. More information is available at http://www.healthcare.gov.
    Sincerely,
    Jane

  • Dear Dan,
    Your Medicare coverage can continue while you are working. Please refer to our article ” Can I keep getting benefits when I am working on Social Security Disability?” This will explain it in more detail and if you still have questions send another post.You can find the article in “After Approval” in the drop down menu under the “Soical Security Disability/SSI” button at the top of this webpage.
    Sincerely,
    Jane

  • Dear Dustin,

    One work incentive whether or not you are in the Ticket to Work program is a nine-month Trial Work Period (TWP) during which benefits continue while you attempt to work. The benefits you receive in those nine months count toward the twenty-four month Medicare waiting period. Given that you have already received seventeen months of benefits, the TWP will carry you past the twenty-four months and you will get Medicare. After the Trial Work Period if your benefits are suspended due to work activity Medicare will continue. If eventually your claim is closed due to your performing substantial gainful activity (SGA), your Medicare entitlement will continue for 57 months after claim termination. You can read about the various work incentives in the Red Book available online at http://www.ssa.gov.

    Sincerely,
    Kay

  • Dear Roger,

    My understanding is the same as yours: if your wife has recovered medically, she is not eligible for continued Medicare. I suggest that she ask her local Social Security office to look at the termination code on her claims record. The code should be a code for no longer medically disabled versus termination for substantial gainful activity. If it is the wrong code, she can ask the local office to ask the program service center to correct the type of closure. Posting the correct closure code is on the record should automatically result in termination of Part A Medicare. If the local office declines to make the request to the program service center, your wife might try formally appealing the closing reason/code.

    Sincerely,
    Kay

  • Dear Richard,

    Whether or not Medicare ends when benefits end depends on the reason benefits are terminated. If you have recovered medically, Medicare ends. If your benefits stop due to work activity only, Medicare will continue throughout the thirty-six month Extended Period of Eligibility and for another fifty-seven months after your claim has been closed. You can mail in your payments, pay online or by credit card. The following link has more specific information.
    https://www.medicare.gov/your-medicare-costs/paying-parts-a-and-b/pay-parts-a-and-b-premiums.html

    Sincerely,
    Kay

  • You are welcome, Scott.

  • Dear Scott,

    Voluntary termination of disability benefits will result in termination of Medicare as well. If she were to return to work and have benefits suspended or terminated after using up the Trial Work Period, Medicare would continue. Once she lost her Medicare coverage, she could try to get insurance in the Affordable Care Act marketplace, which might provide a government subsidy to help with premiums. More information about the ACA is available at http://www.healthinsurance.com.

    Sincerely,
    Kay

  • Dear Elisa,

    Yes, as you have described your situation, I believe your only option would be to work and earn the credits, although if you have worked very little, the retirement benefit might not be more than the SSI. Currently, you need $1,300 gross wages for one quarter of coverage and you can earn up to four a year.

    Sincerely,
    Kay

  • Dear Kayla,

    At that time, nearly five years from now, you could investigate purchasing health insurance for yourself or by then maybe you will be working for an employer that provides health insurance.

    Sincerely,
    Kay

  • Dear Elisa,

    If you have enough work credits to be insured for Social Security retirement benefits, you will be required to apply for reduced retirement benefits at age sixty-two. At that time your Supplemental Security Income (SSI) will be reduced or terminated depending on how high the Social Security benefit is. If SSI continues, it will continue past age sixty-five based on your age rather than disability.

    Sincerely,
    Kay

  • Dear Christina,

    Please see my reply to your first post.

    Thank you,
    Kay

  • Dear Christine,

    If your son’s Social Security Disability (SSDI) was terminated due to performing substantial gainful activity (SGA) and not due to medical recovery found in a continuing disability review (CDR) prompted by his work and if he pays the Part B and Part D premiums, his Medicare will continue for ninety-three months after the end of his nine-month Trial Work Period. Part A will continue for the same period without the need to pay premiums.

    Sincerely,
    Kay

  • Dear Ian,

    To continue Parts B and D, you do have to pay the premiums. I am uncertain about the premium penalty, but I don’t think you would be penalized. I think that if you enroll when you turn sixty-five, there would not be a penalty. However, I suggest that you check with your local Social Security office to be sure.

    Sincerely,
    Kay

  • Dear Andrea,

    If your benefits are suspended for work and Medicare has continued, it is unlikely at this point you will have a continuing disability review. If you consider yourself medically recovered, you should report the recovery and your claim will be closed and Medicare stopped. With a medical recovery, if you have a relapse, you will not be entitled to an Expedited Reinstatement. Instead, you willl have to file a new claim.

    Sincerely,
    Kay

  • You are welcome.

  • Dear Wedding14,

    Your Medicare will end when your benefits terminate. At that time you will have a sixty-day personal enrollment period to investigate and, if you wish, to sign up for health insurance under the Affordable Care Act, which may provide a government subsidy to help with the premiums. (About 85% of enrollees receive subsidies.) More information is available at www. healthcare.gov.

    Sincerely,
    Kay

  • Dear Anonymous One,

    Medicare will terminate in the same month as benefits terminate due to medical recovery. You will have a sixty-day personal enrollment period after Medicare has terminated to apply for insurance under the Affordable Care Act, which depending on your income may give you a government subsidy to help pay the premiums.

    Sincerely,
    Kay

  • Dear Anonymous,

    Yes, Medicare insurance stops the same month as benefits are terminated for medical improvement.

    Sincerely,
    Kay

  • Susan

    Hi, my boyfriend had brain injury 4yrs ago in 2012 He just received a letter from Medicare that his benefits will be suspended. His income right now is only Social security. His income is not enough because he live alone and renting his own place. He doesn’t know what to do. Please help. Thank you.
    Sincerely,
    Susan

    • Kay Derochie

      Dear Susan,

      I am not aware of situations in which Medicare is lost when Social Security benefits continue unless premiums have not been paid. Premiums are withheld from the Social Security benefits unless your boyfriend asked to have the withholding stopped. I suggest that you and your boyfriend, go to Social Security with the suspension letter to have the reason for the suspension explained. If he finds that an error has been made, he can appeal the suspension.

      Sincerely,
      Kay

  • Kevin

    I received disability benefits but have returned to work. Reported that I was released from doctor and returning to full time work which I did. I checked with social because they started taking part B premiums out told them I had my own insurance, they said to check with my carrier to make sure who was primary and I did they said they BCBSI would be primary but to check with my employer to be sure . I did that and was told as far as they could tell my BCBSIL would be primary. Called b a ck to social security and told them my results and they said I didn’t need part B then but I should take part A because it was free. So I took the part A . Had a surgery and my BCBSIL now won’t pay because they say I was offered part B when I was eligible and my employer has me as disabled working part A. My employer says if I get off medicare that they will honor my insurance and bills as well . Tried to disenroll from part A but was denied says only two ways to get off medicare disability by turning 65 then I get medicare retirement or upon my death. How can I be made to take this when I am no longer disabled. Can I now get part B I do need continue medical. Need some help on this please just way to miss informed on disability and medicare

    • Kay Derochie

      Dear Kevin,

      Your situation is complex. I don’t know whether legal help would get your past medical care paid by BCBS because you were given misinformation.

      I also don’t know whether if you start Part B again that you can make it retroactive to the time you had surgery, but I doubt it. Usually when a person wants to enroll in Part B after declining it, enrollment can occur only during open enrollment at the end of the year and coverage starts the following July.

      The only solution I can think of is to again try to terminate Part A on the basis that it should not have been continued. Check to see what termination code is on your Social Security claim. If it shows termination due to return to work instead of due to medical recovery, that might be the problem. The law says Medicare continues for fifty-four months after insurance terminates due to return to work; that is probably the reason you can’t terminate Part A. Because you reported medical recovery, you might have a case to have Social Security correct the code to medical recovery, which would, I believe, stop the Medicare retroactively because you were never eligible to have it continued. If you hit a wall on this, an attorney might help.

      Sincerely,
      Kay

  • Phillip

    Hi

    I have been back to work for almost two years now after being on SSDI for close to two years. I still have medical issues including Meniere’s Disease which causes sudden vertigo and can keep me out of work for weeks at a time. My question is am I allowed to cancel my employer sponsored insurance and keep Medicare as my primary insurance along with a Medigap policy that I purchase. Our employee insurance is not only expensive but has ridiculous deductibles and out of pocket limits.I also deal with this insurance company constantly as they continue to flip flop on whether they are primary which they are. Tired of arguing with . Menifee’s is why I received disability so I am still considered disabled.

    • Kay Derochie

      Dear Phillip,

      Medicare will not continue indefinitely. It continues during an Extended Period of Eligibility and fifty-four months after that. To figure out what month you are in in your EPE and from that point how long your Medicare will continue, I suggest that you either figure it out by using Social Security’s Red Book (available at local offices or online at http://www.ssa.gov) or that you make an appointment with a claims representative to help you determine it.

      Also, if you do dis-enroll from your company’s insurance, it may be advisable to watch for when Medicare will end so that you can re-enroll in your company’s insurance during the last open enrollment before Medicare ends.

      Sincerely,
      Kay

  • Shawn

    I currently work for temp agency making 14 a hour with no benifts jobs ends in December. I need my Medicare for my health . I did report it to my pass plan worker .I been failing road test and having hard time finding permanent work with benifts. I want to know how much can I make end the year so, keep my benefits. I don’t mind loosing Ssi but this jobs ends in December. I need my benifts to pay my living expenses and Medicare for my eplisey as well bipolar disorder. Please help me

    • Kay Derochie

      Dear Shawn,

      I suggest that you read Social Security’s Red Book to learn about Social Security’s work incentives. The book is available from a local office or online at http://www.ssa.gov. I suggest that then you review with Social Security where you are in using the several Social Security work incentives. Are you in the first nine-month Trial Work Period or in the following thirty-six-month Extended Period of Eligibility or have you used up both those periods? That will inform you whether or not you will continue to get benefits in months that you earn more than $1,090 or you have to stay under $1,090 gross per month for benefits to continue. Even if you have used up both of those periods of time and you are earning more than $1,090, your Medicare will continue for another fifty-seven months.

      Sincerely,
      Kay

  • lorrain

    Hi, I wanted to konw if you try to work 2 hours a day while receiving SSDI, 10 hour a week and couldn’t perform, will my check be cut off, and will i loose my medicare, and how long before they cut uour check off , i been receiving since 2001, started receiving review forms in the mail, please answer worried, i have rsd, cataracts diabetes menopause, urinary incontinence, diabetic nerve pain

    • Kay Derochie

      Dear Lorrain,

      The work you did should not cause you Social Security to stop. You do need to list it on the review forms. Be sure to be clear that you stopped work because of your health. Be as specific as possible about the problems you had on the job that caused you to stop working.

      Sincerely,
      Kay

  • emma

    I have really bad asthma and that is why i am consider disable. i am in the hospital once a month or so with pneumonia. However i want to work at a store where there is not much physical activities and try to sustain myself. I am a college student and i soon will turn 21. However i can not lose my medicare because my medicine is too expensive and i will not have the money to pay for it. i just want to try to work and i don’t care if i lose the paycheck but i just don’t want to lose my insurance. what can i do? is there a different program or way to keep my insurance? I take medicine every single day.

    • Kay Derochie

      Dear Emma,

      Before I respond, please confirm that you are receiving Social Security Disability or Social Security Disabled Adult Child benefits and Medicare and not Supplemental Security Income (SSI). Once I hear from you, I will respond.

      Thanks,
      Kay

      • Laura

        Hi I currently receive SSI & SSDI and I just finished school. I’m in the ticket to work program and the job I have will be ending in December. I want to know how much I have to make a month to keep SSI & SSDI. It’s been very difficult keeping a job due to my medical condition.

        • Kay Derochie

          Dear Laura,

          There is no certain amount you have to make to keep the benefits; the Ticket to Work does not require work. If you have already used up your nine-month trial work period, you will receive Social Security Disability benefits for the following thirty-six calendar months in any month that you do not earn $1,090 gross or more per month. If you earn $1,090 or more after the thirty-six months, your SSDI benefits stop and your Medicare benefits continue.

          Supplemental Security Income (SSI) considers not only the $1.090 substantial earnings level, it counts your income to determine whether you meet the financial eligibility for SSI. The first $65 earnings is excluded and also one-half of the excess earnings above $65 is excluded. If your remainder (total earnings – $65 divided by 2) is less than your SSI payment, your benefits will continue though possible in a reduced amount.

          You can read about SSDI and SSI return-to-work incentives in Social Security’s Red Book which can be viewed online at http://www.ssa.gov or obtained from your local office.

          Sincerely,
          Kay

  • Michael

    I have recovered medically, returned to work, and no longer receive SSDI. To get off the Medicare roll do I need to request a medical review to prove that I’m no longer disabled? Or will the SSA just take my word for it? Can you direct me to the specific part in the Code of Federal Regulations that pertains to a person who has recovered medically and no longer wants Medicare? I can only find the law for the opposite: a person who wants to contest a finding that the person is no longer disabled. I want to SHOW that I’m no longer disabled. Thank you.

    • Kay Derochie

      Dear Michael,

      I suggest that you just go to Social Security and explain that not only have you returned to work that you have recovered medically and, therefore, believe that you are not entitled to continuation of Medicare under the work incentive program. You could take a statement from your physician that you have recovered. That may allow then to terminate the Medicare. Presumably, they would have to change the code for the reason you benefits stopped. Otherwise, the law provides for automatic continuation of Medicare for a lengthy period after termination of benefits due to return to work. The continuation is an incentive to work because many employers don’t offer health insurance. HOWEVER, EXERCISE CAUTION! If you are successful in doing what I suggested, you will probably loose not only Medicare but also your right to Expedited Reinstatement should you become disabled again within five years due to the same condition. Without Expedited Reinstatement rights, you would also have another five-month, unpaid waiting period before benefits resumed.

      Sincerely,
      Kay

      • Michael

        Thank you, Kay. I would really like to read the section in the federal law that pertains to my situation. Can you direct me to that law? Thank you.

        • Kay Derochie

          Dear Michael,

          I suggest that you ask your local Social Security office to give you a copy of the regulations that govern voluntarily stopping Medicare after disability. You can read about the Extended Period of Disability and Medicare continuation in the Red Book at http://www.ssa.gov. You can also try looking through the abbreviated POMS (Social Security’s procedural guidelines) at https://secure.ssa.gov/poms.nsf/home!readform. Another possibility is to check http://www.healthcare.gov.

          Sincerely,
          Kay

          Sincerely,
          Kay

          Sincerely,
          Kay

  • Carol

    I’ve been on SSDI since 2008. I’m finally able to return to work part time even though my medical issues are not fully resolved. The work I’m doing (bookkeeping) is part time, pays well per hour, and is very flexible. The income will really only be replacing the SSDI benefit, but feeling productive again is important to me. Ill be earning enough that my cash benefits will cease after 12 months, but I understand that I can remain on Medicare for 7 years.

    Because the cash benefits weren’t sufficient to cover expenses, I’ve been taking annual disbursements from my IRA to supplement my income. Because I’m disabled I was able to avoid the 10% early withdrawal penalty but still had to pay income taxes on the funds.

    If I’m not receiving cash SSDI benefits, but remain on Medicare as my health issues are not resolved, am I still considered disabled in regard to the IRA access without penalty?

    • Kay Derochie

      Dear Carol,

      My guess is that you will not be able to avoid the penalty; however, you should pose your question to the IRS and/or to your IRA plan administrator.

      Sincerely,
      Kay

  • Che

    Hello,
    I got a letter stating that my medicare will be terminated in 09/2015 but I’m still a kidney transplant patient & still taking anti-rejection medications. I’m only working part time 20 hrs a week due to my health condition. What’s best thing to do.? Need help..

    Thanks,
    Cheryl

    • Kay Derochie

      Dear Che,

      I suggest that you double check with Social Security; however, I believe that entitlement for Medicare only (without disability benefits) based on renal failure is available only while you are on dialysis.
      If you have lost coverage, you can apply for insurance under the Affordable Care Act (Obamacare). You must apply within sixty days of termination of Medicare or you will have to wait until the annual open enrollment period in the last quarter of the year. More information is available at http://www.healthcare.gov.

      As an aside, if you are earning less than $1,090 per month and your health is the reason for limited earnings, you might be eligible for Social Security Disability benefits.

      Sincerely,
      Kay

  • amber

    I went back to work full time 2 years ago and dropped my medicare insurance per my request because i was covered under my employers plan. i am starting a new job that does not provide health insurance and i want to buy it in the marketplace. however, the advisor i spoke with at the marketplace said i can not buy insurance even though i dont have medicare coverage now because i am “eligible” for medicare. i went to the social security office and they said i am eligible for medicare for 96 months after my work trial period has ended. i asked if i could discontinue my “eligibility” and they told me no. why cant i discontinue eligibility?

    • Kay Derochie

      Dear Amber,

      You are eligible for Medicare whether or not you wish to use it. You currently have Part A which covers hospital stays and some other services at no cost to you and you also have the option of purchasing Part B for doctors and other outpatient services, Part D for prescription. Many Medicare supplement policies are available for what Medicare doesn’t cover. The cost might not be more than the exchange insurance.

      Sincerely,
      Kay

      • Ruthie

        I went back to October 2013, after being on disability. I had been covered on my husbands health insurance since September 2011 and did not need nor want part A or part B. Now I am being told I cannot opt out of part A even though I have been working for 1-1/2 yrs. not receiving any disability benefits.

        My health insurance says that Medicare is primary but I only have part A and I have not had any hospital services only dr appointments. Anthem is not paying the full benefit amount all of a sudden. I have been on the phone multiple times with SSA Medicar Anthem and the company billing the services. Every person I talked to told me something different. I’m so confused. Any insight?

        I want to opt out of Medicare Part A

        • Kay Derochie

          Dear Ruthie,

          You cannot opt out of Medicare Part A. It is an earned benefit that you paid for with Medicare taxes and does not now require a premium. There are a few outpatient services that are covered by Part A. You can look up what is covered to see if the claims that aren’t being paid in full are Part A services. If so, the charges may be paid in full once Medicare Part A pays. If that is not the case, then it sounds as if your problem is a processing error on the part of your insurance company and not related to having Part A Medicare.

          Sincerely,
          Kay

  • Kathleen Zipperer

    My Brother-in-law receives SSDI. He also receives full time disability pay from his former employer and receives excellent medical benefits from them. He has recently gotten the medicare card sent to him effective in April. He does not want medicare (nor does he need it) until age 65. He is 54 now. Will signing the medicare card on the back “I do not want medical insurance” be sufficient to stop the medicare coverage from starting with no penalty if he needs it later? Thank you.

    • Kay Derochie

      Dear Kathleen,

      If your brother-in-law declines Medicare now, when he wants it, he will pay a higher premium for it. To stop the Medicare, he needs to make a written request to have it stop effective with a certain month–not just a note on the card. Also before he does this, it might be a good idea for him to check with his current medical insurance carrier to be sure that they don’t require him to keep Medicare if he is eligible for it as some companies require. If that is the case, he would likely still have coverage through his employer’s policy, but both Medicare and the private insurance company would pay on medical bills. He can learn more about Medicare at http://www.medicare.gov.

      Sincerely,
      Kay

  • Roger Flemming

    I returned to work last year and am no longer receiving SSDI as per my own request. I feel very confident that I will not need SSDI again.

    I had been automatically enrolled in Medicare but I never used any Medicare services.

    In the year before I returned to work SSA asked me if I was still disabled. I replied yes because I knew I met the legal definition. But I am now able to work and support myself.

    I firmly do not want to return to SSDI or be on Medicare. I want to buy health insurance through the Marketplace Exchange. I applied through the Healthcare.gov website and was approved ***pending submitting proof that I am not enrolled in Medicare.

    I called SSA and they said they would send me a form asking to be disenrolled from Medicare. QUESTIONS:

    1) Will filling out that form be sufficient to prove to Healthcare.gov that I am not enrolled in Medicare? Or do I need some further letter from SSA?

    2) What reason should I give for requesting disenrollment, given that I reported the previous year that I was still disabled? Will the reason that I give determine whether my request is approved and whether I can buy insurance from the Marketplace?

    Do you have any further advice about this? Thank you very much.

    • Kay Derochie

      Dear Roger,

      I am not an expert on Medicare and Marketplace Exchange enrollment under the Affordable Care Act. Proof of the date Medicare ended is needed to show that you are eligible for a special sixty-day enrollment period and don’t have to wait until the next enrollment period to enroll. I believe (but am not sure) that the ACA is not for individuals who are eligible for Medicare.

      You probably need a letter from Social Security saying your Medicare has ended to prove termination. The letter probably will not be sent until you request termination because you have Medicare protection for a length of time after you return to work, if you wish to continue it. As far as the reason, you would tell the truth–you are working and no longer disabled. How that will impact eligibility in the Marketplace, I cannot answer. (If you haven’t already, before you cancel your Medicare, it might be a good idea to find out how much your premiums will be for insurance comparable to Medicare through the Marketplace Exchange to be sure you can afford it.)

      Sincerely,
      Kay

  • Jake

    Hello. My SSDI payment (should) will stop because I had earnings over the limit for October, November and now December. I reported the increased earnings in October and they finally sent me the paperwork acknowledging my increase. I believe my work will continue at higher than SGA. I am now filling out the “work review” paperwork but have not received anything about a medical review yet. I am well past my TWP (ended in 2008) and the 36 month extended entitlement period. How quickly do they terminate (shut off) my Medicare? They still sent me a check in November so I know I will have to return the funds. I have still been using my Medicare insurance. But, I feel that I am back to work now and would no longer meet the disability requirements in a medical review (which is a very good thing!) So if I have to re-apply for Medicare since I am with in the 93 months I wouldn’t get it since I work above SGA and would not pass the medical review. Do they turn off my Medicare instantly or will it be good at least until they notify me they have terminated it or will they back date the termination to October 1 and deny any claims out there? Or, will it still be active while I go thru the current work review paperwork or while I go thru a future medical review? Thanks!

    • Kay Derochie

      Dear Jake,

      If you have recovered medically, you may not be eligible for all the return-to-work incentives including continuation of Medicare. If you are eligible because you are within the ninety-three-month Medicare continuation period you do not have to re-apply for Medicare. The coverage should continue automatically. I suggest that when your return the incorrect payment, you tell the representative that you believe you are no longer medically disabled. If Medicare stops, you have thirty days to enroll in an insurance plan through the Affordable Care Act (Obamacare). You can get more information at http://www.healthcare.gov.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • George

    I stopped receiving SSI due to overpayment because I working. I know I can continue to get Medicare provided I pay for it out of pocket. When I called SSA they said I am eligible for Medicare for five years after the ending of SSI. Have you ever called SSA? You never get the same answer twice. So is this true? And, thank you for this article and your time and attention to this issue.

    • Kay Derochie

      Dear George,

      I can see from the information you provided that you were receiving Social Security Disability (SSDI) not SSI, which is Supplemental Security Income.
      It is correct that Medicare can continue for fifty-six months, which is close to five years, after you exhausted your Extended Period of Disability and benefits were terminated.

      Sincerely,
      Kay

  • Margaret

    If u are not renewed for ss disability do checks stop immediately?

    • Kay Derochie

      Dear Margaret,

      Whether or not checks stop immediately depends on the reason you are no longer eligible for Social Security Disability benefits.

      Sincerely,
      Kay

  • Deb

    I am interested to know if your advice helped Tom? Did he write the letter you suggested and did that take care of the problem? I have been fighting this for 3 years with my employer provided insurance plan and have gotten nowhere. I went to my local Social Security office and they were of no help. Their advice was not to dis-enroll in Part A because when I need it at retirement age that will pose a problem.

    • Kay Derochie

      Dear Deb,

      I have no more information about how Tom handled his situation than is posted on the site. I assume that the information that Social Security gave you about dis-enrolling from Part A Medicare (which does not have a premium) is correct. Dis-enrolling in Part B Medicare and then applying for it later could result in an increased premium. Additionally, one has to wait for the open enrollment period at the end of the calendar year and the insurance does not become effective until the following July 1.

      Sincerely,

      Kay

  • Fantastic! Incredibly unusual piece of writing. I am storing this web page currently. With thanks!

  • Tom

    My disability benefits will be ending next month due to returning to work. I have the opportunity to receive health coverage paid for by my employer. Can I withdraw for Medicare Part A and B because I will not need it?

    • Kay Derochie

      Dear Tom,

      Congratulations on returning to work.

      If your Social Security benefits stop and you are eligible for continued Medicare while working and not receiving benefits, you will receive a bill for Part B Medicare and Part D for prescriptions, if you had that coverage. Both Parts B and D will stop if you stop paying the premium. Before you make the final decision, I suggest that you discuss with both Social Security and your employer whether there is any negative impact of your not continuing Medicare for which you are eligible. One thing to consider is that some employer plans require people to be enrolled in Medicare if they are eligible and it would be a good thing to find out if your employer’s plan has such a provision.

      The Disability Advisor

      • Tom

        Thank you so much for your advice. I recently ran into a problem with providers because I was on the group health plan with my employer. I discontinued Part B in April 2012. I was seen by providers and billing issues cam about because Blue Cross was stating Medicare was my primary, which I do not want, and they terminated my coverage due to that reason. I can get back on the group plan only if I no longer have Medicare. I do not want Medicare. My question is being that I no longer receive disablity benefits, can I discontinue Part A without paying any penalties? I have never used Part A so there has been no benefits paid through Part A. I thank you. You have provided me with more info in a small paragraph than the reps I have spoken to on the phone. It has been very confusing and also very frustrating to say the least.

        • Kay Derochie

          Dear Tom,

          I suggest that you write a dated letter to the Social Security Administration asking them to discontinue your entitlement to Part A Medicare immediately. Explain that you have returned to work and do not want the coverage because you want your employer’s insurance to pay. Request that they send you notification when it has been canceled.

          I would deliver the letter in person if possible. That way, if there is some other procedure you have to follow, you will find out what it is right away. Also, you will be able to ask how long it will take for the coverage to be canceled. If the person at the front desk can’t tell you whether the letter is adequate, ask to speak to a claims representative or a supervisor.

          We would appreciate your letting us know if our suggestion works and, if not, what you learn about the correct procedure.

          The Disability Advisor

          • Tom

            Thank you. I will let you know.

  • Moderator

    Hello Michelle,

    Whether or not you can continue to have Medicare insurance coverage after your Social Security Disability benefits end depends on your personal circumstances.

    If your benefits stop because you are no longer disabled, even though you still have health problems, then your Medicare will not be extended.

    On the other hand, if your benefits stop because of work activity, your Medicare may be extended as explained is the article you commented on.

    To understand your rights around Medicare given your specific situation, I suggest contacting the Social Security Administration.

    If you are not eligible to have Medicare continued, your state’s insurance commissioner is likely to have a list of companies selling health insurance in your state. You might also contact your county or state social services department to see whether they have any options for you.

  • Michelle

    I was wondering if it was determined that I no longer can receive benefits from SSD. Is there any way to continue receivign Medicare benefits. Obviously I was on SSD for a reason and I still need to receive medical help. SO wondered if there is anyway to continue Medicare or how to get insurance.

    • Kay Derochie

      Dear Michelle,

      If it has been determined that you are no longer disabled, your Medicare will stop when your SSDI stopped. If your benefits are stopping because of your work activity, Medicare will continue for fifty-four months. If your Medicare stops, you can apply during the next sixty days for insurance under the Affordable Care Act and possibly get a government subsidy to help with the premiums. More information is available at http://www.healthcare.gov.

      Sincerely,
      Kay

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