If I am approved for Social Security Disability, will I be eligible for Medicare and Medicaid health insurance?

By / March 3, 2016 / Social Security Disability & SSI Basic Facts / 400 Comments

Learn about Medicare and Medicaid medical insurance and how you can qualify for Medicare with Social Security Disability and Medicaid with SSI.

Medicare for Social Security Disability Beneficiaries
If you are eligible for Social Security Disability, you are entitled to Medicare after you have received twenty-four months of disability benefits, including any back-pay months. Because benefits begin after five full months of disability, Medicare starts in the thirtieth calendar month of your disability.  The waiting period will be waived if you have permanent kidney failure requiring regular dialysis or a transplant or if you have amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig’s Disease.

The Three Parts of Medicare
Medicare consists of three kinds of coverages. Medicare Part A does not require a premium. You paid for Part A when you paid Medicare payroll or self-employment taxes while you were working. Part A Medicare covers hospitals, hospice, and other benefits. Both Medicare Part B, which is for doctors and most outpatient services, and Medicare Part D, which is for prescription medication, require payment of a monthly premium.

Medicaid for Supplemental Security Income—SSI—Recipients
Medicaid is a separate medical insurance program. There are many ways to qualify for Medicaid, but eligibility for Social Security Disability is not one of them. In general, Medicaid provides health insurance coverage for people who have limited income and assets and meet other requirements. For example, people who are eligible for SSI receive Medicaid at no cost. You may also qualify for Medicaid coverage with programs available through your state or county human services department.

For information about continuation of Medicare after Social Security benefits have ended due to work, see our article Can I Keep Getting Benefits When I Am Working on Social Security Disability?

If I am approved for Social Security Disability, will I be eligible for Medicare and Medicaid health insurance?
2.25 (45%) 4 votes

  • Dear Cheryl,

    There is no guideline of the type you refer to. The payee should pay for shelter, food, medical care, hygiene items, basic clothing, transportation, and other basic necessities first. If money is left over, then more discretional needs and desires could be paid for such as entertainment and personal spending money. Money can be saved for future needs or larger special purchases if the disabled person’s current needs are being met.

    Sincerely,
    Kay

  • Thank you for sharing, Jose.

  • Dear Jackie,

    I suggest that your daughter contact her physicians and other providers to find out if they accept Medicare. If they do then all she may need, if she can afford it, is a Medicare supplement policy to help cover the annual deductible and co-pays. One way to identify such policies is to contact an insurance agent who sells health insurance policies including Medigap (supplemental) policies and Medicare Advantage plans (usually at HMOs). The agent will be able to help analyze the best coverage for your daughter based on her needs and access to her providers and will be able to illustrative comparative costs.

    Sincerely,
    Kay

  • Dear Cindi,

    The county office should be able to tell you whether or not you are eligible for MediCal to pay your Medicare premiums when you are no longer eligible for SSI. The Social Security office would have no control over the issue.

    Sincerely,
    Kay

  • Dear CW

    You correctly used your child’s dependent benefits while he lived with you for his shelter (part of the mortgage) and his food and clothing, school supplies, entertainment, etc. You do not say who he lived with after you divorced. If he lived with his mother and you gave her money for his support or otherwise spent the money on him, you have used the money properly.

    Sincerely,
    Kay

  • Dear Earl,

    I do not know the answer to your question, but logically it is possible because the extra help program is to assist people who are having trouble paying the premium. I suggest completing the application and getting a decision.

    Sincerely,
    Kay

  • You are welcome, Earl.

  • Dear Linda,

    If you are approved for Social Security Disability (SSDI), you will be eligible for Medicare after you receive twenty-four months of benefits including any back pay months. If you are approved for Supplemental Security Income (SSI), you will be eligible for Medicaid as soon as SSI starts. The SSDI and SSI received are income. SSDI and Medicare does not have resource limits. Back SSDI and SSI benefits that you save do not count as a resource for SSI (and Medicaid eligibility based on SSI) until nine months after the back pay is received.

    Sincerely,
    Kay

  • Dear Rosemary,

    You should have received a notification of automatic enrollment for Medicare at least a month before the insurance starts and with twenty-four months of Social Security Disability benefits ending in April, Medicare should start in May. I suggest that you call Social Security to inquire about the status of the benefit.

    Sincerely,
    Kay

  • Tori Parrish

    if i am on a medicaid waiver program in the state of florida
    and they want to discharge me can they cause me to lose my disability benefits? I have medicare and medicaid also

    • Dear Tori,

      Could you please explain what you mean by “discharge you” and tell me which kind of disability benefits are you receiving. When I hear back from you, I will try to answer your question.

      Sincerely,
      Kay

  • Dear Earl,

    You are due at least twenty-four months of back pay. I would have to know your application date and established date of disability onset to give you the specific number. Social Security Disability (SSD aka SSDI), benefits begin to accrue the later of twelve months before the month you applied or the sixth full calendar month of disability, as established by Social Security.

    Sincerely,
    Kay

    • earl

      Thank you Kay …here’s the on set date my disability started October 9th of 2014.

      • Dear Earl,

        At this point you are eligible for twenty-five months of back pay from April 2015, the sixth calendar month of disability through April 2017. For each additional month you wait for monthly benefits to start, one more month of back pay will accumulate.

        Sincerely,
        Kay

  • Dear Matt,

    I suggest starting with your local state or county social services department to see if your son qualifies for Medicaid under some criteria other than SSI eligibility. You might also look into the Children’s Health Insurance Program (CHIP). Information about CHIP is available at http://www.healthcare.gov. Another idea is to contact the nearest Shriners organization. The Shriners have been providing hospital care and surgical care for children for many, many years. Their service is not limited to “crippled children,” which is what they are the most known for. Lastly, if he is within sixty days of losing Medicaid, he would have a personal open enrollment period under the Affordable Care Act, where you might find coverage with a government subsidy to cover part of the premiums.

    Sincerely,
    Kay

  • Dear Jason,

    I do not have information about the income guidelines for Medi-Cal. I suggest that you contact a Medi-Cal office for information about their income limits.

    Sincerely,
    Kay

  • Dear J.,

    I was unable to find anything that addresses your question in my research. I did find that our housing allowance would count to reduce early retirement benefits while you were still working, so it is possible that the allowance also is counts when determining substantial gainful activity. I suggest that you contact Social Security to get an answer and that you request a copy of the regulations that state that it does or doesn’t count.

    Sincerely,
    Kay

  • Dear Kellie,

    Each benefit program has different rules. Most benefits that are based on financial need (welfare programs) count money only when it is received because a person can’t pay for things with money that is accruing and not paid. Conversely, when sufficient money is received that the need for assistance ends (at least for a while), the assistance ends.

    Sincerely,
    Kay

  • Dear Kellie,

    Termination of Medicaid is not punishment. Medicaid is a needs based medical insurance for people with low income and assets. Your ineligibility for Medicaid is due to the large back pay is because the back pay money is available to cover your premiums and medical expenses including medications. I suggest that you clarify the point at which you will become eligible for Medicaid (and Extra Help) again if you use the back pay for medical expenses.

    You might also be able to enroll in a Medicare gap or advantage insurance that would provide prescription coverage. You will have a sixty-day personal enrollment period after your Medicare starts. You could use some of the back pay to pay the Medi-gap or Medicare Advantage premiums.

    Sincerely,
    Kay

  • Dear Susan,

    Medicaid based on SSI eligibility will stop. Your son can apply for Medicaid to see whether he qualifies under any other Medicaid eligibility criteria.

    Sincerely,
    Kay

  • Dear Karla,

    You do not have sufficient work credits to receive Social Security and you will not qualify for Medicare until you are age sixty-five. If the Affordable Care Act (ACA) is still in existence next open enrollment in the last quarter of the year, you might try getting your insurance through the ACA to see whether you would be eligible for a government subsidy to help you pay the premiums.

    Although you might have a public pension offset, you might qualify for divorced spouse’s benefit when you turn sixty-two or disabled surviving divorced spouse’s benefits at age fifty if he dies.

    Sincerely,
    Kay

  • Dear Stephen,

    Supplemental Security Income (SSI) paid for disability is paid to disabled persons from as young as infancy to as old as up to age sixty-five. I think that the SSI denial you got may have been a medical denial, which considers age in determining whether someone can work in a new occupation. Regardless of what happened in the past, you can apply for SSI now that you have already been medically approved for SSDI.

    Sincerely,
    Kay

  • Dear Steve,

    It sounds as if your Medicare premiums may have been paid by the Medicaid program and you lost eligibility for the Medicaid program. However, that is just conjecture on my part. I suggest that you contact the office that set up the premium payment for you to find out the reason and get any errors corrected.

    If you don’t qualify under whatever rules you initially did and if your only income is $748 gross Social Security and you are not married or your spouse’s income is low enough, you might qualify for a small amount of Supplemental Security Income (SSI), which would give you Medicaid in most states. SSI applications can be filed at your closest Social Security office or by telephone appointment if necessary.

    Sincerely,
    Kay

  • Dear Barbara,

    I am unable to answer your question because your state administers Medicaid. I suggest that to report the change to the state Medicaid office when you start receiving the additional benefit. They will be able to tell you whether or not Medicaid will continue.

    Sincerely,
    Kay

  • Dear Ian,

    Given that your income won’t be changing, you may continue to be eligible for Medicare. If you are able to remain on Medicaid, the Medicaid program will probably pay your Medicare premiums. If not, I suggest investigating Medicare’s extra help program, which provides some assistance with Medicare premiums. More information about it is available at http://www.Medicare.gov.

    Sincerely,
    Kay

  • Dear Sean,

    You need to check with your state social services offices to find out whether you qualify for Medicaid. If you are not going to be able to work for a period of twelve months, I recommend that you apply for Social Security Disability (SSDI) now while you have some income to support yourself while your SSDI claim is being processed.

    Sincerely,
    Kay

  • Dear Nancy,

    She needs to report the receipt of divorce settlement proceedings to the food stamp and Medicaid office to find out whether either entitlement will stop. If so, she may need the money for food and medical care. That office can also tell her what she can use the money on to spend down to again be eligible for food stamps and Medicaid.

    If she gets Social Security, as far as the Social Security goes, she can spend it on anything she wants. If she gets SSI, the same is true as long as she does not give the money away and keeps receipts.)

    Sincerely,
    Kay

  • Jennifer Waldron

    I have Social Security Disability. I make just over the amount to receive SSI as well. I have Medicare as well and also make just over the amount to get Medicaid in the state of NY. Which is ridiculous, Im now disabled to the point where I’m in the hospital every few months. The Medicare Plans I’ve had in the past crushed my little over $1000 month with I get to live off..With high copays. I get so.little I end up giving it back… But I have a lot of medical bills will that help me get Medicaid & avoid a spend down which I absolutely cannot afford??? I have ALOT of medical procedures & so on coming up I was told by three different social workers to get Medicaid & do a spend down but that leaves me with nothing.

    HELP!!!

    • Dear Jennifer,

      I am unable to answer your question about Medicaid. One small help would be to apply for “extra help” with your Medicare premiums, which will lower your Medicare premiums. Information about this is available at http://www.medicare.gov.

      For a longer term solution, if you are a renter, you might try to get into government subsidized housing to lower your shelter costs. If you own your home outright, you could consult with banks about a reverse mortgage in which you would sell your house to a bank while you continue to live in the home indefinitely.

      Sincerely,
      Kay

  • Dear Donald,

    When determining substantial gainful activity (SGA), earnings count when earned, not when paid. However, because three bi-weekly or five weekly paychecks in a month can make it look as if you are earning more than SGA if an analysis is not made of when the money was earned. If the pay stubs show the dates the payment covers, you can divide out the payments in a single month to attribute them to the actual month earned to show that the work is still below SGA in all months. I suggest being proactive in doing this and keeping your pay stubs and a copy of the calculations you give SSA indefinitely in case questions come up in the future.

    Sincerely,
    Kay

  • Dear Susan,

    Your son’s Medicaid eligibility based on SSI eligibility will end. It is possible that he might be eligible for Medicaid based on other criteria. He can investigate this by contacting his closest state or county social services office.

    Sincerely,
    Kay

  • Dear Rae,

    It looks as if you posted your question twice. Please see my response to your first posting.

    Sincerely,
    Kay

  • Dear Linda,

    Your SSDI and Medicare will not be affected by having a roommate. I think that you may have meant to type Medicaid in addition to Medicare. If so and if your eligibility for Medicaid depends in part on how much you are paying for housing, then having a roommate reduce your housing costs could affect your Medicaid eligibility. I suggest you check with the Medicaid office on this point.

    Sincerely,
    Kay

  • Dear Ken,

    Medicaid eligibility accompanies Supplemental Security Income (SSI) eligibility in most states; however, SSI eligibility is not the only way to qualify for Medicaid. I suggest that you inquire at your local state or county social services office about the various paths to Medicaid. If that is not successful and your son is under age eighteen, he might qualify for insurance under the Children’s Health Insurance Program (CHIP). Information about CHIP is available at http://www.healthcare.gov.

    Sincerely,
    Kay

  • Dear Antisocial,

    Any medical facility can have any payment requirements they deem fit. Presumably, they expect your husband to have a lot of out-of-pocket expenses for deductible and co-pays that the Part B Medicare would cover. I suggest that you look into what Part B Medicare pays for kidney treatment either by asking the kidney center or by calling Medicare claims department. I know that is pays for dialysis, but presumably your husband would not need ongoing dialysis after surgery.

    Sincerely,
    Kay

  • Dear Rae,

    You will remain on Social Security Disability if you remain disabled until you reach full retirement age, which for you is age sixty-six.

    Sincerely,
    Kay

  • Dear Beauty for Ashes,

    Medicare starts after twenty-four months of benefits including benefits paid for past months. I do not know whether someone will come to your home, but there are insurance agents who can provide an overview of the different plans comparing the services you need with the coverage each company offers and comparing the prices and deductibles and co-pays. There is no charge because they will be paid a commission by the company you select. You can also contact our state Insurance Commissioner’s office to ask for resources in your area.

    Sincerely,
    Kay

  • Dear Pat,

    If you drop Medicare and want to pick it up later, you will pay a higher premium. You will only be able to enroll at the end of each year during the open enrollment and the insurance will not become effective until the following July. Before you cancel, I suggest that you check to see if Medicare Extra Help would help you better than the Medicaid spend down. More information about the Extra Help is available at http://www.Medicare.gov. Also, if your drop Medicare, you may lose the Medicaid as well; I suggest that you check with the Medicaid office to inform yourself before making a decision.

    Sincerely,
    Kay

  • Dear Andy,

    Of course, you will have to make the decision what to do about your insurance, but I can offer you some information and thoughts. If your wife were to become unemployed or had to change employment to an employer that did not offer health insurance and you cancel Medicare, you would be left with no insurance for doctors and most outpatient testing and some other services. (Part A for hospitals, hospice, and some other services does not require a premium.) If you cancel Medicare, unless you re-enroll in a personal enrollment period within thirty days of losing your insurance through your wife, you will only be able to enroll in the last quarter of the year and coverage will begin the following July. Lastly, when you go back on Part B Medicare, your premiums will be higher than normal because you did not keep continuous coverage.

    Sincerely,
    Kay

  • Dear Christine,

    Your child will not be eligible for Medicaid based on your Medicare, but he may be eligible for Medicaid based on other rules. I suggest you check with your closest state or county social services office. If he is not eligible for Medicaid, check for eligibility under the Children’s Health Insurance Plan (CHIP). More information is available at http://www.healthcare.gov.

    Sincerely,
    Kay

  • You are welcome.

  • Dear Craig,

    At age 71, your father is not eligible for disability benefits because disability benefits are paid only to individuals who are younger than full retirement age. Although Supplemental Security Income (SSI) benefits are paid to individuals age sixty-five or older, your father’s income is too high for SSI unless he is married and living with a spouse who has no income.

    Sincerely,
    Kay

  • Dear Rae,

    Your can talk with your state social services office to see whether you qualify for Medicaid under any of the Medicaid access paths. If not, you might quality for Extra Help to help pay your Medicare premiums. More information about this is available on http://www.medicare.gov.

    Sincerely,
    Kay

  • Dear June,

    Your best option for getting the rehab taken care of is probably the $1,000 spend down if there is any way you can swing it. With regard to the outstanding medical bills, I suggest contacting the providers and telling him that he has had a second stroke, is in rehab and half his income is going to Medicaid spend down to pay for the rehab. Ask if they have any programs that would reduce or eliminate part of the debt. Most hospitals do some write offs and even doctors’ offices will sometimes provide some relief. Expect to have to fill out financial statements showing your fiances income and expenses as part of the application for debt relief.

    Sincerely,
    Kay

  • Dear Mel,

    Typically Medicaid will require you to take Medicare when you become eligible, but typically Medicaid will pay the Part B and Part D premiums.

    Sincerely,
    Kay

  • Dear Barryn,

    Medicaid and SNAP (food assistance) are needs-based public assistance programs. It is likely correct that when your income increased your eligibility ended. If, however, you have not submitted your current housing and medical expenses to SNAP, you might do so to see whether the family is eligible for any food stamps considering your increased medical expenses. You might also find out whether you qualify for any Medicaid buy-down program, where Medicaid picks up after you have paid a certain amount. Lastly, you have sixty days after termination of insurance to enroll in an insurance through the Affordable Care Act with a possible government subsidy to help with premiums and/or your children may qualify for the Children’s Health Insurance Plan (CHIP). Information about both can be found at http://www.healthcare.gov.

    Sincerely,
    Kay

  • Dear Mary,

    I suggest contacting the Medicaid office.

    Sincerely,
    Kay

  • Dear Ashley,

    Your husband can look to see what options are available under the Affordable Care Act by going online at http://www.healthcare.gov. If he lost his insurance in the past sixty days, he is entitled to a personal enrollment period. Other resources to gather information about policies available in your geographic area are a medical insurance broker and/or your state Insurance Commissioners office. You can also search online. Input “health insurance + the county and state you live in.”

    Sincerely,
    Kay

  • Dear Ricardo,

    Your Medicare eligibility will begin twenty-four months after the month for which benefits were first paid, which would not be the date of your disability onset and likely would not be the date on which your claim was determined.

    Sincerely,
    Kay

  • Dear G.,

    You can decline Part B Medicare and keep your cash benefits. Just be aware that if you do and then want Part B in the future, you will pay a higher premium and will be able to enroll only during the open enrollment in the last quarter of the year with coverage beginning the following July.

    Sincerely,
    Kay

  • Dear David,

    An individual who is twenty-two when disability began and has not worked enough to be covered by Social Security will not be eligible for Medicare. The individual could possibly be eligible for Supplemental Security Income (SSI), which does not have a work credit requirement for U.S. citizens and some legal aliens. In most states SSI eligibility automatically makes a person eligible for Medicaid.

    Sincerely,
    Kay

  • Dear Shelley,

    Social Security Disability (SSD aka SSDI) provides Medicare (not Medicaid) insurance after two years of benefits. Many private health insurance policy have a provision in them about Medicare entitlement and how the two insurances coordinate. The spouse can request a copy of the policy and read through it for information about Medicare. If it is not mentioned, then presumably you can use both or just the private. The maximum paid from both if you use both is likely to be the highest amount the private insurance pays.

    Supplemental Security Income (SSI) eligibility provides Medicaid insurance immediately in most states. The private insurance probably does not address Medicaid entitlement. If it doesn’t, you can just not use the Medicaid card and present only the private insurance coverage.

    Sincerely,
    Kay

  • Dear Kris,

    The notification may be automatic or taken care of by Medicaid office staff because usually Medicaid entitlement will result in Medicaid paying the Medicare Part B premium. Then when you go to the doctor, you can present both cards. However, I suggest that you ask the Medicaid office to be sure how coordination is handled.

    Sincerely,
    Kay

  • Dear Sue,

    Double dheck with the Medicaid office, but I believe that you can own one vehicle and still be eligible.

    Sincerely,
    Kay

  • Dear Naomi,

    I think that being given Medicaid is the government subsidy your husband is eligible for. Depending on which Medicaid program your husband is on, he will have either no premium, deductible, and/or co-pays or very low ones including for prescription medication. So, even though he will have to change doctors, the insurance is very favorable financially. Your Medicare entitlement will not be affected.

    Sincerely,
    Kay

  • Dear Paula,

    To help you make the insurance decision, check with each of the doctors to see whether each accepts Medicaid. I think that if they do accept it they have to accept what Medicaid pays as full payment. If the doctors do not accept Medicaid, you could just keep your son enrolled in the current plan to keep the current doctors and not use the Medicaid.

    You can double check this with the state Medicaid office or in the packet you received, but I think that Medicaid insurance that comes with SSI eligibility does not require any co-pays or deductibles for either medical services or prescription medications, so the issue of using Medicaid to pay co-pays and deductibles would be moot. If more information is needed, you could talk to the current insurance company to find out whether benefits can be coordinated between the two coverages and how. (Note that it is rare that two insurances can be combined to provide 100% coverage. Also, as noted above, coordination may not be possible.)

    Sincerely,
    Kay

  • Dear Kathy,

    If the Indiana Health Plan is not a Medicaid plan or one with different requirements and coverage, you will be switched over to Medicaid based on Supplemental Security Income (SSI) eligibility within a month of final processing of your SSI payments.

    Sincerely,
    Kay

  • You are welcome, Linda.

  • Dear Linda,

    With a disability onset date of December 2014, your husband’s benefits would have started June 2015 and his Medicare eligibility should begin June 2017 after he has received twenty-four months of benefits. He will be notified automatically by at least May.

    Sincerely,
    Kay

  • Dear Fernando,

    Just a point of clarification; the benefit you have been receiving has not been SSDI; it has been Supplemental Security Income (SSI). Loss of SSI resulted in loss of Medicaid based on SSI eligibility. You might contact your state or county social services office to find out whether you quaify for Medicaid under other rules. Another resource might be to apply for health insurance under the Affordable Care Act to see if you can get a government subsidy to help with the insurance premiums. Information is available at http://www.healthcare.gov, where you can also file an application.

    Sincerely,
    Kay

  • Dear Virginia,

    I’m not sure what your situation is. Are you saying that if your daughter has Medicaid, you cannot keep her on your health insurance through another source and that you want to dis-enroll her from Medicaid? If so, I don’t think the Social Security Administration has anyway to do that. The SSI approval sends an automated notice to the state’s Medicaid department, which triggers enrollment.

    You might be successful in dis-enrolling her if you submit a written statement declining Medicaid for her and send or take that to the state or county social services office that handles food stamps and Medicaid applications.

    Please let me know if this works.

    Sincerely,
    Kay

  • ALD

    Thanks for the excellent and easy to read answers! I hope you can help me; I have been getting the run around from both Social Security and Medicaid (MAHealth).
    I am 52 years old and have a 13 year old dependent son for whom I share legal custody; I have physical custody over 50% of the time.. My son’s father is court ordered to pay his health insurance. I have been on SSDI since 2005. I get a check for $1172 for myself, and another check for $586 for my son (as my dependent). From that I have Medicare Part B deduction of $104.90, and Medicare Part D ($23.40 as of 10/1/16, which will increase to $32.50 on 1/1/17-the only way to have certain medications covered was to change from a 0 cost Part D plan to this new Part D plan as of 10/1/16) and I send a check to Medicaid each month for $26, for a total deduction of $154 now which will go up to $163 on 1/1/17. I receive a full Extra Help subsidy with Part D or it would be even higher! I have 5 monthly medications now, one a non-generic, for a total of @$20 a month, and also have unreimbursed medical costs of @$200 for acupuncture (when I can afford it!) and another $60-$75 for OTC
    medications. In the past, Medicaid paid my Medicare Part D premiums. I was then told that I missed the income threshold cutoff for payment by Medicaid by a few dollars, and I have been paying as above for several years. My question is 2 part: what is the income cutoff for Medicaid (MaHealth) to pay for Part B (and/or the new Part D) premiums? And is the income solely my SSDI income or is the dependent check I receive for my son included (in other words, since SSDI is my sole source of income, are subsidies based on my check or the family total (my check plus my son’s dependent check)
    And since I am asked every time I try to get the $$ income levels for Medicaid to pay for Medicare premiums–I AM DISABLED and on SSDI–my son is not disabled and at sge 13, he does not have any income to contribute; our family income includes my SSDI check and the dependent SSDI check which helps with the care of my minor son). I know this is a lot of facts and figures but I wanted to provide as much as possible to assist you.

    Thanks for your assistance!

    ALD

    • Kay Derochie

      Dear ALD,

      I do not have the answers to your questions. I suggest that you ask the government agency that administers the MaHealth program about what the income limits are for Medicaid to pay your Medicare premiums and whether your children’s benefits are counted.

      Sincerely,
      Kay

  • Maria

    Hello,
    About 7 years ago, my mom applied for disability. When the ACA was approved, she was able to apply for an individual healthcare plan. After being on the two years she became eligible for Medicare. Under one of the Medicare clauses, she was able to keep her insurance because she had the insurance before she was eligible for Medicare. Is this rule still valid?

    • Kay Derochie

      Dear Maria,

      I do not know the answer to your question. I suggest that you check the Affordable Care Act website and/or the Medicare website or help line to find out.

      Sincerely,
      Kay

  • Vonda McAllister

    I am 71 and on ssi and medicaid if I marry another senior who was on ss disability and this year was transferred because of turning 66 to social security and has medicare,what would happen to my ssi and medicaid. This is my ex-husband of whom I was married for 14 years and now want to get married again. Would this change my income? I ask because my medicine is thousands a month because of a car accident to my spine,

    • Kay Derochie

      Dear Vonda,

      If you remarry, your husband’s income will be considered in determining whether you are eligible for Supplemental Security Income (SSI) and Medicaid. If you tell me the amount of his Social Security before reduction for Medicare premiums, I will let you know whether you will continue to be eligible for SSI, which in most states makes you automatically eligible for Medicaid.

      Sincerely,
      Kay

  • James Scott

    well i went on disability 2 years ago for fibromyalgia.Now i get a letter from medicare that i am being automatically enrolled.I have been on medicaid and only pay $15 a month for that.My disability check is $1050 and i have to live on that! Now they are going to automatically take out $125 a month from my check for medicare!! That only leaves $975 a month plus i will have to pay more for medical,doctors and prescriptions than i currently pay on medicaid.
    I don’t see how they can force you to take something that costs more…

    • Kay Derochie

      Dear James,

      Medicaid is the insurance of last resort. If you are eligible for other insurance, you typically cannot get Medicaid; however, some people have both Medicaid and Medicare. You may possibly still be eligible for Medicaid. If you are, Medicaid may pay your Medicare premium.

      Sincerely,
      Kay

  • Maribel

    Hi my name is Maribel. My husband is on SS disability since 2011 and has been covered by Medicare since 2013. He received disability based on the arthritis ok his knees. He is considering getting both his knees replaced and the doctor said this may cure his arthritis. Would he lose his SSD and Medicare if he had this surgery?

    • Kay Derochie

      Dear Maribel,

      I can’t predict whether your husband will be disabled according to Social Security law after he recovers from his knee surgeries. It will depend on what his lifting, walking, kneeling, squatting limitations are after the knee replacements and what his work history was prior to becoming disabled.

      Sincerely,
      Kay

  • Hi Mrs Kay I applied for ssdi and ssi my my pcp will not let me work be cause of pulmonary embolism and dvt I’ve also had breast cancer but now in remission I also have arthritis in my feet and knees do you think I would be approved are denied thank you

    • Kay Derochie

      Dear Glenda,

      As you describe your conditions, you may be medically eligible for Social Security Disability benefits.

      Sincerely,
      Kay

  • annie magnum

    Helpful analysis . I Appreciate the points ! Does someone know if my business would be able to get access to a sample SSA-632-BK. example to fill out ?

  • VANESSA

    Hi Kay
    My dad is 100% disabled after a stroke and receives disability and Medicare benefits. My mom who cares for him on a full time basis is also pending her disability application since she herself has several medical issues and is no longer able to work. She does however care for him on a full time basis and my question is if she receives disability benefits can she also apply to get paid for caring for my dad at the same time through Medicaid?

    • Kay Derochie

      Dear Vanessa,

      Whether or not being paid wages to care for your father would affect your mother’s Social Security Disability (SSD) benefits depends on how much she would be earning. Earnings of $810 gross are Trial Work Period (TWP) months during which full benefits are paid. After the nine TWP months, there is an Extended Period of Eligibility (EPE) during which benefits are paid for any month in which earnings don’t reach Substantial Gainful Activity (SGA). Currently the SGA benchmark is $1,130 gross wages. SGA after the thirty-six month EPE cause the claim to be closed. More information about working while receiving Social Security Disability is available in the Red Book, which is available online at http://www.ssa.gov.

      Sincerely,
      Kay

  • Kevin

    My mom is on SSID. her husband of 32 years is divorcing her. She is confused she thinks she’ll be able to get a higher amount of disability but she thinks if she does so she’ll lose her Medicare/medicade. I have absolutely no idea what the truth is I’ve tried to find out the answer online but so far it’s only confusing me now.
    If you can help I would greatly appreciate it. We live in Michigan if that makes any difference m
    Thanks

    • Kay Derochie

      Dear Kevin,

      Divorce does not affect the amount of Social Security Disability your mother will receive. If she is also getting Supplemental Security Income (SSI), the SSI could increase if it has been reduced for her husband’s income. Or, the SSI could be decreased if he moves out and pays alimony. If she loses SSI, she might lose Medicaid. Medicare eligibility, on the other hand, is not tied to marital status or income (though individuals with high income pay higher premiums).

      Sincerely,
      Kay

  • Melinda

    I am on SSDI @ $1306/mo., and have been on Medicare since 7/2015. I also am on Medicaid in Illinois for just over 2 years. I been receiving Plan D coverage (“extra help”) at no cost as a QMB, & Medicaid has also been paying my monthly Medicare premiums.

    I voluntarily disenrolled from Medicaid, effective 8/1/16. I’ve received a letter from Medicaid confirming my disenrollment date of 8/1/16 that also states I no longer am a QMB (qualified medical beneficiary). Does this mean I have lost my Plan D prescription coverage as of 8/1/16, even though I am still at what Medicaid calls an “extra low income” level? From what I can decipher from the qualifications, and since there are other classifications to qualify, I believe I would still continue receiving Plan D coverage even without Medicaid, since my income would still qualify me for coverage. Am I correct?

    Also, since Medicare open enrollment isn’t until December, does this also mean I cannot enroll in a secondary Medicare Advantage or Medigap plan? I am very confused by the differences between these two types of plans and/or which one I should consider signing up for – whether I can do that now or later in the year.

    Also, will I now have to pay the monthly Medicare premium?

    Thanks so much for any assistance or advice you can give me.

    • Kay Derochie

      Dear Melinda,

      Now that you do not have Medicaid, you will have to pay your Part B Medicare premium unless you qualify for governmental premium assistance such as you have for the Part D. I recommend that you double check to be sure your QMB status is continuing for the Part D premium. I believe that you have a personal enrollment period of thirty days after your Medicaid ended to enroll in a Medigap policy or a Medicare Advantage plan. If you do not enroll in that limited period, you would have wait for the open enrollment in November or December.

      A Medigap policy is one that pays some or all of the covered charges, such as deductibles and co-pays, that Medicare does not pay. A Medicare Advantage plan is similar but it wraps Medicare into the plan. These plans are offered by HMO’s–health care organizations–that either provide the services or have a specific list of providers that their plan covers.

      Sincerely,
      Kay

      You can go to http://www.medicare.gov and search for Medigap and Medicare Advantage companies to compare their cost and coverage. alternatively, you can contact your state’s insurance commissioner’s office for a list of such providers in your state. You can then compare the coverages and costs. Insurance brokers who sell the Medicare plans can help you in your analysis.

      Sincerely,
      Kay

      • In 2007 I received disability and received my back pay. I did not qualify for SSI Bc my husband made too much. I have a Medicare advantage plan now. And have had it since 2008. I am 48 years old and my husband passed away at the age of 49 two years ago. I had to move out of our rental house and move in with my dad and stepmom Bc I can’t afford to live on my own since he passed away. I only have $657 deposited every month for disability that’s my only income. Would I qualify for SSI now and Medicaid?

        • Kay Derochie

          Dear GeeGee,

          Your Social Security before Medicare premium deduction is your countable income and it is too high for a federal Supplemental Security Income (SSI) payment. You could, however, check to see if your state has an SSI state supplement that allows somewhat higher income than the federal program. If you become eligible for SSI, in most states you will become eligible for Medicaid, which will pay your Medicare premium. Another possibility is you may qualify for financial assistance to pay your Medicare premium. Information is available at http://www.medicare.gov. Note that when you turn fifty, you can apply for disabled widows benefits if the benefit would be more than you have now.

          Sincerely,
          Kay

          Note

  • I applied for disability in December 2015. I have chronic hypertension and chronic high blood pressure. I had a stroke and heart attack, and my doctors say I am prone to attacks. My blood pressure runs everyday at 200/100 everyday. And when they do get it down to normal I have the shakes and get worse. I have headaches no matter how bad or not so bad they are. I have chest pains every night, sometimes sever and I throw up. I don’t know what I applied for either SSI/SSDI. I am married but separated and been separated for 8 years. He lives in a totally different city then I do. And we have 5 children of which all are grown, except 1. I have Medicaid because my doctors told me I was just not doing good with everything wrong with me. So my question is am I eligible for both SSI/SSDI since I have Medicaid and I take care of my daughter? My case is pending so I just want to know, I have no other income and haven’t worked since February. And why do they take so long, and I have other things wrong with me too. I guess they are waiting till I have another stroke and heart attack.

    • Kay Derochie

      Dear Robin,

      Typical processing time runs two to five months. I suggest that you call the claims examiner at the Disability Determination Services (DDS) to be sure that they have received all the medical records and reports they have requested. If not, you can follow up to get them submitted. Your local Social Security office or the call center at 800-772-1213 should be able to get you the phone number for the DDS that serves you.

      The financial information you gave would seem to indicate that you are financially eligible for Supplemental Security Income (SSI). If you are medically and financially eligible for SSI, your Medicaid will continue. Whether or not you are insured for Social Security Disability (SSD aka SSDI), depends on the amount you have worked, especially in the last ten years. You can be eligible for both benefits ongoing if your Social Security is less than $753 a month and you do not have other countable income.

      Sincerely,
      Kay

      • Robin R Minor

        This is Robin again Mrs. Kay. I don’t work so my Social Security is $0. So does that matter? I really just signed up and don’t know which one. I did it online on my phone. I’ve been seen by the disability doctor they assigned me to. I can barely see and have rheumatoid arthritis in both knees. And when I was living in Fort Worth TX I had 2 specialist and a cardiac specialist. I even had a Home Health Care taker come to my house 2 times a week. Will the Social Security people let me know if I’m eligible for both?

        • Kay Derochie

          Dear Robin,

          Social Security will screen you for Social Security if you apply for SSI because you are required to apply for Social Security if you have the work credits. I was not aware that you could apply for SSI online. If you were asked about your current income and assets, you applied for SSI. All that said, you can call Social Security at 1-800-772-1213 and ask them to clarify which claims you have pending.

          Sincerely,
          Kay

          • Robin R Minor

            Hello I applied for it over my phone online. But I was told it should have been done by Android phone. That was done in December, I didn’t receive a call interview till March 31st of this year. I’m getting worse and I have received 8 letters. But they are not denial letters. My doctor’s and specialist say they can’t figure out why I’m not deceased yet. My blood pressure stays so high. I can have the 5/10 years of work and more and more than enough credits. And I was told there are special circumstances where I could get concurrent benefits. Because I have no income and im taking care of my 16 year old daughter.

            • Kay Derochie

              Dear Robin,

              If your Social Security Disability (SSD) benefit is low enough, you could receive both SSD and Supplemental Security Income (SSI) ongoing. Otherwise, the SSI would stop once the Social Security got started.

              Sincerely,
              Kay

        • Robin R Minor

          Hello again I’m confused. I was checking on the status of my case today. And they said I applied for both SSI and SSDI. My question is when I applied I just applied for help. Because my PCP, cardiac specialist and hypertension specialist said I needed to apply. I didn’t know what I was doing. So I called the SSA they said I applied for both. And I don’t know how that’s possible. Is it possible b they are the ones that are saying I applied for both, or I’m going to get both. It’s so confusing to me. I’ve worked more than 5/10 years and I don’t have no other income. And I get Medicaid. Please help me understand, I’m separated and been separated for 9 years. And I have a 16 year old daughter. Please Please help me

          • Kay Derochie

            Dear Robin,

            Entitlement to Social Security Disability (SSD/SSDI) depends on your being disabled according to Social Security law your having enough work credits and the amount of the benefit depends on your pre-disability earnings record. Supplemental Security Income (SSI) does not require work earnings if you are a citizen or have certain alien status. Eligibility depends on having countable assets of $2,000 or less ($3,000 if you are married and living with your spouse) and family income below the SSI limits. The amount of SSI paid depends on the amount of your income including the value of free housing or free food from sources other than government programs (food stamps and government housing).

            When you apply for disability, the Social Security Administration will screen you for eligibility for both programs. If you are approved for both, SSI will be paid first and, depending on the amount of our SSD, will stop or be reduced when SSD starts. You can learn more about the SSI program in the articles under the SSI tab at the top of this webpage.

            Sincerely,
            Kay

  • Wayne W

    When I started on Disability I received a SSI check for two months but after that because my wife worked I did not qualify for SSI well now we are separted and I am wondering if I can start getting my SSI back since I dont have her income anymore. I only get 1252.00 but with her gone I will no longer be on her insurance beginning in Oct 2016 so I am gonna need some help somewhere can you help me please and point me in the right direction. Thanks

    • Kay Derochie

      Dear Wayne,

      You do not say what type of income the $1,252 is; however, if it is unearned income such as Social Security Disability or alimony, your income is too high for Supplemental Security Income (SSI) benefits. If you are paying a Medicare premium, you might be able to get help with that. More information is available at http://www.medicare.gov.

      Sincerely,
      Kay

  • Debbie

    I started receiving SSDI benefits and back-pay in March 2016. Social Security sent me a Medicare Card (I am 59 years old) and also sent me a letter stating that if I chose not to accept Medicare that my payments would change from $783 a month to $894 a month. I sent them the letter back saying that I did not want Medicare as I was covered by my husband’s insurance through his employer. However, my SSDI did not increase and when I go on the Medicare.gov website it shows that they have no record of me. Who do I contact to get information regarding this. I was assigned to one Social Security office, but because I filed for a financial hardship, I was transferred to a different office for my ALJ hearing. I live in California, yet all my letters from Social Security come from New York (where I was born). This all has me confused.

    • Kay Derochie

      Dear Debbie,

      Go to your local Social Security office in California and ask them to review your record to see whether your refusal of Medicare has been posted on your record or a follow-up is needed. Ask that they be shown as your servicing office because your residence is in their area.

      Sincerely,
      Kay

  • Anna Mulhollem

    Hi. I received SSDI benefits. I got a letter after a 5 year review that said I am no longer eligible because not disabled so will have to pay back after a certain date. The letter stated that social security would let me know about Medicare coverage. So I have been using my Medicare and saving the monthly checks to pay back. I got a letter today that said the state will no longer pay my premiums and they would be taken from my check. So, I am still saving the checks that keep being deposited but now a Medicare premium is being deducted. So I guess I should set aside money to pay back for the premiums? How long will I be eligible to pay my premiums and keep Medicare at age 40 and no longer eligible for disability because I’m not disabled anymore? I am getting ready to have surgery so need to know. Thanks.

    • Kay Derochie

      Dear Anna,

      Medicare should stop the same month that your eligibility for benefits ends because your claim is being closed for medical recovery. I suggest that you contact the local office to ask that benefits be stopped. As a side note, you mention needing surgery. If it is related to your original disability, you might have grounds to appeal.

      Sincerely,
      Kay

  • Vicki

    I have Parkinsons disease and dystonia among other things. I have been on disability for about 2 years and I am 62 years old. When I am full retirement age I was told that I could apply for social security based on my ex husbands record instead of receiving disability if the amount I receive is more. I know I can not collect both. We were married 12 years and have been divorced over 2 years. Is this true? I believe I would receive approx. 50% of his benefit.

    • Kay Derochie

      Dear Vicki,

      If your ex- husband is deceased, you can switch to his earnings record if the benefit would be more. Surviving divorced spouse’s receive 100% of the workers benefit if the ex-spouse is full retirement age.

      If your ex-husband is still living when you reach retirement age, you will be switched to retirement benefits on your own record and if the divorced spouse’s record is higher, your retirement will be supplemented to reach the divorced spouse’s benefit amount. For example, If your benefit is $800 and the spouse benefit is $1,000, you will get $800 from your own record and $200 from your former husband’s record. The maximum between the two benefits will be 50% of his record.

      Sincerely,
      Kay

  • Michele Lockard

    I am going to start receiving SSDI and Medicare in a few months. I live in Nevada and the only company that offers medi gap, to those under 65 is Aetna, at a cost of $400 per month. I also fall into the donut hole as my medication is $6700 per month. I only get $1671 in benefits, then I have to deduct for part B and D. I cannot afford to pay the medigap and my donut hole, what can I do? More than half my income would go to medical expenses. Obamacare is better than Medicare, is there any way I can keep that instead of Medicare? What else can I do?

    • Kay Derochie

      Dear Michele,

      I am not an expert on medical insurance so I don’t know the answer to your question. You can refuse Medicare Parts B and D, but I do not know that there is anyway to terminate eligibility for Part A because you already paid for it with Medicare tax. You might try consulting with a health insurance agent to see if you can elect a government-subsidized insurance instead of Medicare. Another possibility is to discuss with your physician whether there are any less expensive medical medications that would be effective for you.

      Sincerely,
      Kay

  • Jennifer Simms

    Hello,

    First of all thank you for your time in answering my question. I am currently on SSDI and have been since 2011. I have not changed anything in regards to my Medicare Advantage Plan or any other insurance but as of 2016 I began getting a deduction for medical insurance premiums. I read about part B and understand what the premium is for but I do not understand why I never have had my benefits deducted from until 2016. I would understand if I had made report some changes to my information but everything, as far as I know, is still the same as it was when I was not getting deducted. Again thank you for any and all information as Social Security is extremely confusing for me.

    Sincerely,
    J.S.

    • Kay Derochie

      Dear Jennifer,

      The only thing I can think of is there was a change in the terms of your Medical Advantage Plan. I suggest that you contact the Plan to try to get an explanation. If that fails, try contacting one of the resources that you can find at https://www.medicare.gov/Contacts/

      Sincerely,
      Kay

  • Carrie

    Hi Kay,
    My Dad was just approved for SSDI and wasinformedabout the 24 month waiting period for Medicare benefits. He will turn 65 before the 24 months end. Can he get Medicare at 65 (as he would if he were not disabled) or does he have to wait longer until his 24 month period is complete?
    Thanks,
    Carrie

    • Kay Derochie

      Dear Carrie,

      Your father will be eligible for Medicare at age sixty-five.

      Sincerely,
      Kay

  • gladys

    Hi my name is Gladys and I have two children. We all three receive social security from my husband who passed away from cancer in 2012. My portion is 833 a month. I applied for medicaid benefits but was denied and in turn was able to get the children on CHIPS. My question is what are my options as far as getting myself insured goes. I can’t afford the monthly cost of an individual health plan and I’m 32 and have had several medical issues. Two brain surgeries and I’m living with one kidney that I’ve had several hospital stays with. Any advice is greatly appreciated. Thank you for your time.

    • Kay Derochie

      Dear Gladys,

      At the next open enrollment in December, you can enroll in an insurance plan through the Affordable Care Act. With your low income, you may qualify for a government premium subsidy, which comes in the form of an advance tax credit. More information is available at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Cate

    My dad has Huntington’s Disease and got his first check in June 2015 from Disability. Obviously, it has not been 24 months since he got it but his health has decline so quickly that he is starting to require more and more help. Obviously, my mother works (and has to ) and has him on her insurance. They do not qualify for any help as far as Medicaid goes but we cannot afford to have personal help come in or send him to a nursing home.

    • Kay Derochie

      Dear Cate,

      Check with your county or state social services office to find out whether there is any government-funded or -assisted home-care available in your state or locality.

      Sincerely,
      Kay

  • Ann Lowe

    I forgot to mention my brother is 58 years old.

  • Ann Lowe

    My brother lives in Oakland, CA. He is getting SSDI and receiving medicare part A & B and medicaid, I have been told if he moves to Omaha, Nebraska he will lose his medicare and medicaid if he has over $2,000 in the bank.

    Is this true?
    If he moves to Las Vegas will he lose his medicare and medicaid? He can not afford to live in California any more. He makes about $1250 a month and I think he may have saved over $9,000. Is he disqualified from receiving these benefits?

    • Kay Derochie

      Dear Ann,

      Your brother’s SSDI and Medicare are based on his work history and will be the same in all states. His savings do not affect benefits. Medicaid eligibility requirement vary from state to state. He would have to check with each state’s social services department to find out whether he qualifies for Medicaid in that state.

      Sincerely,
      Kay

      • Crystal

        I was just approved SSDI and I wanted to know if my Children still will get SSDI from their Father who is also disabled.
        Another question can my children draw benefits from myself or no since they already get benefit from their father.
        Thank you

        • Kay Derochie

          Dear Crystal,

          If your work history is sufficient to provide dependent benefits, your children can draw benefits from both your and their father’s earnings records under a combined family maximum benefit (FMB).

          Sincerely,
          Kay

  • Dottie Miller

    Kay, I have a cousin that’s on SSDI and has Medicare coverage.. She has a hard time making ends meet because she has to pay her co-pay and buys her medications. She has brain injury due to a car wreck and her Father takes care of her financial responsibilities by writing her checks.. Her long and short term memory is very bad. My question is does she qualify for Medicaid which would help out some.. She lives in Denton, NC 27239.

    Would appreciate any help you could give me..a friend is on both and gets $1236 a month.

    Thank You..

    • Kay Derochie

      Dear Dottie,

      Your cousin can try applying for Medicaid at her county or state social services office. if she qualifies for Medicaid, usually Medicaid pays the Medicare premium. There are also some programs that help with Medicare premiums. You can learn more about these at http://www.medicare.gov.

      Sincerely,
      Kay

  • Margaret Sullivan

    Hi Kay, I’ve learned a lot from your comments and truly appreciate them. I received my first ssd check on 3/1/15. So I assume I will be eligible for Medicare 4/1/17? My Cobra (which I’ve extended to the max) ends 2/1/17, so I will have a lapse of coverage for 2 months, correct? What can I do to cover the 2 months, can you purchase coverage for that short amount of time? Thanks so much for your time!

    • Kay Derochie

      Dear Margaret,

      If your first check paid on March 1 was for one month, it was for February and your entitlement to Medicare will begin February 2017 with no gap.

      Sincerely,
      Kay

  • Are ssi and disability laws different in each state? I need to file for disability but i am a 52 year old widow,I was told I couldn’t receive my late husbands benefits until i am 60 which would be alot more than my benefits will be.I live in Alabama. I lived in Florida in 1994 where and when husband died,the law changed,it used to be 50 years old and disabled.Thanks

    • Kay Derochie

      Dear Laurie,

      Eligibility for Social Security and federal Supplemental Security Income benefits are the same in all states. You can apply for disabled widow’s benefits at age fifty or older or widow’s benefits age age sixty based on age. Those benefits are reduced progressively more for each month you receive them before reaching full retirement age. Another non-medical requirement is that you became disabled within seven years of your husband’s death or within seven years of your last entitlement, if any, for mother’s benefits for having a young child in your care. You can choose to file for disability on your own earnings record only and leave the widow’s benefits until you are older or you can apply for both now.

      Sincerely,
      Kay

  • Paul Gifford

    I am surrently on SSDI foor mental dissabilty. I have PTSD, severe anxiety and depression. I was on SNAP and MedicAid, but they are taking me off that at the end of the montnh as my SSDI payments are to high. I live n SoCal, sharing a two bedroom low income apartment and that costs over two grand a month. My SSDI is running out in a few months, what are my options. Scared I will end up homeless.

    • Kay Derochie

      Dear Paul,

      I don’t understand your statement that your SSDI is running out in a few months. Please explain.

      Sincerely,
      Kay

      • DJ Stelly

        Dear Kay,
        I think the Paul is referring to the limit for certain Mental Health issues, 24 months is the maximum time allowed to draw benefits for those. If he has a Physical Disability that developes while on Mental Disability then he could add or file for the Physical and if approved his Benefits would be continued. But it will not make a change to the monthly $ amount. Things may have changed but this was my experience, my mental issues were easier to be approved & I needed help asap, my Physical Disabilities, which were partially the cause of my mental issues,were filed and approved during that 24 month period so my SSDI benefits were extended. Hope this helps.
        Sincerely,
        DJ

        • Kay Derochie

          Dear DJ,

          Social Security Disability (SSD) and Supplemental Security Income (SSI) do not have twenty-four month benefit limitations for mental illness. Most private long-term disability (LTD) insurance policies, whether purchased individually or by an employer, do have a twenty-four month limit for disability caused by mental illness.

          Sincerely,
          Kay

  • Ron

    I live in Washington state. I was approved for SSDI last year with the “onset” date being December 31st 2014, the first month of my 24 month waiting period. I understand that Medicare benefits will not begin for 24 months which should be January 1, 2017 (I believe). However, I will be 65 mid April 2017, so my initial enrollment period for Medicare will begin Jan 1, 2017 with first coverage beginning the first of April 17. As I am on SSDI now, I have the following questions:
    1. Will my Medicare benefits begin in January or April?
    2. Understanding that Part A is covered from my ongoing payments through self employment tax, will Part B be paid for under SSDI or will I have to pay that premium?
    3. When I turn 66, April 2018 and my SSDI becomes regular SS, will I then have to pay for Part B if it is indeed paid for through my disability classification?
    4. Does SSDI contact me regarding Medicare eligibility prior to the end of my 24 month waiting period?

    Thanks for your answers in this forum. Nothing else as clearly stated in any Medicare or Social Security information.

    • Kay Derochie

      Dear Ron,

      Your twenty-four-month Medicare waiting period started with the month your benefits started, which based on a December 2014 disability onset date, was June 2015. The twenty-four months ends May 2017. You can get Medicare earlier (April 2017). You should receive a notice three months before. If you have not received a notice of Medicare eligibility by February 1, contact Social Security to apply.

      You have to pay the Part B premium regardless of the type of benefit your are receiving. There are some programs to help some people with the premiums. More information is available at http://www.ssa.gov.

      Sincerely,
      Kay

  • Frank Gardner

    My ex-wife is on SSDI.She gets 13,600 a year.She gets Medicare port A and B,but their are no clinics that will accept A or B.She has Crohns disease,so she needs to be seen by a doctor on a regular basis. The state of CO. Has told her she makes to much money a year to get Medicad,and now SSDI is taking 130.00 out of her chicks a mounth to pay her premiums.. Is their any way she can get HELP…??????????

    • Kay Derochie

      Dear Frank,

      I suggest that your ex-wife talk to the local clinics to find out whether they would accept Medicare insurance if she also had a Medicare supplement that paid the deductible and the co-pays as well. She might also get some ideas of options from a health insurance broker and read the Medicare site at http://www.medicare.gov. She might be eligible for one of the Medicare premium assistance programs. Though it would be a radical step, she could move to an area where there is a clinic that will accept her as a Medicare patient.

      Sincerely,
      Kay

  • Marco

    I had a liver transplant in 2013. So I was told that I had to wait 24 months for medicare. In the meantime. I had to replace my family health Insurance thru the Marketplace in which we dont pay for anything. Now that its been 24 months the state of PA Pu. ts me on Medicare A and B and they pay the monthly premiums. Can I still keep the Health Insurance thru the marketplace to may my deductibles and the 20%?
    If not can I just keep the market place Insurance and decline the Medicare part B?

    • Kay Derochie

      Dear Marco,

      I suggest that you check with the insurance you have through the marketplace. You may no longer be eligible for it because you are Medicare eligible. Another possibility is that even if you can keep both Medicare and the private insurance, the private insurance may not pay the deductible or 20% co-pays. You may have to replace the marketplace insurance with a Medicare Supplement or Medicare Advantage insurance policy to get the deductible paid and reduction of co-pays. It might be helpful to engage the assistance of a health insurance broker (paid by the insurance companies) to clarify your options.

      Sincerely,
      Kay

  • William Fairbanks

    I retired early at age 57. I have a medical condition (cancer) and I am certain that I would qualify for social security disability. How does this effect my current medical insurance that is fully paid for by my past employer, up until age 65? My current age is 60. thank you Bill

    • Kay Derochie

      Dear William,

      Medicare does not begin until you have received twenty-four months of Social Security Disability benefits. I suggest that you review your full health insurance policy to see if there are provisions that relate to Medicare entitlement. Some policies will continue and pay an additional amount above what Medicare pays if the insurance has a higher reimbursement rate. Regardless of the insurance, it could be to your advantage to apply for SSDI benefits now because to be eligible for benefits you have to prove that you became disabled while insured for disability benefits. Because of the time lag, the longer you are off work without filing the harder it is to prove disability at a point of time in the past when disability began and you were insured.

      Sincerely,
      Kay

  • My ex husband was on SSID from age 25 or 26 until it converted to retirement at age 66, he also has free medicare part A, We were married for 17 yrs. but are divorced now. I am turning 65 in July. I only have 26 quarters paid into medicare. Will I be able to get Medicare from him. He definately never had 40 quarters paid in to medicare. I worked for a public school since 8/86 but they never took medicare taxes out on me.Please Help!

    • Kay Derochie

      Dear Linda,

      I believe that to may be eligible for Medicare at age sixty-five on your former husband’s Social Security record because you have the right to apply for divorced wife’s benefits on his earnings record, assuming you have not remarried. You can either apply for reduced wife’s benefits now or wait for full benefits at age sixty-six. Note that your divorced wife’s benefits might be reduced if you are eligible for a public retirement pension based on the work that was not taxed for Social Security. (As an aside, your husband is Medicare eligible because he has been receiving SSDI benefits for more than two years.)

      Sincerely,
      Kay

  • I am in process of going to Medicare in Oct of 2016. My Medicaid runs out? Or I make too much on my ssdi payments here in NY so I will have a spend down ? I am being told its like a monthly deductable in my case of over $550 a month. So I know I have to pay over $550 in med bills each month before Medicaid kicks in. In October will I be paying a premium or will Medicaid pay the premium or will I have to go to obummercare? It’s very confusing. The Medicaid max in NY is $850, they want me to pay them $585 a month to keep full Medicaid coverage. That sounds rediculous and there is no way I will be doing that. My biggest question right now is what happens in October when Medicare kicks in….do I lose Medicaid completely and go through affordablecareact?

    Thank you

    • Kay Derochie

      Dear John,

      I am not an expert on New York Medicaid buy-down so I can’t comment on that. If you are still Medicaid eligible, usually Medicaid will pay your premiums. If you choose, you can also purchase a Medicare supplement or enroll in a Medicare Advantage plan that will help pay costs that Medicare doesn’t cover. A health insurance broker or your state’s insurance commissioner’s office should be able to give you a list of companies in New York that offer such plans.

      Sincerely,
      Kay

  • Jordan

    My fiance is on disability because he has epilepsy, he gets a monthly check and his medicare card says Part A and B. When it comes to this, we don’t have much knowledge. We did have an understanding that he wouldn’t be able to work when he is on disability or else he would lose his medicare. But his check is not something he would be able to live on when we have a family of our own. Would he ever be able to work and receive an income and he would be able to keep the part of medicare that pays for his medication and his hospital visits? He feels like he could work and lose the part that pays him monthly and just receive an income but we wouldn’t be able to afford his medication seeing as its almost 32k a year. Also, when we have children, would they receive a check as well if he is still on disability or would they receive medicare? We are having a difficult time understanding it all.

    • Kay Derochie

      Dear Jordan,

      If your fiance is now eligible for Medicare, he will continue to be eligible as long as he is eligible to receive a benefit. If he starts working, he needs to report his work, but it is possible to work and earn a limited amount of money and still receive full benefits. As long as he continues to be medically disabled and does not earn more than $1,130 gross per month, his benefits and Medicare are likely to continue. He can read about Social Security’s work incentives including a Ticket to Work in the Red Book, which is available online at http://www.ssa.gov.
      It is important to note that Medicare Parts A and B do not cover prescription medication. He needs to enroll in one of the Medicare Part D options or to purchase a Medicare supplement or Medicare Advantage plan that Pays for medications to have prescription coverage. He can learn more about Part D Medicare at http://www.medicare.gov. His states insurance commissioner’s office can give him a list of insurance companies that offer Medicare supplements and advantage plans.

      Sincerely,
      Kay

      • Jordan

        Thank you for your reply! I also have a question about when we get married. We have heard that once we get married his benefits will stop because I make over $30k a year. Is this true?

        • Kay Derochie

          Dear Jordan,

          Your spouse’s Social Security Disability (SSDI) will not be affected by your income because the amount he gets is based on his work history and taxes paid into the Social Security insurance program, not on financial need.

          Sincerely,
          Kay

  • Judy B

    My husband and I were separated for many years. I am disabled and have been so for over 10 years and received SSI. My estranged husband kept me on his health insurance and I never asked for Medicaid. My husband passed away Nov 2014. I am now receiving widows benefits from his record. SSA first told me that I would get medicare after 24 months. Now they say not until I turn 65 which is 3 more years because I had been disable for over 7 years prior to his death. I don’t understand!

    • Kay Derochie

      Dear Judy,

      The regulations in the attached link seem to support the information that you were given. You cannot file a disabled widow’s claim after age sixty solely for the purpose of Medicare eligibility if disability began before age sixty. See the second bullet under item A.

      Sincerely,
      Kay

      • Judy B

        Dear Kay
        Thank you for your help. It doesn’t make a lot of sense to me but it is what it is…
        It’s hard and scary not having any insurance. I receive a little to much for Medicade and can’t afford the 400+ a month for Obama Care. What’s a body to do.
        Again, thank you for your help.
        Judy

        • Kay Derochie

          You are welcome, Judy.

  • D Gilbert

    I have used my trial months back in 2009 mostly because my job scheduled me too much. That aside I am nearing this 93 month barrier for whatever it means by

    “You can keep your medicare for at least 93 months after your trial work period ends. Your hospital insurance will be free, but you will still pay your medical insurance. Beginning in July 1990, you can keep your Medicare after your free hospital insurance coverage ends. But, you must pay a premium for both parts.”

    I am not sure what this means, but This same letter claims I was jsut determined to still be disabled. The only reason I work is I get the minimum of money SS gives and it is not enough to survive off of. Every job I have had has made special exceptions for me etc… What does this mean exactly?

    • Kay Derochie

      Dear D.

      If you are still working and performing substantial gainful activity, which is usually, but not always, earning $1,130 gross per month or more, your Medicare will end 93 months after the end of the Trial Work Period. To have Part B and Part D Medicare continue until then, you have to pay the premiums.

      You mention that you get special exceptions in your jobs. Depending how much the job is being modified for you and how, you might be able to assert that you are not earning the full amount you are being paid because of assistance you get or other factors. If you feel that is the case, you can apply for Expedited Reinstatement and, if approved, benefits would be paid and Medicare continued past the ninety-three months.

      Sincerely,
      Kay

  • Carrie Jones

    My husband currently collects ssdi, he was eligible for benefits sept 2014, I am confused as to when he will be eligible for medicare. From what I understand it is 24 months after he became eligible for ssdi. Question – Will he be eligible in 24 months or is it before that due to the waiting period?

    Appreciate any insight I can get.

    • Kay Derochie

      Dear Carrie,

      Medicare eligibility begins after twenty-four months of payments including back pay months but not waiting period months.

      Sincerely,
      Kay

      • Carrie Jones

        Thank you for the insight. It is greatly appreciated.

        • Kay Derochie

          You are welcome, Carrie.

  • Yvonne Waterloo

    Hello Kay,
    Thank you for such an insightful advisory page for those of us
    who so confused and those just wondering.
    I am turning 66 yrs old in 2017. I am receiving SSDI, Medicare & Medicaid along with food stamp. I am permanently disabled.
    My question is: Will I continue to receive the same assistance
    that I get now once I reach my retirement age?
    I understand about the “Freeze” for SSDI. I am wondering about the other 3 that help keep me alive and happy to be here.

    Thank You for your
    Time and Knowledge.

    • Kay Derochie

      Dear Yvonne,

      As long as there is not a change in the laws, you can expect your benefits to continue as they are when you reach age sixty-six.

      Sincerely,
      Kay

  • Sonny

    Last year my sister received about $10,000 from her Medicaid and she is on Disability, I too am on disability but I did not receive the money why is that?

    • Kay Derochie

      Dear Sonny,

      I have never heard of Medicaid or Medicare paying cash payments to anyone. I suggest that if you want more information, you have your sister clarify where the money came from and what it represented.

      Sincerely,
      Kay

  • Dayna

    My husband draws ssdi do I automatically qualify for Medicaid

    • Kay Derochie

      Dear Dayna,

      When your husband has received twenty-four months of Social Security Disability, he will be eligible for Medicare. Dependents do not receive medical coverage of any kind. If you do not have insurance, during the next open enrollment period at the end of 2016, you can apply for insurance benefits under the Affordable Care Act (ACA). If you just lost insurance, you can apply now. More information is available at http://www.healthcare.gov. You might also check with your state social services office to see if any coverage is available through the state while you wait for access through the ACA.

      Sincerely,
      Kay

  • Lorrie Brewer

    I live in PA, and receive SSDI, I know that I have to sign up for Part B, or face a penalty, is the same true for Part D? I can not find this information in any of my paper work. Thanks for your help!

    • Kay Derochie

      Dear Lorrie,

      There is a penalty for not enrolling in Part D when you initially can unless you enroll in a Medicare Advantage plan that includes drug coverage and thus don’t need Part D. The following link mentions the penalty. https://www.medicare.gov/part-d/costs/premiums/drug-plan-premiums.html. If you do not enroll when you are first eligible, you will have to wait for an open enrollment period.

      A Medicare Advantage plan is a form of Medicare supplement that pays deductibles and reduces co-pays. You may find it helpful to go to an insurance broker who is knowledgeable about Medicare supplements and advantage plans in your state to help you sort out what your best choices are. Brokers will not charge you because they get paid if you choose one of the insurance plans they show you.

      Sincerely,
      Kay

  • Jerri

    I have stage 4 cancer on ssd. My husband has employer insurance that pays 100%, in network. Who pays first . Do I need to use Medicare since he pays 100%. Also if Medicare pays first does his insurance pay for the rest of bill at 100%

    • Kay Derochie

      Dear Jerri,

      Probably Medicare pays first and the insurance company pays the difference up to what it would pay if you didn’t have Medicare. (It is also possible that since you have Medicare that the insurance policy may require you to keep it.) To be sure of how your insurance coordinates, I suggest that you read the employer insurance policy and if you have any questions about it, contact the claims department of the insurance company for explanation.

      Sincerely,
      Kay

  • David

    I am receiving Extra Help for Part D through Medicare Savings program which is up for renewal through medi cal. Last November, I was in receipt of a one time unearned income of over $10,000 which I immediately “spent” on repaying some of my Loan balance on which I have been drawing to meet my living expenses. My monthly income and assets ( resources) remain within the threshold of Low Income Subsidy/Medicare savings program. So, for purposes of annual renewal, can I safely assume that the one time receipt of other income last Nov. would not affect my eligibility for MSP or Part D Extra Help?

    Is it correct that even if one were to lose MSP for part of the year ( because of temporary higher income), Extra Help remains effective until the Dec 31 regardless?

    • Kay Derochie

      Dear David,

      I do not have the answers to your question. I suggest that you direct them to the office that administers your Medicare Savings program.

      Sincerely,
      Kay

  • Sar

    Hi I posted this the other day but I didn’t receive a respone so I wasn’t sure if it got over looked I am disperate for any advice u might have. Thank you
    I am in North Carolina and was approved for SSI in March 2014. At that time I already had insurance through with BlueCross BlueShield through healthcare.gov . I kept my BlueCross BlueShield health insurance through healthcare.gov even after being approved for SSI because many of the doctors and specialist that I going to and are being referred to do not take Medicaid. I have never used the Medicaid be have not be able to find out how to opt out. I need to find out how to opt out now because I got notification for healthcare.gov that I will loose my subsidy if I can not prove that I am not using medicaid. I have not be able to find out how to get this information so I do not loose my subsidy. Thank you so much for your help.

    • Kay Derochie

      Dear Sar,

      Please see my reply for March 8 that was addressed to Sarah because that was the name you used in your first post.

      Sincerely,
      Kay

  • Kay Derochie

    Dear A.B.,

    Part A does cover hospital charges–specifically hospital charges–as I stated. Part B covers doctors of all kinds, as I stated. It does not matter where the doctor is practicing–in a hospital or in an office. For both parts of Medicare, there are, of course, deductibles and co-pays unless you have a Medicare supplement.

    Sincerely,
    Kay

  • Anita

    She will be released from hospital on Tuesday, really need an answer

    • Kay Derochie

      Dear Anita,

      See my response of a few minutes ago.

      Sincerely,
      Kay

  • Sarah

    Hi,
    I am in North Carolina and was approved for SSI in March 2014. At that time I already had insurance through with BlueCross BlueShield through healthcare.gov . I kept my BlueCross BlueShield health insurance through healthcare.gov even after being approved for SSI because many of the doctors and specialist that I going to and are being referred to do not take Medicaid. I have never used the Medicaid be have not be able to find out how to opt out. I need to find out how to opt out now because I got notification for healthcare.gov that I will loose my subsidy if I can not prove that I am not using medicaid. I have not be able to find out how to get this information so I do not loose my subsidy. Thank you so much for your help.

    • Sarah

      Sorry I just posted about but this is just my question. I was looking at some other answers and question and some how it go attached into my question below is just my question sorry about that.
      Hi,
      I am in North Carolina and was approved for SSI in March 2014. At that time I already had insurance through with BlueCross BlueShield through healthcare.gov . I kept my BlueCross BlueShield health insurance through healthcare.gov even after being approved for SSI because many of the doctors and specialist that I going to and are being referred to do not take Medicaid. I have never used the Medicaid be have not be able to find out how to opt out. I need to find out how to opt out now because I got notification for healthcare.gov that I will loose my subsidy if I can not prove that I am not using medicaid. I have not be able to find out how to get this information so I do not loose my subsidy. Thank you so much for your help.

      • Kay Derochie

        Dear Sarah,

        I figured out what happened and removed the extra material from your first post. Please see my response of March 8.

        Sincerely,
        Kay

    • Kay Derochie

      Dear Sarah,

      Refusing Medicaid should not affect your Supplemental Security Income (SSI) benefits.

      It sounds as if you are getting your private insurance through the Affordable Care Act exchange. Before you dis-enroll from Medicaid be sure that refusing it won’t affect your eligibility for the other insurance. You should be able to get a summary of your Medicaid usage (or non-usage) from the state agency in your state that handles the Medicaid program. To locate that office, try checking your state’s directory of public agencies.

      Sincerely,
      Kay

      • Sarah

        Thank you so much for your reply. I do not seemed to be able to find out how to refuse the medicaid (dis-enroll- I never enrolled to begin with I was automatically enrolled when I was approved for SSI.) When I call the NC Department of Health and Human Service they say that all I need to do is call my local medicaid office for my county. But every time I call them they say that I can not refuse/dis-enroll in the medicaid they say that if I receive SSI I receive medicaid. Do you have any advice on how I can dis enroll I seem to get a different answer with every person I talk to? The reason I want to refuse the medicaid is because if I do not then I will not longer receive the subsidy that I am receiving with my Bluecross Blueshield through the market place and I want to keep my bluecross blueshield plan because alot of the doctors that I go to and have been referred to do not take medicaid. thank you so much for your help.

        • Kay Derochie

          Dear Sarah,

          Please see my response to your first post. The only thing I can add is that your might get the name and number of the person and in the state office who said disenrollment is possible and give that to the county worker as a reference. Or, you might ask the state worker for how it is done so you can tell the county worker.

          Sincerely,
          Kay

  • Anita

    I am on SSDI and my grand daughter has just been taken from my son can I be her foster parent even though I am on disability and will it affect my SSDI, if I dont take her she will go to a foster home and I dont want her to think that I dont want her, but I cant risk losing my only source of income either and even though I cant work will be her foster parent will I have to tell SSDI and will they force me off of SSDI. Thank you right now she is in a group home. Help me please.

    • Kay Derochie

      Dear Anita,

      Having a foster child will not affect your Social Security Disability benefit.

      Sincerely,
      Kay

      • Anita

        Thank you for your reply, really appreciate it didnt know where to and my son was feeling that I didnt care and I hated telling him that I couldnt risk the only income that I had ie since I have no other way to live.

        • Kay Derochie

          You are welcome, Anita.

  • joshua

    Hello, I am living in the philippines, and i am disabled recieving ssdi. Since medicare does not cover any medical here in the philippines will i still have to decline my part b, or will it automatically be declined because of where i am living. Thank you

    • Kay Derochie

      Dear Joshua,

      If you decide to decline Part B, to be safe, mail in a statement declining the coverage. Keep a copy of the statement. If you plan to return to the United States fairly soon, it might be better to pay Part B premiums while in the Philippines to avoid the higher premiums you will have to pay when you return. There is a premium surcharge for every year that you do not accept Part B and limitations on when you can apply and have it start.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • Dawn

    Hi, I just received my medicare card for part A & part B. I am 48 yrs. Old…. I know I will be receiving some back pay but I am not sure if I will be receiving a monthly payment from SSDI. My judgement was partially favored and I have heard different things from my atty. & social security. So I’m very confused…

    • Kay Derochie

      Dear Dawn,

      I suggest that you read the partially favorable decision again to review why it is partially favorable. If the reason is that the judge ruled that your disability ended, you will not get ongoing benefits. If the unfavorable part of the decision was that your disability started later than you claimed, then you will get ongoing benefits.

      Sincerely,
      Kay

  • Randall

    My wife is on SSI Disability for over 10 years. I carry her on my insurance and have always carried her, however, over $100 is taken out of her check every month, and she doesnt have medicare have never had medicare. On the annual benefit amount form it states that the amount we deduct for Medicare Insurance is $104.90 or if someone else plays your premium we show 0.00. Since she doesnt have Medicare how can she get the money back that has been deducted over 10 years, my wife is very paranoid and is angry at me because this is happening. She suffers from bipolar and a paranoia personality. Need to know how to get this money back. Thank you in advance for your assistance.

    • Kay Derochie

      Dear Randall,

      Your wife does have Medicare whether she has ever used it or not; otherwise the premiums would not be withheld. Part A Medicare for hospitals and some other services has no premium. Part B Medicare for doctors and outpatient tests and procedures has a premium, which is the $104.90 a month. She can opt out of Part B Medicare in the future, but she cannot get past premiums back.

      Before opting out, here are some things to consider: 1) If you lose your job or retire or your employer stops providing medical insurance, you wife may need her Medicare coverage and her premiums would be increased for each year she refuses coverage; 2) your current insurance company may require her to take Medicare because she is eligible; that is they may want Medicare to pay first and they pay the difference between the Medicare payment and their usual payment. You can read your insurance policy to see if that is the case.

      (As an aside, if your wife has Medicare and is under age sixty-five, she is getting Social Security Disability (SSDI), not SSI., which is Supplemental Security Income.)

      Sincerely,
      Kay

      • Randall

        Why wasnt she sent an insurance card of something, alerting her of this. She didnt use it because she never recieve information that she has it. They have taken over all of these years without paying for anything.

        • Kay Derochie

          Dear Randall,

          Your wife would have been sent a letter notifying her of when the Medicare benefit started and how much the premium would be. If she received twenty-four months of back benefits when she was initially approved, the information about Medicare would have been in her initial award letter. Medicare cards would have been mailed at that time. To opt out of Part B Medicare, she would have had to opt out at that time.

          Sincerely,
          Kay

          • Randall

            she never received any of that information i am her payee and i never received any of that information.

            • Kay Derochie

              Dear Randall,

              Apparently, the letter was lost in the mail.

              Sincerely,
              Kay

  • nazo

    Hi,
    I receive social security disability and i m female over 65 years old. i was told since i am on social security disability i will be enrolled in medicare and i dont have to pay anything it will be free for me. but now i have received medicare premium bill for $400 . i dont work i never worked i live with my daughter i pay her half of the rent. please tell me how can i waive the bill and still get benefits. Or will medicaid pay for me to medicare?

    thankyou

    • Kay Derochie

      Dear Nazo,

      Part A Medicare for hospitals and a few other services has no premium; Part B that covers doctors and outpatient tests and some outpatient procedures has a premium. The bill you receives is probably for three months. If you have Medicaid, Medicaid may pay the premium for you; it depends on which Medicaid plan you are on. You can also investigate premium payment assistance at http://www.medicare.gov.

      Sincerely,
      Kay

  • Susan Knight

    First i want to thank you for all your help!
    My question is I am on social security disability and have been getting medicaid. Yesterday I received a letter from soctal security informing me that I will now be getting medicare part A and B.
    I can not afford the $121 for Medicare part B because this will leave me $820 for the month to live on.
    Can I NOT get medicare and just keep getting medicaid? Then at least I can just about pay
    my bills instead of no way possible pay my bills!
    Thank you for your time, you are helping a little of people.

    • Kay Derochie

      Dear Susan,

      I doubt that the Medicaid program will allow you to refuse Part B Medicare and continue getting Medicaid. However, if you have Medicaid because you have SSI and SSI will be ongoing, typically Medicaid pays the Part B Premium. However, it usually take a couple of months before the premium subsidy gets started. I suggest you check with the Medicaid office to find out about your rights and requirements. If Medicaid will not pay the premiums, you may qualify for other Medicare premium assistance, which is described on http://www.medicare.gov.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • Audrey

    Hi, my 40 year old husband was recently diagnosed with stage 4 pancreatic cancer and is unable to work due to the treatment. He has been approved for Social Security Disability but his 5 months are not up yet, so could he be eligible for Medicaid and will they cover his treatment?

    Thanks,
    Audrey

    • Kay Derochie

      Dear Audrey,

      Social Security Disability entitlement will not provide Medicaid coverage. It will provide Medicare coverage after twenty-four months of benefits. If your husband has lost health insurance in the last sixty days, he can apply for insurance under the Affordable Care Act by going to http://www.healthcare.gov. (The annual open enrollment period ended January 31.) Also, depending on your family income and assets, he might qualify for Supplemental Security Income (SSI) while he is waiting for Social Security to start and in most states it comes with Medicaid coverage. You can inquire about SSI in your local SSI office.

      Sincerely,
      Kay

  • Angelo. my aprilcation for ssd has been partially aproved by the
    ald judge,i receive the letter how long will it take for me to get
    the lump sum check

    • Kay Derochie

      Dear Angelo,

      Your monthly Social Security Disability (SSD) benefits will likely start before you receive the back pay. Your monthly payment should come within two months and it can take a couple months more to get the back pay.

      Sincerely,
      Kay

  • Angela

    Hi!

    My kids father is permanently disabled and receives medicare and disability. We broke up and I went to file for child support and about a month or so later, I received benefits cards for our girls and they now have medi-cal. Is it normal for kids to get medi-cal in this situation? Are they entitled to anything else?

    • Angela

      The girls are ages 5 and 2. We’re in California. Their dad is 31 and has had his disability since he was a kid. We broke up in 2014. At that time he was really not in their lives at all. Which is why I went to file for child support. I’m still not getting child support because they somehow “can’t find him” but as I said, we did get the girls’ benefits cards within a month or so of filing. He only sees the girls when is convenient for him.

      • Kay Derochie

        Dear Angela,

        The children’s father probably is not getting Social Security on his own earnings record. If that is true, there are no dependent benefits payable for the children. You can inquire about the public assistance I mentioned (TANF).

        Sincerely,
        Kay

    • Kay Derochie

      Dear Angela,

      I am not familiar with Medi-Cal law, so I can’t comment on that. Check with the Social Security Administration to find out whether the children are eligible for dependents benefits related on their father’s earnings record. Depending on your income, they might be eligible for Temporary Assistance to Needy Families, which would be administered by your state or county social services office.

      Sincerely,
      Kay

  • John

    In Indiana, I’m on Medicaid and SSI. I don’t qualify for SSDI or Medicare. I would like to “disqualify” myself from Medicaid (get rid of it), and switch to an Obamacare plan….but I still want to be able to keep my SSI.

    How do I do all this? I currently am disabled (neck injury), and I don’t work, but I’m looking for work. Also, I’m not in school.

    • Kay Derochie

      Dear John,

      I suppose theoretically you could refuse Medicaid, but before you take such an action, I suggest that you research what kind of insurance coverage is available to you in your state under Obamacare. You might find that your coverage would not be as cover as much as Medicaid and/or would require payment of premiums. If you try to opt out of Medicaid, probably your local state’s department of human services would be the place to find out how to do so.

      Sincerely,
      Kay

  • Ali Tagita

    I’m hoping you can answer my question, btw, your advice seems great. I’ve been receiving SSDI, Medicare and Medicaid secondary, due to low income. My question is I’m up for 1year recertification for Medicaid, since I’ve received my back due lump sum of 26,000. will this make me ineligible for my continuing Medicaid? I’m due to have two surgeries within this year, and I’m afraid of losing the extra help. This back pay is my only future money. I appreciate your response.
    Thank you,
    A.T.

    • Kay Derochie

      Dear Ali,

      The back pay may make you ineligible for Medicaid. Perhaps you can use part of it to pay premiums for a Medicare Supplement or Medicare Advantage policy. If you apply within thirty days of losing the Medicaid, you can apply for the supplemental insurance any time during the year. The Insurance Commissioner’s office in your state should have a list of all Medicare supplements and advantage policies offered in your state.

      Sincerely,
      Kay

  • Jo Lyn Arnold

    I am 42 yrs old and I have Lupus. I was told that I probably will become disabled from this and will have to stop working. My question is what will I be intitled to if I become disabled? (Medical and prescriptions plans)

    • Kay Derochie

      Dear Jo Lyn,

      You can get a Social Security Disability (SSDI) benefit estimate by setting up a My Social Security account on http://www.ssa.gov and requesting an earnings statement (not a benefit statement). After two years of SSDI benefits have been paid, you will be eligible for Medicare. In the meantime, you might qualify for health insurance with partially subsidized premiums through the Affordable Care Act (Obamacare). More information is available at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Chris Corley

    Kay,

    I am on Disability. I recently learned I will have to take Medicare as I am coming up on 24mo. I have an excellent American Indian plan through the ACA . My total cost is $7.34 mo. EVERYTHING else is $0
    Can I turn down the Medicare and keep this insurance?
    My prescriptions run $11,800.00 a month and the co-pay with Medicare will kill me.
    Thanks,
    Chris

    • Kay Derochie

      Dear Chris,

      I suggest that you check with your American Indian plan to find out whether you are required to take the Medicare coverage once you are eligible for it and if so what parts of Medicare.

      Within the Medicare program, there is no requirement that you take Parts B and D; however, Part A coverage is automatic. Part A Medicare is for hospitalization, hospice, and a few other things and has already been paid for with Medicare taxes you paid while working. Outpatient and physician services are covered by Part B and prescriptions by Part D. Parts B and D require a monthly premium and are optional.

      Sincerely,
      Kay

      • Marcello Rogers

        I am %100 disabled from a car accident when I was thrown 100 ft and landed on my head. I coded but was revived. My mother does so much for me via paying my bills and checking on me for several hours a day ever day 7 days a week. She also has a job but I cost her so much money and interfere with her work constantly. My spend down in $342 for my medical insurance. If I were to pay $342 out of my pay a month would that then mean that medicade would pay mom hourly for the hours she is over here taking away from her life? I feel do badly and I am trying to help her out. Thank you for your time.

        Marcello Rogers
        marsh1st@yahoo.com

        • Kay Derochie

          Dear Marcello,

          I am not sufficiently knowledgeable in Medicaid law to answer your question about spending down for your insurance. Some states have programs that pay wages to relatives who care for severely disabled relatives. I suggest that you contact your local department of social services to see if such a program is available in your area.

          Sincerely,
          Kay

  • brittany

    hi Kay my name is Brittany I am the age of 22 years old I have scoliosis and type one diabetes do you think I will get approved for disability benefits

    • Kay Derochie

      Dear Brittany,

      Whether or not you would be approved for disability benefits depends on whether or not your diabetes and scoliosis keep you from being able to work. Since you are young, in addition to pursuing disability benefits, you might also try to get employment counseling and vocational assessment to identify whether there are jobs you can perform.

      Sincerely,
      Kay

      • Angleik Carter

        Good morning. I need some information regarding disability. I received a letter stating that I was approved for medical and that they haven’t made a decision about whether I meet the non-medical requirements. What does that mean and if I’m approved for the medical and not non-medical, will i still get disability payments?

        • Kay Derochie

          Dear Angleik,

          You must meet both the medical and non-medical requirements to receive benefits. Social Security Disability non-medical requirement is that you have enough Social Security-taxed work in the past to insure you for Social Security Disability. If you applied for Supplemental Security Income (SSI), you must have income and assets below a certain limit. If you didn’t receive a letter denying SSDI for lack of insured status shortly after you applied, then you are probably insured.

          Sincerely,
          Kay

  • Jury

    Hi, my daughter is now 19, she have kidney failure end stage and received disability benefits and now she just start peritoneal dialysis , her benefits increase because of this? Because i spend to much time taking care of her that i need to abscent at my work and asking for days off. That is any other help that i can get?

    • Kay Derochie

      Dear Jury,

      Your daughter’s benefits will not go up because she has started dialysis; however, she will be eligible for Medicare if she is not already. You might also check with your local social services office and/or the National or America Kidney Foundations to find out whether your daughter can get home health assistance or transportation for dialysis that could keep you on the job.

      Sincerely,
      Kay

  • Jo fleury

    My husband works for Ford and was diagnosed in Aug with stage 4 cancer. He took a short term leave for work and now sedgwick is calling him telling him he must apply for ssdi and he will receive medicaid. He has bcbs insurance now and does not want the ssdi and is afraid they will force him to take the ssdi. He was told if he accepts the ssdi he will get to keep his bcbs but to tell them he wants part A and not part B. Is it his best interest to accept the ssdi and will he get to keep his bcbs? Or is there a time limit on how long he will be able to keep his bcbs? The hospital he’s been treated at for chemo does not accept medicaid or medicare.

    • Kay Derochie

      Dear Jo,

      Medicare benefits for disabled individuals do not start until twenty-four months of Social Security Disability benefits have been paid. Additionally, there is an unpaid, five-month waiting period, so your husband will not have to be concerned about Medicare interfering with his other insurance for quite some time, not until February 2018.

      If he is getting long-term disability (LTD) benefits and the LTD carrier is telling him he has to apply for SSDI, he probably has to apply in order to keep getting the LTD. His LTD will be reduced by the amount of Social Security that he receives, so he should report to the LTD company as soon as he is approved.

      Sincerely,
      Kay

  • Tina

    Ok I had medicaid when I live in NJ which I filed for Disability in Oct 2014 I moved to Georgia and NJ kicked me off and now Georgia is telling me I can’t get it because I dont have small children and I am not 60 years old but I have an open Disability claim what can I do

    • Kay Derochie

      Dear Tina,

      I am not knowledgeable in each state’s laws regarding Medicaid. For another possible source of medical insurance, you might investigate insurance under the Affordable Care Act (Obamacare). The annual open enrollment period is going on now through January 31. More information is available at http://www.healthinsurance.gov.

      Sincerely,
      Kay

  • bernice Graham

    My son recently had a stroke related to HPB he didn’t have insurance and the last date he worked was 16th of November and had the stroke on the 29th, my question is the social worker at the hospital stated he doesn’t qualify for medicaid since he doesn’t have his kids staying with him now he won’t be able to recieve rehab upon discharge from the hospital. Needs help.

    • Kay Derochie

      Dear Bernice,

      Your son should apply right away for insurance under the Affordable Care Act (Obamacare). The open enrollment period is in progress now through January 31. If he has low income, he may qualify for a government subsidy of the premiums, which will allow him to get insurance. More information is available at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Robert Johnson

    I have been receiving ssd for two years in my fully favorable letter it says I I’m insured through 2016 what dose that mean

    • Kay Derochie

      Dear Robert,

      Now that you are approved, the date is not important. It was just saying that you were insured on the date of established disability and, therefore, eligible.

      Sincerely,
      Kay

  • Kelley Cornwell

    My mom is 64 and is receiving survivor’s benefits( SSI) does she need to sign up for Medicare or will she be automatically enrolled?

    • Kay Derochie

      Dear Kelley,

      She should be automatically enrolled, but if she does not receive notification at least by the month before her sixty-fourth birthday, she should go to a Social Security office to be sure that it is processed.

      Sincerely,
      Kay

  • Elaine

    I was recently awarded full disability and my start date for Medicare Part A was May 2014 but Part B started Oct 2015. Can I purchase back my Part B to May 2014?

    • Kay Derochie

      Dear Elaine,

      Yes, you should be able to do that. Go to Social Security to make the request to have the retroactive Part B premiums withheld from your back pay.If you have already received the back pay, be prepared to pay the premiums for the full retroactive year. Keep a copy of your request and the cancelled check if you pay directly.

      Sincerely,
      Kay

  • Philip

    Hi. My partner has been on SSI since 09/2014. He applied for SSDI first but was denied due to not enough worked hours (?). Will he be eligible for Medicare in 09/2016? He will then be 59 1/2 years old. He remains physically disabled. He was told there is a 2 year waiting period for Medicare from the onset date…but from what we’ve read, it’s confusing.

    • Kay Derochie

      Dear Philip,

      Your partner will not be eligible for Medicare after two years of Supplemental Security Income (SSI) benefits. Medicare for disabled individuals applies to people who are insured for Social Security Disability (SSDI) benefits. If he has enough work (different criteria than for disability), he will be eligible for Medicare at age sixty-five. In the meantime, he should be eligible for Medicaid. If he doesn’t not have Medicaid, he can ask Social Security whether he has to apply to the state for Medicaid or whether Social Security needs to do something on their end to get it started. (States, which administer Medicaid, have various arrangements with Social Security.)

      Sincerely,
      Kay

      • Philip

        He has Medicaid now, plus a monthly SSI check. So, even though still disabled, he has to wait until 65 for Medicare?

        • Kay Derochie

          Dear Philip,

          Yes, that is correct because he is not getting Social Security Disability. Note that the medical coverage through Medicaid is usually more comprehensive than Medicare coverage.

          Sincerely,
          Kay

  • Joe Arena

    I receive SSDI and SSI. How can I get Medicaid?

    • Kay Derochie

      Dear Joe,

      Most people who receive Supplemental Security Income (SSI) are eligible for Medicaid. Ask you local office whether you have to apply in a state office to be insured under Medicaid or it was supposed to start automatically. (Social Security’s arrangement with the state Medicaid offices varies from state to state.)

      Sincerely,
      Kay

  • Tiffany Smith

    hello, my husband receives SSDI from working he has stage 4 kidney failure the past 4 months they have been taking $104 a month from his check but has no Medicare card or never got any information about Medicare. He also has limited Medicaid which covers his prescriptions could we have this fee stopped because he’s not using nothing dealing with Medicare at all

    • Kay Derochie

      Dear Tiffany,

      If you husband has been receiving outpatient kidney dialysis, he probably has had Medicare Part B with Medicaid paying the premium. If he is not on dialysis, then it is possible that he reached twenty-four months of Social Security benefits, which automatically starts Medicare unless it is refused. Either way, he should have a Medicare card.

      I suggest that he contact his local Social Security office to clarify his Medicare status and to get a card if eligible. If he is eligible for Part B Medicare, which requires a premium, Medicaid might pay the premium, so I suggest that he then contact the Medicaid office to see if Medicaid will pick up the premium.

      Sincerely,
      Kay

  • Walter

    Hi
    My wife is currently on ssdi .she is working now and is not receiving a check. But still has medicare pt a . My question is can she decline midicare pt a . Also she is 58 and had retired benifits from her work

    • Kay Derochie

      Dear Walter,

      Your wife cannot decline Part A Medicare. She is entitled to it because she paid Medicare taxes while she was working prior to becoming disabled. She does not pay a premium for Part A.

      Sincerely,
      Kay

  • Zach

    Hello Kay,

    Could you be so kind as to inform on whether it is mandatory to renew my Medicare benefits annually if I am receiving SSDI?

    • Kay Derochie

      Dear Zach,

      Paying for Part B and/or Part D Medicare is not mandatory; however, it may be the best insurance available to you or it may be that your current insurance requires you to take the Medicare because you are eligible for it. Additionally, unless one of the exceptions applies, if you stop the Medicare coverage now and want it later, it will cost more and you will have to enroll in November or December and coverage will not start until the following July. You can learn more about Medicare at http://www.medicare.gov.

      Sincerely,
      Kay

  • Whitney

    I am under the age 65 and was awarded SSDI. I’m currently receiving Cobra health insurance through a former employer that I’m receiving Accidental Disability from for the rest of my life. My question is I was automatically enrolled in Medicare but I’m not sure I need it because I already have BCBS insurance. At this point I am paying for two insurances. Is one insurance suffice? If so which one Medicare or BCBS? Your advice on this matter is much appreciated. Thank you.

    • Kay Derochie

      Dear Whitney,

      I suggest that you find out from your employer how long the COBRA can continue. My understanding that there is a time limit. Additionally, check your Cobra policy to see whether there is a provision that requires you to take Medicare so that the Cobra policy can pay less.

      If there is, it could be advantageous to stay enrolled in Medicare. If you decline Medicare now, unless one of the exceptions applies, you will have to pay higher premiums when you want Medicare later. Also, if you decline now and aren’t given a special general enrollment period due to an exception, you will only be able to enroll in November or December of each year and coverage will not start until the following July. I suggest that you research your situation either online at http://www.medicare.gov or with Social Security.

      Sincerely,
      Kay

      • Shania Phillips

        Hello my husband is on ssdi and we recently found out that $104.00 was being taken out for insurance but he was not on that insurance and said that he will get reimburse. Does anyone know if he will get reimburse the whole time he was paying that or will he just receive the 104 on his ssdi check from now on? Thanks for the advice.
        Shania

        • Kay Derochie

          Dear Shania,

          From what you wrote, I assume that the premium withholding was a mistake because your husband had not been eligible for twenty-four months. If that is the case, then they will refund all the premiums. If your husband decided he didn’t want the insurance because he has other insurance, then it is unlikely any premiums for months before he requested termination will be refunded.

          Sincerely,
          Kay

          • theo

            what if i am automatically enrolled in part b. i find out 2 weeks before the premium will be withdrew and try to cancel. i can’t cancel by phone so i mail in a form. SSI says they have no proof i mailed in a form which is an illogical argument because i could say i have no proof they didn’t lose it. trust me, i mailed it and remember what i had to go thru to do it. so after 3 premiums have been taken out of my check they say they can not refund it. i have not appealed it yet but after dealing with SSI for so long I am sure they will deny appeal. what would be my next step? or the next after that?

            • Kay Derochie

              Dear Theo,

              If you still don’t want the benefit, you can request termination of Medicare in writing and either take it in and request a date-stamped copy of it to be returned to you so you have proof of requesting termination or send certified mail signature required.

              You can do this at the same time as you appeal for return of prior month premiums. However, if you did not send the rejection of Medicare via certified mail, it may be difficult to prove that you opted out.

              Sincerely,
              Kay

  • Angelica

    I am receiving SSDI. I own my home and vehicle. Are these considered resources? And, will it affect my getting placed on Medicare after the 2 year Medicaid program? My family member left me a CD. . . will this affect my getting assistance, etc.? What are considered resources and can you have money saved in an account? Thank you

    • Kay Derochie

      Dear Angelica,

      I believe you are confusing SSDI with SSI. If you are receiving Social Security Disability (SSDI) and not Supplemental Security Income (SSI), what you own (your assets) has no effect on your SSDI or Medicare. The only types of income that can affect SSDI are workers compensation and, in some circumstances, public pensions.

      Sincerely,
      Kay

  • Fred

    Hi,
    my wife is on SSD now. she has been on it for over 2 years. she is covered under my work insurance now. i would like fr her to have her own insurance in case something happens to me. she has rumatory arthritis and has to pay a co- pay for the remicade prescription and doctor. what parts A,B,C ETC would be best to purchase
    Thank you

    • Kay Derochie

      Dear Fred,

      Part A Medicare is automatic and does not have premium because it was paid for with payroll tax deductions while your wife worked. Part B Medicare to cover most outpatient services including doctors. Part D covers medications and has more than one option to choose from. At least one of Part D options leaves a gap with no coverage once a certain medication dollar amount has been met and then picks up later when a second dollar amount has been reached in a year. The uncovered period has become known as the doughnut hole. You can get more information at http://www.medicare.gov.

      Medicare pays less than other insurances for the same services. Therefore, not all doctors take Medicare patients and some of those who do, do not accept assignment. That means that they will take Medicare Insurance but the patient has to pay the difference between what Medicare pays and the provider’s usual charges. This means that the patient is responsible for more than the usual co-pay.

      Most people purchase a Medicare supplement insurance or a Medicare Advantage plan that wraps Medicare and the supplemental insurance together to obtain good wraparound coverage so that full or nearly full coverage is obtained with just small co-pays. Some of these include prescription coverage with or without the purchase of part D.

      I suggest that you research whether it is more advantageous monetarily and coverage wise for your wife to have Medicare and the current work insurance. Also look carefully at your work insurance to see whether the policy requires their insureds to enroll in Medicare when they become eligible in order to have insurance continue or whether the policy terminates with Medicare eligibility. Compare costs to the cost of Medicare and a Medicare supplement or Advantage plan.

      As you can see this is a complicated choice. You may want to get help from an insurance broker who is knowledgeable about Medicare and Medicare supplements in your state.

      Sincerely,
      Kay

    • Christine

      Hi,

      I just started getting SSI benefits back in July 2015. I received 12,000 in back pay and get $685.00 a month after the SSA takes 105.00 out for Medicare premiums. I applied for Medicaid and was told my application was approved for Spenddown Medicaid in Spenddown status. What does this mean? I can’t afford to live on only Ssi payments if I can’t get help paying the 105.00 dollars that is taken out.

      • Kay Derochie

        Dear Christine,

        You are receiving SSDI (Social Security Disability), not SSI (Supplemental Security Income. I am not able to give you the details about Medicaid Spenddown. I suggest that you ask the office where you applied to explain it to you. If you have not applied for SNAP (formerly called food stamps), I suggest you do so.

        Sincerely,
        Kay

        • Christine

          No, I have been told many times that I am only getting AS I, not SSDI. I am confused, can you explain?

          • Kay Derochie

            Dear Christine,

            I suggest that you contact Social Security again. Medicare premiums are not withheld from Supplemental Security Income (SSI) benefits. Perhaps the $105 being withheld has something to do with the Medicaid spend down. To be eligible for Medicare you have to be age sixty-five or have to have received twenty-four months of Social Security Disability benefits or have to be on kidney dialysis.

            Sincerely,
            Kay

            Sincerely,
            Kay

  • Bernice

    I recently started receiving ssi and now the department of children and family in Florida is saying I can’t get both. Is this correct? I have Parkinson’s my meds are 682 dollars. I’m so confused nobody explains any of this to people. Maybe I should have gone to school for social work

    • Kay Derochie

      Dear Bernice,

      If your Supplemental Security Income (SSI) is too high for you to receive aid for your children, then that benefit will stop. The amount of your food stamps might also be affected. The children should be able to continue to have health insurance. If the state does not continue insurance for them, go to http://www.healthcare.gov and apply for insurance for them under Children’s Health Insurance Program (CHIP). Typically, a person who is eligible for SSI is also eligible for Medicaid, which should cover your medications. In the meantime, try contacting the pharmaceutical companies that make your medications to see if you can get a month or so of free medications. Some companies will do temporarily provide free medications that are critically needed.

      Sincerely,
      Kay

  • David

    Hi, I live in Florida and receive SSD and my health care is Medicaid medically needy. I just received information that I am now eligible for Medicare. My question is, do I continue to receive Medicaid to help Medicare part B and D expenses or should I enroll in a Medicare Advantage Plan? Thank you.

    • Kay Derochie

      Dear David,

      I suggest that you talk with the Medicaid program administrator to find out whether the part of the Medicaid program you are covered under will continue now that you have Medicare. In some circumstances Medicaid will continue to pay prescriptions and will pay the Part B premium.

      Sincerely,
      Kay

  • Dorienne

    I’m 56 year old female. I receive SSI and Medicaid. Disabled since 1993. Can I also apply for Medicare in addition to having Medicaid?

    • Kay Derochie

      Dear Dorienne,

      To receive Medicare before age sixty-five, you have to receive Social Security Disability for twenty-four months. Whether or not you will be eligible for Medicare at age sixty-five will depend on whether you worked enough to be insured for Medicare or are a eligible dependent or survivor of someone who has.

      Sincerely,
      Kay

  • I’ve been on permanent disability for 15 years. I am divorced and Social Security Disability is and has been my only income during this time. I receive help with Part B premium thru Medicaid and receive a very small food subsidy. Over the years my status has changed several times from SLMB to QI. It is my understanding that is due to my annual cost of living increases. I am now at the bottom step, QI, so my question is regarding what happens next. Is it possible to lose the $104 monthly Part B premium Texas Medicaid has been paying for so many years simply through cost of living increase? Nothing else has changed to disqualify me but I’m looking ahead without even knowing what the increase will be. Thank you.

    • Kay Derochie

      Dear Deborah,

      I presume that if the cost-of-living increases raise your income too high to qualify Medicaid that you will lose the Medicaid and its payment of your Medicare Part B premium. If that happens, I suggest that you review the Medicare website (www.medicare.gov) to see whether there are other programs that might help.

      Sincerely,
      Kay

  • Hello KAY i have been on ssid for 4 years after being tuned down for 7 years trying to get on it once i hired and attorney i got my benefits the doctors from ssid who performed my physical stated that i should not be working and they still turned me down it wast until i hired the attorney before i finally got excepted but for the last 2 years they keep on wanting to re-certified me by having to fill out a 12 page questionaire to see if i am still disable i just turn 60 on september 1 why are they doing this to me i called my attorney and he advised me not to piss them off just get it filled out and send it back to them asap also he stated to me that when i turn 65 and go on regular ssi retirement that my benefits will get cut by 200 to 300 dollars how is that possible since they based my ssid on how much i made for the best 10 years of employment how does that change to regular ssi retirement can you please explain why im being harass and do my amount changes and why thank you ralph

    • Kay Derochie

      Dear Ralph,

      Your medical records apparently still hold information that indicates your condition could improve significantly. That is why your claim is being reviewed frequently. Follow your attorney’s advice and keep filling out the forms.

      Disability benefits are not based on the highest ten years. The formula considers your earnings and your age when becoming disabled. Typically benefits stay the same when being switched from disability to retirement benefits at full retirement age. Your full retirement age is probably age sixty-six, not sixty-five.

      Sincerely,
      Kay

  • Carmella

    Hi
    My son will be receiving benefits shortly because his father is disabled. Is my son entitled to Medicare or Medicaid through the state?

    • Kay Derochie

      Dear Carmella,

      If you and your son have limited income, your son may be eligible for Medicaid or other insurance through the CHIP (Children’s Health Insurance Program), but the eligibility will not be based on his receiving Social Security dependents benefits. You may also be eligible for insurance for yourself through the Affordable Care Act (aka Obamacare). Check online at http://www.healthcare.gov and/or at your local state or county social services department.

      Sincerely,
      Kay

      • Carmella

        Thank you! Also my son is 20 months and his father never told me he received social security. Is there and appeals process that I can file because he should have been receiving since he was born?

        • Kay Derochie

          Dear Carmella,

          Any decision regarding the amount of benefits or when benefits begin can be appealed; however, it may not be successful in this case. The maximum retroactivity for childrens benefits is six months prior to the date of application for the child. If your son was born after his father applied for benefits or his father did not list the child on his application, it is unlikely further benefits will be paid. If you think the child might have been listed on his father’s application, you could try appealing.

          Sincerely,
          Kay

  • Ronna Schultz

    My sister is currently receiving SSI and is on Medicaid. She will turn 65 in September. She received a letter from SSA stating she will receive an additional $300 a month for Part A and Part B and in the next paragraph it states her monthly Part B premium will be $105. Is this because she is going from Medicaid to Medicare because she has turned 65? In addition, does this mean she will be seeing an approximate $200 increase in her monthly distribution?

    • Kay Derochie

      Dear Ronna,

      I can’t tell what the situation is with your sister’s benefits without seeing the context in which the figures were presented. I suggest that she take the letter to Social Security or call the call center at 1-800-772-1213 and request an explanation. I can, however, provide some general information: $104.90 is the current Medicare premium for individuals enrolling in Part B Medicare at age sixty-five. There is no premium for Part A. If your sister continues to be eligible for Supplemental Security Income (SSI) and Medicaid, it would be typical for Medicaid to pay the Medicare premium.

      Sincerely,
      Kay

  • Andrew

    Hello, My sister had been on Medicaid for two years as well as her 2 year old daughter. The hospital for the pregnancy were all under Medicaid. Now She has been approved for SSDI for being legally blind and given retroactive pay for 25000.00. She previously worked for 15 years but didn’t work for 2 years prior to Dad i approval. Will the Medicaid continue to cover her and the child, and will the try to take the back pay. Thanks so much

    • Kay Derochie

      Dear Andrew,

      It is likely that your sister and niece will not be eligible for Medicaid at least for a period of time because she can afford to buy her family’s health insurance. Your sister has sixty days after the Medicaid stops to apply for insurance for her daughter and herself through the Affordable Care Act (aka Obamacare). She can get more information at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Larry reiss

    In need of a second opinion just to make sure I have the correct facts.

    Larry made too much money last month. With his pay check and social security he made 775.00. He lost his 30 dollars from SSI. I was told will keep his hospital coverage, but needs to pay his premium? The letter states that he will lose his SSI related medicaid benefits. They could not tell me how much his premium will be as he is covered until August 31st.

    • Kay Derochie

      Dear Larry,

      I am not sure what your question is. The standard Part B premium is $104.90 per month.

      Sincerely,
      Kat

  • analisa

    my mother is 57 and on social security. she currently has some kind of medicaid, but it covers nothing. no drs visits, no hospital bills. she has crohns disease and currently has to go to the county emergency room, sitting for 3 or 4 hours at the least just to get put into a room. What, if any, other medical insurance choices does she have? she has to pay some outrageous $1100 premium if she does choose to go to any regular clinic or urgent care. this is ridiculous. please help me to help my mother.

    • Kay Derochie

      Dear Analisa,

      I think the first step is for you and your mother to go to the office that administers her Medicaid coverage and get a better understanding of what it pays and where she can go for treatment that is not an emergency room. If she has Medicare and doesn’t have doctor visit coverage, she may have refused Part B Medicare, which covers doctors. If that is the case, she might be able to start it up now because she has Medicaid; otherwise she will have to wait until November to enroll and coverage will start in July. (There is a penalty for refusing Part B Medicare when it is first available and part of that is having to wait to get on it.) She might also visit http://www.healthcare.gov to see what her options are under the Affordable Care Act (Obamacare).

      Sincerely,
      Kay

  • Holly

    So I have a question regarding Social security, medicaid and disability. My father in law who is 62, does not work, is disabled and is currently on medicaid was told he did not qualify to receive SS because he did not work the last five years prior to enrolling so the state had signed him up for medicaid because they were going to lose their grant if they did not have so many people sign up. He was getting say $700 a month, now medicaid has now told him he needs to sign up for SS disability. Social Security disability has approved him but is paying him even less and in reading the paper work sounds like he is now going to loose medicaid. I believe SS will pay him now $400 which he should be getting at least $1000 from SS. Why would he lose his benefits of medicaid and get less from SS which now he would have to apply for medicare and pay a fee. This is the only income he gets I need to know what is his options? would obama care help him, his medical condition is no so good he needs to seek medical treatment for his condition on a regular basis but is not able to afford his living expenses and now medical.

    • Kay Derochie

      Dear Holly,

      People who receive Supplemental Security Income (SSI) are required to apply for all other benefits they may be eligible for. Therefore, your father-in-law was required to apply for Social Security Retirement benefits when he became eligible at age sixty-two. If he Social Security Retirement is less than $753, he will continue to be eligible for SSI in a reduced amount. The two benefits together, will total $753. The amount of his Social Security Retirement is reduced because benefits are being paid four years before he reaches full retirement age.

      In most states, as long as your father-in-law is eligible for at least $1 of SSI, he will continue to be eligible for Medicaid. If he is not, yes, it would be a good idea for him to see if he qualifies under the Affordable Care Act (aka Obamacare).

      Sincerely,
      Kay

  • Karen

    My sister is on disability, lives in Virginia, is under 65 and on Medicare. Because she lives in VA and is under 65 she has not been able to get supplemental insurance. She has cancer and is on dialysis and needs additional coverage to help cover all of her costs. Is the Medicare mandatory because she is on disability or could she drop it and apply for Obama Care? Are there other options for VA residents?

    • Karen

      It’s been a while and I have not received a reply. Checking back to see if there is any response you can provide to my questions?

      • Kay Derochie

        Dear Karen,

        Please see my reply of June 21.

        Sincerely,
        Kay

        • Lisa

          If a person is getting SSDI, do they have to accept Medicare if under age 65? Does turning down Medicare now affect their income check in any way?

          • Kay Derochie

            Dear Lisa,

            You cannot refuse Part A Medicare because you are insured for it and it does not require premiums. You can decline to pay the premiums for Part B Medicare; however, it you do, you may find that you have trouble getting health insurance elsewhere. I suggest that you investigate whether turning it down will have a negative impact on the health insurance you are planning to secure or keep before making a decision to decline the insurance.

            Sincerely,
            Kay

      • Elaine Simms

        Contact her dialysis Social Worker immediately! She can assist with finding supplemental coverage Plan F thru Blue Cross Blue Shield or Mutual of Omaha. She can also see if the American Kidney Fund can pay the premiums if your sister meets low income requirements. I am a former LCSW with 10 year history of working in the dialysis clinics as the Social Worker in Georgia. I am newly retired. Hope this helps.

        • aletha bradford

          I read your reply my question to you is can you or do you get an increase when you signed that paper at dialysis something that has to be sent in to the Social Security Office not sure what exactly the form was but I just started dialysis about 2 months ago and they had me to sign a paper and I wanted to know does it increase my monthly benefits or what is the purpose of sending that into Social Security

          • Kay Derochie

            Dear Aletha,

            The paper was probably to get you Medicare to cover the cost of your dialysis. It will not increase your benefit.

            Sincerely,
            Kay

    • Kay Derochie

      Dear Karen,

      I do not know the answer to your question for sure, but a few weeks ago another visitor to the site posted that he was not eligible for insurance in the marketplace because he was was eligible for Medicare and refusing Medicare did not change the fact of eligibility. I suggest that your sister contact a medical insurance broker for knowledgeable professional help in making her decision.

      Sincerely,
      Kay

    • Stephanie

      Hi. I’m also under 65 in va on disability because I’m on dialysis also. I have Medicare and just recently was approved for medicaide after applying 3 different times. I would say just keep trying and make sure you tell them what bills medical or not that she has to pay. Also has anyone talked to her about a spend down? I’m not good at explaining that but talk to her social worker they should be able to help

  • Jean

    I have been approved for ssd Jan 2015. I receive 925 a month. I called the insurance market place to tell them about my income increase. My sub. went from 146 per month to 23 dollars a month. My premium is now 525.00 per month. I can’t afford this premium. My husband is 67 and still works part time. If he retires right away, will it decrease my premium. I was told that I am locked in until Nov 15, 2015. We have been denied ssi. What can I do for the next 6 months? Also the insurance company is asking for back pay premiums. It seems as though we have slipped in the cracks. Please advise

    • Kay Derochie

      Dear Jean,

      I am not knowledgeable enough in the insurance market place particulars to advise you; however, it seems as if premiums can be raised retroactively, you should be able to have the premiums lowered mid-year when family income goes down. I suggest you discuss the matter with the office to which you reported the income increase.

      Sincerely,
      Kay

  • Patricia Westfall

    I am 63. Won’t be 65 til Nov 2016. I have insurance MDWise HIP Plus. It’s good ins. But not Medicaid. I can’t afford the 87.00 monthly premium for Medicare. My ins. Here in Indiana is 15.00. I have great insurance coverage. Do I have to take the part B or D. My meds aren’t that expensive. They just sent me the papers for this just 6/6/2015 and now they want to take it out this month. Help me please. Susan

    • Kay Derochie

      Dear Patricia,

      I suggest that you check with your MDWise HIP Plus insurer about the impact of eligibility for Medicare. It is possible that your current insurance company requires that you take Medicare Part B and/or D once you are eligible. I suggest that you also check with the Social Security Administration to find out if your declining Medicare based on having received two years of disability benefits will cause your Medicare premiums to be higher when you turn sixty-five and can qualify based on age, at which time your private insurance is even more likely to require you to take Medicare. Additional Medicare information can be found on http://www.medicare.gov.

      Sincerely,
      Kay

  • Gayle

    Hi, I was contacted by my former employer, a large telecom from, advising me that I may be eligible for SSDI. I am 53 and retired with full benefits. However I do have a chronic serious condition that my former employer and doctor believe has a good chance of being approved. I have searched and searched and made call after call and cannot get an answer to this question: I know I can keep my Blue Cross Blue Cross for two years. BCBS tells me they would become secondary to Medicare. Is that true, can I not keep BCBS. I’m guessing not, my employer is trying to drop health care for as many as possible. They are also taking a survey to see who is not taking Medicare B. My biggest worry is I have a medication that is about 3,000 per month and I don’t think it is covered by Medicare but BCBS says if Medicare doesn’t pay, they will pay primarily, generally. Does any of this sound feasible? I would hate to give up good insurance just for a not so minor check. I can’t get anyone at Medicare to answer this question. Thanks for any advice

    • Kay Derochie

      Dear Gayle,

      Medicare for disabled individuals starts after you have been paid twenty-four months of Social Security Disability benefits and those benefits start with the sixth full calendar month of disability. This means that your Medicare will not begin until the thirtieth month of disability. Therefore, it does not appear that Medicare and your continued Blue Cross-Blue Shield will overlap. (After your Medicare starts, there are many Medicare supplemental insurances that can be purchased, some of which offer prescription coverage.

      Sincerely,
      Kay

    • Kathleen M Munro

      Just wanted to let you know I also have a med that has a very high co-pay ($2300) and I have been without it for some time. However, as a disabled person receiving SSDI, I applied for the Medicare Extra Help Program online and now my co-pays have been reduced. I picked up 7 prescriptions yesterday at a cost of $18.55. That was $2.65 each. My Part D payment to the insurance company has been reduced by half. I would suggest that any one who reads this make the application today!!! It is so easy and you can do it all online at the Medicare website.

      • Kathleen M Munro

        I should have mentioned that those were all 90 day supplies!!!

      • Kay Derochie

        Dear Kathleen,

        Thank you for the useful information.

        To readers: The Medicare link is http://www.medicare.gov.

        Sincerely,
        Kay

  • linda woodcock

    Hi I recievessd of 732.00 a month they take like 104.00 out of my check for medicare I only receive 617.00 I can barely make it I have seizures can I get ssi and medicaid once they take the amount out of my check I still have to pay Dr and visits cost me 20.00 plus my med I need more money and medicaid to help me through month. Please anything I can do? Thanks in advance.

    • Kay Derochie

      Dear Linda,

      You could be eligible for $1 Supplemental Security Income (SSI. In most states that would make you eligible for Medicaid. The Medicaid program will then pay your Medicare premium for you. Call Social Security at 1-800-772-1213 before the end of the month to avoid potential loss of benefits. When you call request an appointment to apply for SSI and ask that the date you call be your protected filing date. (Depending on the amount of the cost-of-living adjustment next year, you may be eligible for SSI only through the rest of this year.)

      Sincerely,
      Kay

  • Carrie

    I have been disabled since I was 58 and received my SSDI. So my for different forms has been “Disabled”. Now that I’ve reached my full retirement age of 66 I received a letter from Social Security Retirement stating that fact! My benefits haven’t changed! My question is, what is my on different forms now, am I considered “Disabled or Retired”? I’m still disabled but I’ve just reached ‘Full Retirement Age’ Thanks for your consideration of this matter?

    • Kay Derochie

      Dear Carrie,

      Once you receive full retirement age, disability is not material to receiving benefits so you are switched to retirement status. There are no longer restrictions on your working or how much you can earn and receive benefits.

      Sincerely,
      Kay

  • natachia

    I live in the State of Texas and I am disabled widow, and receive SSI, and receiving Medicaid and will be turning 50 in a month. I was told as a disabled widow, I am in titled to my husbands Social Security, which i would be receiving 1,700 a month. I now only receive 720 a month and allowed $2000 in the bank to keep SSI and Medicaid. I have expensive medicines IVIG to stay alive and i do not know if I take my late husbands Social Security benefits if I will be kicked off Medicaid and forced to have Medicare? Or am I allowed to the $2000.00, which I think i might be in worst shape financially with having to pay 20% co payments ( or whatever the amount is) and or also have to buy a insurance supplement ??? Please Help

    • Kay Derochie

      Dear Natachia,

      Supplemental Security Income (SSI) law requires that you apply for and receive all benefits payable to you because SSI is supposed to supplement other income (as the name implies.) Accordingly, you will have to accept the widow’s benefits. You will not be eligible for Medicare until you have received two years of disabled widow’s benefits. If your Medicaid ends when your SSI ends, you can immediately apply for insurance under the Affordable Care Act (Obamacare). It is possible that you might qualify for a government subsidy to pay part of the insurance premiums. You can obtain more information at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Amelia

    I am 51 and have been receiving SSDI and Medicare for about 3 years. I don’t have any assets to speak. I rent and work from home about 20 hours a week. A family member has offered to provide a down payment on a small house and co-sign for the house so that I will have a place later down the road.

    I understand that this would not affect my SSDI, but I’m not sure about the Medicare. It’s the only insurance I have so I don’t want to jeopardize it. I have parts A, B, and D.

    Do you know how this situation might affect me? Thank you.

    • Kay Derochie

      Dear Amelia,

      Gifts you receive will not affect your Medicare entitlement.

      Sincerely,
      Kay

  • I am a 64 year old male that has worked all my life in construction .I drive dump truck for a living and payed into social security. I suffered a heart attack and am now in heart failure from time to time . I am not physically able to go back to work. I am not able to drive. Can I receive any help because of my age! What can I apply for ? Didn’t see any situation posted similar to what is happening with me. Thanks for you response.

    • Kay Derochie

      Dear George,

      You can apply for Social Security Retirement benefits right away. Retirement claims are processed and paid quickly. Start your application before the end of the month in order not to lose benefits. At the same time, you can and should file a disability application, which will take longer to process. If you are approved for Social Security Disability, your retirement benefit, which will be reduced somewhat because you are not at your full retirement age of sixty-six, will be changed to the higher disability rate comparable to unreduced retirement benefits. You can file your applications online at http://www.ssa.gov or by going to your local Social Security office or you can call Social Security 1-800-772-1213 and ask for an appointment either by phone or in an office to apply for both retirement and disability.

      Sincerely,
      Kay

  • leon

    I am currently applying for ssdi , waiting on approval.I have my home up for sale if I sell it will it affect my out come of ssdi

    • Kay Derochie

      Dear Leon,

      If you are applying for SSDI (Social Security Disability based on your work record) and not SSI (Supplemental Security Income based on low income and assets), selling your house will have no effect on your claim. If you have an SSI claim and don’t plan to buy and actually buy another house within three calendar months of the sale, the proceeds of the sale would likely make you financially ineligible for SSI for a period of time.

      Sincerely,
      Kay

  • Nasser

    I receive SSD 987.00/ month and my wife and 2 kids receive $178/ month each. recent my wife she became full time at DOE_NYC earning 22k per year. she and my kids has Medicaid health Ins. myself I am disabled receive AARP Medicare complete by United Heath Care and my copay is high. what is the best way cut down on my high co-pay? Can she keep her Medicaid with the Kids? do you suggest transfer my kids to my case? or transfer everyone to buying additional insurance through my wife employer’s Insurance?

    • Kay Derochie

      Dear Nassar,

      Your dependents cannot be covered by Medicare and I doubt that they can be wrapped into your insurance plan, which sounds as if it might be a Medigap or Medicare Advantage plan. I suggest that you contact an insurance agent who is experienced in insurance and have them help you compare Medicare supplement plans to see which would work the best for you at the best price. Typically these agents do not charge a fee because they receive a commission the insurance company that you pick.

      Sincerely,
      Kay

  • U.K.Sharan

    If I go out of USA for a period of 3 years with intimation to Social Security Office and when I come back,will my SSI be resumed after stay in USA for 30 days.Will this affect my duel eligible health coverage.

    • Kay Derochie

      Dear U.K.,

      If you leave the United States for three years, when you return you will have to file a new application to establish eligibility. Benefits will not start automatically because you will have been ineligible for twelve months.

      Sincerely,
      Kay

  • Andrea

    Hello Kay,
    I have been on Medicaid while my SSD case is pending. Now its been approved and I will receive almost 2 years of backpay at once. Will this make me immediately ineligible for Medicaid?

    • Kay Derochie

      Dear Andrea,

      If you have two years of back pay coming, it may make you ineligible for Medicaid; however, after twenty-four months of Social Security benefits including back pay months, you will be eligible for Medicare and can apply for a Medicare supplement insurance.

      Sincerely,
      Kay

  • Becky

    My son receives s.s.I due to a disability; the state started deducting xx.oo dollars from his child support check for medical coverage in 2011 that was court ordered them. My question is, since my son was already receiving medicaid through s.si., can the state still make his dad pay for state medicaid? Wouldn’t that be double coverage?

    • Kay Derochie

      Dear Becky,

      I suggest that you discuss this with a family law attorney or the court directly. Some things to consider are whether the medical coverage that was being provided before your son’s SSI eligibility is more comprehensive in coverages your son needs than the Medicaid coverage he will get with SSI eligibility.

      Sincerely,
      Kay

  • Brad

    I am the guardian for my son(autistic), he is 18 lives with me and is under my care, We recently applied and started receiving SSI benefits(Texas) in the amount of $733 a month.
    My question is: Can I continue to keep him on my Ins. (Aetna) until his age of 26, which ends his coverage under age restrictions. And he is receiving SSI benefits?

    • Kay Derochie

      Dear Aetna,

      You will have to review your Aetna policy or check with Aetna for an answer to your question. Given that your son has been approved for SSI, he may also be approved for Medicaid and that could be a factor in whether or not he can continue on the Aetna policy.

      Sincerely,
      Kay

  • Sandra

    I collect disability and SSI and was wondering if Me getting marriedwill affect my social security income? his net pay monthly is around $1700 dollars and my net income a month $753. I’m not so much worried about losing the $77 check for SSI but I don’t want to lose my Medicaid it helps me pay for my doctor’s visit. can anyone help answer this question?

    • Kay Derochie

      Dear Sandra,

      I believe that you will be ineligible for Supplemental Security Income (SSI) given your Social Security and your future husband’s income; however, you should check directly with the Social Security Administration. If you cannot get health insurance through your husband’s employment, you can apply for health insurance through the Affordable Care Act (ACA), also known as Obamacare. You must apply through the ACA within sixty days of losing your Medicaid or else you have to wait until the open enrollment period at the end of the year. Through the ACA, you and your husband my qualify for a government subsidy to help pay the insurance premiums. You can get more information at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Kimberly

    My ex husband has SSI income and my daughter gets a dependent check (instead of child support) bc he is disabled. She had recently been sick and run up a weeks worth of hospital bills our insurance(provided through employer) doesn’t cover all her expenses so we will be paying 4K or 5K out of pocket. My current husband and I make too much money to qualify for medicaid. Is there a way for my ex to qualify for medicaid for my daughter or get my daughter medicad to cover her hospital bills? Legally he is responsible for 50 percent of all her medical expenses but you can’t squeeze juice out of a turnip. Plus I am worried about my credit rating if I only pay 50 percent of the bill. We live in Texas.

    Best Regards,

    Kim

    • Kay Derochie

      Dear Kimberly,

      Your daughter cannot get health insurance through your husband’s disability benefits or his Medicare coverage. I suggest that you get a copy of the employer-sponsored insurance policy and read through it very carefully, especially co-pay amounts, covered services and excluded services and compare the coverage to the itemized billings to be sure that the insurance company has paid correctly. You can also look into a government-sponsored insurance program for children, but I don’t think she will qualify because she already has insurance, plus coverage probably would not be retroactive. You can get information about the program at http://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program.

      Sincerely,
      Kay

  • Mishele Cramer

    I have been on a ssi for more then 24 months.I decided not to have the insurance payments taken out on my ssi check. Can I still be eligible for insurance.

    • Kay Derochie

      Dear Mishele,

      Apparently you are receiving Social Security Disability (SSDI), not SSI, which is Supplemental Security Income (SSI). You can enroll during the next open enrollment period, which will be in late 2015, for the Part B Medicare (and apparently Part D Medicare for prescription medicine) that you previously refused. Your insurance will start the following July at a higher rate than if you had accepted it when initially offered. I do not know whether you can enroll in other insurance after declining Medicare Part B. You can check by contacting insurance companies or visiting the Affordable Care Act (Obamacare) website at http://www.healthcare.gov.

      Note that you still have Part A Medicare which covers hospitalizations and some other services because Part A was funded through payroll tax deductions while you are working. Part B that you refused covers most doctors and outpatient services.

      Sincerely,
      Kay

  • caroll d. crowley

    I have recently been approved for disability, Im 60 years old , my work leave payments and company insurance will end of 04/ 2015.I know about the 2 year wait , but what are my options for insurance for myself and wife who is 54 years old. Ive had a stroke and I am diabetic ,both require medicines to control. My company has ANTHEM AND I Live in KENTUCKY,Where do I GO from here? Ive worked for 41 years with the same company,they say I will not be able to stay on their coverage. Please give me some direction toward coverage for myself and wife.

    • Kay Derochie

      Dear Caroll,

      If you and your wife apply for insurance through the Affordable Care Act (Obamacare) within sixty days of the date your and your wife’s insurance terminates, you can get insurance through the insurance exchange. With reduced family income, you may qualify for a government subsidy to help pay for premiums. You can get more information and apply at http://www.healthcare.gov.

      Sincerely,
      Kay

  • jvahe

    My boyfriend is 38, he was in a car accident that has prevented him from working since December, while at the hospital we started an application for SSI but have not heard the decision yet. He does not have health insurance, and so far everything has been added to the “hospital bill”, which the other person’s auto insurance should cover; my question is that now that he needs to continue to go to the doctors for follow up, would he automatically qualify for medicaid or medicare? Should we do a different application for health insurance?
    Thank you!

    • Kay Derochie

      Dear Jvahe,

      The auto insurance that is covering your boyfriend’s hospital stay should cover his outpatient medical bills for treatment of his accident-caused injuries. If he is approved for Supplemental Security Income (SSI), in most states he will be eligible for Medicaid. If he is approved for Social Security Disability (SSDI), he will be eligible for Medicare after receiving twenty-four months of benefits. To be eligible for either SSI or SSDI, he has to be disabled for twelve months or be expected to be disabled for twelve months.

      Regarding health insurance in general, the law requires individuals who do not have health insurance to apply for it under the Affordable Care Act (Obamacare). Government subsidies helps those with low income with the cost of premiums. The open enrollment period to enroll for 2016 will be in the last calendar quarter of 2015. You can obtain more information about this at http://www.healthcare.gov. Your boyfriend could also apply to the state or county social services department to see whether he might be eligible for Medicaid. A social worker at the hospital might provide help with the application. If he is eligible, the Medicaid program will require the auto insurance to pay before Medicaid pays.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • Robert

    Hello Kay, you certainly seem to be a real expert here. I would like to assist my brother-in-law in this complexity. He is 55 and has just been diagnosed with multiple myeloma, and is now unable to work (maybe forever). He has been told he will qualify for SSD. They also gave him a rough estimate of his monthly benefit. I expect income taxes will come out of each payment, but am wondering if his benefit payments will also trigger a deduction for Medicare or Medicaid? Or, if Medicare/Medicaid are even in the picture at his age? His wife has basic family health care coverage through her job; perhaps that coverage can be reduced if Medicare/Medicaid does apply? Can you help with some direction? Thanks

    • Kay Derochie

      Dear Robert,

      Your brother-in-law will qualify for Medicare after he has received twenty-four months of Social Security Disability (SSD) benefits including any back benefits that may be due by the time his claim is approved and paid. Medicaid is a government health insurance program for people with low income and no other insurance.

      If your brother-in-law still has health insurance through his wife’s job by the time Medicare starts, the two benefits will be coordinated usually with Medicare paying first and the other insurance paying any amount between what Medicare pays and what the other insurance would have otherwise paid. The biggest benefit of keeping him on his wife’s group insurance may be the difference in prescription coverages between it and Medicare.

      Sincerely,
      Kay

  • Amanda

    I’m 37 and I’m currently getting disability and medicaid. The 2 year mark is coming in June of this year. So at that point I will be able to enroll in medicare. I see on the paperwork that, other than part A, I have to pay for medicare. I’m a little nervous because my ssi is $1316. per month and it is already tight money wise. Do you think I can keep medicaid also? I do not know how I can pay my mortgage, utilities, car insurance, etc on any less money than I have now. Please advise. Thanks!

    • Kay Derochie

      Dear Amanda,

      From what you describe, you are receiving Social Security Disability (SSDI), not SSI, which is Supplemental Security Income. If you continue to be eligible for Medicaid after you also become eligible for Medicare, the Medicaid program will likely pay your Medicare premium. (The Medicaid program probably requires you to accept Medicare.) If you are no longer eligible for Medicaid after the Medicare eligibility begins and you have to pay for Parts B and D medicare, perhaps you can apply for SNAP (formerly called food stamps), winter energy assistance, or take in a roomer to help out financially.

      Sincerely,
      Kay

      • Jill

        I am on disability and Medicaire. I need hearing aids. I was told that if I had full Medicaid, this specific place would pay for my aids. DSS pays my Medicare premium and I get extra help. Does that also mean that I have FULL Medicaid as well as Medicare? Need to know so that I can get my hearing aids. Can’t afford them otherwise. Thank you!

        • Kay Derochie

          Dear Jill,

          You need to check with your Medicaid office to find out whether you are on Medicaid and, if so, whether it is the plan that covers hearing aids.

          Sincerely,
          Kay

  • willie

    For two years in a row my local medicade office has lost our application info and all costin me almost $400 a year.finaly got them to admite it.my medicad benifs still of.live in bude,ms but they out of natchez.ms office.they come to my town clinice once a week.. ho do i call in my state to help me with them? Wife called around middle month asking about turning in info ahead of time to renew case said too early to turn in wait until we mail you a letter to come in she brought papers anyway leftward lady helper at clinic so she got renewal letter in on me and termination letter only hurt On February 20th end of the day Friday after business hours so had to wait in the next Monday February the 23rd to call local office put God in mail before to call her termination letter saying she hadn’t turned in her paperwork so they tell her to come in the following Thursday February 26 to redo application the lady works out in Natchez Mississippi office comes a clinic in town here once a week on Thursday she took our applications back to Natchez Mississippi Medicaid office then after that our applications were lost again soba March 26 of security office hasn’t got anything for Medicaid office they send a letter canceling my benefit Medicaid so call the day and they finally admit that they lost applications now I gotta come in Thursday March the 19th redo another application all the time and Medicaid still off. I have QMB medicaid pays what Medicare doesn’t cover even my premium Social Security automatically start withdrawing premiums from my monthly benefits they take 2 months in advance which comes out for me $294 then the next Monday I’ll hold out $104 premium parte Medicare expense then they reimburse you half of what they took from you. I know this because this is the same thing my Medicaid office done to me last year. then it takes until June 6 months into the year to get it back straight they tried to blame it on my wife saying she didn’t redo the paperwork in time they sent the form letting her know it was time but that was a lie they admitted that they lost our applications twice were apologizing for it and even reimburse us last year and it happen again this year we need help losing this amount of money in a month makes us lose food and meals in a day really hurts me and my family need help with my local office don’t know who to call to get them to do my case is right every year never had this problem till I moved to Franklin County Mississippi basically 23 years or longer in a row and keep losing all applications information gets too late benefits get turned off end up having to pay to 3 months of part a Medicare premium deductions all because workers lose paperwork for years now Medicaid get turned off around first year all about the same time Medicare premiums are due are all due to case worker negligence losing papers costing hundreds and grief. help

    • Kay Derochie

      Dear Willie,

      I suggest that you try to talk to the supervisor at the office that handles your Medicaid and explain how much the loss of the application renewal forms is costing you and that it has happened more than once. Ask what can be done on your part or their part so it doesn’t happen again next year.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • Gary

    I have been waiting for 16 months for my hearing fir SSI. I am uncertain if I will quailify. If I do qualify, will my children, that live with their mother, get any benefits? Insurance? Money?

    • Kay Derochie

      Dear Gary,

      If your claim is for SSI (Supplemental Security Income), no dependent benefits are payable. If your claim is for SSDI (Social Security Disability), dependent benefits can be paid to the children’s mother for the children if your earnings have been high enough to allow for dependent benefits.

      Dependent benefits are not accompanied by health insurance; however, the children’s mother could apply to the local state or county social services department to see whether the children qualify for health insurance through the government. Alternative, during the next open enrollment at the end of the year, she could apply for insurance through the Affordable Care Act (Obamacare) and perhaps receive a government subsidy to help with the cost of premiums.

      Sincerely,
      Kay

  • Rebecca Faulk

    I live in Texas,I am on disability,I make $741 a month,I am also on Medicade/Medicare,my husband has been trying to get disability as he has severe back issues.I was told if he gets disability I will loose all my disability insurance and will only get $140 a month from Social Security. I want to know if this is true and why,most states do not go by your spouses income as to what your income is.

    • Kay Derochie

      Dear Rebecca,

      Please clarify a couple points so I can try to respond.

      1. Do you get both Social Security Disability (SSDI) and Supplemental Security Income (SSI)? If so, how much is each?
      2. If you husband is approved, will it be for SSDI? If so, do you know the amount he will receive?

      Thanks,
      Kay

  • Carissa Riner

    I have Parts A, B, and D taken out of my SSDI every month. Can I file taxes to get that money back?

    • Kay Derochie

      Dear Carissa,

      I do not know for sure, but I don’t think that Medicare premiums qualify for a tax credit under the Affordable Care Act because you are buying your insurance from the government, not a private insurance company. You can find out more at http://www.heathcare.gov and http://www.medicare.gov. I suggest that you check with a tax accountant to be sure of tax law.

      Sincerely,
      Kay

  • Karen

    If I am receiving social security disability and receive Medicaid as a result of it (after the waiting period), and I have a dependent who receives a child benefit (who is not disabled), will the child be eligible for Medicaid also?

    • Kay Derochie

      Dear Karen,

      I believe that if you check you will find that your have Medicare, not Medicaid. Your child does not qualify for Medicare. Your child may, however, qualify for another health insurance under the Affordable Care Act (Obamacare). Go to http://www.ssa.gov and look for anything to do with healthcare for children. Another option is to contact your state’s social services department to see whether your state has insurance options for your child.

      Sincerely,
      Kay

  • Rita

    I am 57 and suffer from mental illnesses. I was granted Social Security Disability income as well as SSI which started on 1/3/2015. I received a blue Medicaid (MS) card in December 2014, that on the bottom right of the card reads, “ISS 12/14/14.” I spoke with a doctor’s office for an appointment and was told this blue card expires the end of January 2015, and that I have to apply for “regular Medicaid.” I am getting all sorts of answers, from the SS office, the local Medicaid office and the one in my state capital, to my questions that don’t make sense. Why is this blue card expiring, am I going to lose Medicaid at the end of the first full month that I’ve had it? It is very important that I see my psychiatrist (first appt available is Feb 2015) and continue taking my medications, so losing this Medicaid coverage is extremely frightening. Would you help me sort this and figure out what my plan of action should be? Thank you!

    • Kay Derochie

      Dear Rita,

      I am not a Medicaid expert so can be of limited help. I can say that eligibility that is tied to SSI is determined on a month-by-month basis because SSI eligibility is month by month.

      Rather than trying to figure out what is going on, perhaps you could as the basic question: Am I set up in the computer system for Medicaid in February? Perhaps you could also ask whether you are going to receive a new card every month and, if so, on what day of the month will you receive it? Last question would be, if your card doesn’t come on time, can the medical provider call a number to confirm coverage.

      Sincerely,
      Kay

  • jeanne

    I am receiving SSI I was put on Medicaid Molina will I lose my SSi check if my ex-husband adds me to his medical Ins?

    • Kay Derochie

      Dear Jeanne,

      You will not lose your SSI by being added to a private insurance policy.

      Sincerely,
      Kay

  • John Ray

    I live in Michigan and have stage four breast cancer im on disability ssd we have private health ins. but my wife is loosing her job and ins. i have twins 18 years old and seniors in high school going to graduate this year. Do they my wife and children qualify for medicare or medicaid she cant get unemployment and i get disability on the twins our total amt. is 1800.00 monthly. Or should i be looking at dhs for help. Iam 53.

    • Kay Derochie

      Dear John,

      Your wife and children are not get Medicare. If your children are receiving disabled adult child benefits on your Social Security earnings record, they will be eligible for Medicare after they have received twenty-four months of disability benefits. If they are receiving Supplemental Security Income (SSI) disability benefits, they may qualify for Medicaid because they are SSI eligible. If they get SSI, check with Social Security to see if they have to file an application with the Department of Human Services (DHS) of your state to get Medicaid or whether they should be getting automatically following their SSI approval.

      Your wife (and children if they don’t have Medicaid) can enroll in health insurance through the Affordable Care Act (Obamacare). Depending on the your and your wife’s total income, she may be eligible for government subsidy to pay for part or all of the premiums. (Note that the law now actually requires that people have health insurance. Failure to secure it can result in tax penalties.) She can get more information at http://www.healthcare.gov. It happens to be during the annual open enrollment period until February 15, so the timing is right for her to apply. Note that if the children apply, I believe only their own income will be considered in determining whether they are eligible for a premium subsidy. Let me know if I am mistaken on that.

      Sincerely,
      Kay

  • Hello my name is debbie, I just got my back pay and my first check will be jan. 2015
    My monthly check will be 738.00 a month from ssd. Can I receive medicaid and medicare.

    • Kay Derochie

      Dear Dear Debbie

      You will qualify for Medicare after you have received twenty-four months of Social Security Disability (SSDI) benefits, including retroactive months. If you have no other income and your countable assets (some are not countable) are $2,000 or less ($3,000 or less if you are married living with your spouse), you may qualify for Supplemental Security Income (SSI) benefits depending on your living arrangements (and your spouse’s income, if applicable). SSI eligibility usually results in Medicaid eligibility.

      Sincerely,
      Kay

  • Marvin Ebara

    I was approved for SSI on December 30,2014. I understand that I am automatically on Medi-Cal . I have not received a card yet.

    I needed a refill for Dulera, an inhaler for my asthma, very expensive. I paid out of my pocket on Jan. 2, 2015.

    Dulera is in the approved list for Medi-Cal.

    How do I get reimbursement, if I am entitled. It cost me $274.00

    Thank you.

    • Kay Derochie

      Dear Marvin,

      Check with Medi-Cal, but your payment may not be reimbursable. If it is, Medi-Cal can tell you the procedure to follow.

      Sincerely,
      Kay

  • Steve Bagley

    My ex wife receives SSI and medicade. She will receive SSD in a few months. She just sold her personal home for a $15,000 profit. Does she need to report the home sale and Will she continue to receive Medicare when her SSD kicks in?

    • Kay Derochie

      Dear Steve,

      Your ex-wife needs to report the sale of her home to Social Security because she is still receiving Supplemental Security Income (SSI). She will be ineligible for SSI as long as her resources are over $2,000 or until she reinvests the money in another home in which she lives. She will be eligible for Medicare after she has received twenty-four months of benefits including retroactive months.

      Sincerely,
      Kay

  • Debra chorr

    Hello , Kay I receive social security disability ordered by a judge in Indiana where I also received medicaid ,and while waiting for my medicare to start in 1 year from now. Because of my health condition I was needing to relocate to Texas where my daughter could help me at home. I applied for medicaid and was told I don’t qualify.i need to see my pullomanary Dr and a liver specialist Dr. Here in Texas whom I have been under care in Indiana for 2 years and more. But the Department of aging for people with disabilities or the public aid office will approve me I am not over the monthly income guideline. They only tell me there doing their job when I ask them why? Will you please give me your opioin

    • Kay Derochie

      Dear Debra,

      You have the right to know why you have been denied Medicaid and you probably have the right to a written denial with appeal rights. If you can’t get a clear explanation or get one and agree you are not eligible, I suggest that you look into insurance under the Affordable Care Act (Obamacare). The annual open enrollment period is going on now and you have until February 15, 2015 to apply. If your income is low, you may qualify for a government subsidy to help pay your premiums. For more information visit http://www.healthcare.gov.

      Sincerely,
      Kay

  • valerie moore

    Hi,
    I have just been approved for SSDI & been receiving Medicaid. My monthly will be $1300, but how or when does the two ur waiting period start & do I lose my Medicaid? Help, what do I do in between?

    • Kay Derochie

      Dear Valerie,

      The two-year waiting period for Medicare begins with the first month for which you were paid Social Security Disability benefits including back-pay months. If your Medicaid stops, you may be able to get insurance through the Affordable Care Act (Obamacare), possibly with a government subsidy for premium payment. If you lose your insurance, you can apply any time during the year provided you apply within a specific period of time after the loss of insurance. More information is available at http://www.healthcare.gov.

      Sincerely,
      Kay

  • Bri

    I have been approved for social security disability, my payments will be $845.00 monthly. I have no other income. I received a medicare card in the mail. I have been on medicaid for the last couple years, can I keep using medicaid or do I have to sign up for medicare. I am 60 years old.

    • Kay Derochie

      Dear Bri,

      I believe that you must accept Medicare because the Medicaid program requires it. If you are no longer eligible for Medicaid, I suggest that you also research Medicare supplemental insurance policies to cover some or all of the co-pays and prescription medications.

      Sincerely,
      Kay

  • Nancy

    Hi I won’t be able to get my medicare health insurance until July 2015 I am on SS disability, my question is, the open enrollment is from Nov / March right ? So will I have to wait an additional 4 months until the next open enrollment or will I be able to finally get my insurance in July ?

    • Kay Derochie

      Dear Nancy,

      If you enrolled in Medicare for the first time during the current open enrollment, then your Medicare coverage will start July 2015. If you are saying that your twenty-four month Medicare wailting period ends in June 2015, then your Medicare will start automatically in July without your have to enroll in an open enrollment period.

      Sincerely,
      Kay

  • Sandra graham

    i receive SSD they take around 75.00 a month out for part D and I do receive the extra help. But as of 2014 I have to now also pay co payments on my medicines. After part D is deducted I receive 850.30 a month. I am now on Medicare but it only pays 80% of other medical such as dr and hospital. 22.00 to 27.00 also comes out of that for medicine co pays. Then I also have the other 20% I have to pay my Dr. That I see once a month. I have found an apt for 695.00 that includes utilities. And 99.00 in food stamps. Apt not in real good area . And I cannot walk without a walker . I am 63 years old. Live alone is there any recourse that I have for any kind of supplements. Also have heart decease and now my teeth are in really bad shape and need new glasses. Is there any such program to get more help or supplements?

    • Kay Derochie

      Dear Sandra,

      I suggest that quickly during open enrollment, which ends on December 5, that you investigate Medicare supplement insurances offered in you area. Medicare Supplements pay some or all of costs not covered by Medicare. Some of the supplements wrap Part D Medicare into them and cover prescriptions. It might save you money over all. Also, try searching on the internet for low cost or free dental care in your geographic area. Private non-profits sometimes offer eyeglass vouchers. If you have not reported your new rental expense and all your medical costs to SNAP, do so to see if your food stamp allotment can be increased.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • Mike

    I am 20 and receive both SSDI and SSI. I recently received a Medicare card in the mail and also a letter from SSI saying I would not be getting my Dec. payment because I received a one-time payment for Social Security benefits before deductions for Medicare premiums, which put me over the monthly limit for income and resources. Is this correct? Does SSI count Medicare premiums paid on my behalf? I am very confused about this. Thanks.

    • Kay Derochie

      Dear Mike,

      Yes, the letter appears to be correct.The gross amount of your Social Security benefit before withholding for taxes or Medicare premiums is countable income for Supplemental Security Income (SSI). If your ongoing Social Security is low enough to allow SSI in future months, the Medicaid program will pay your Medicare premium for you, but it usually takes two or three months for the processing to occur.

      Sincerely,
      Kay

  • Gloria

    If I get SSI disability and disable widow benefits am I going to recieve medicaid and Medicare?

    • Kay Derochie

      Dear Gloria,

      In most states, you will receive Medicaid coverage for months that you are eligible for SSI. You must receive twenty-four months of disabled widow’s benefits before Medicare coverage starts. The only exception is if you are receiving dialysis for kidney failure.

      Sincerely,
      Kay

  • Peggy

    I was immediately approved for full disability once I applied… I ‘HAD’ VERY GOOD private insurance which I bought and paid for myself. I was cancelled off the policy cuz I’m eligible for Medicaid while I wait for my full 2 yrs to pass before getting Medicare.
    I am INFURIATED. Florida Medicaid is an absolute joke (at best) & I DO NOT WANT IT. I was an RN for 25 years and I’m painfully aware of the Medicaid BS. U simply cannot find, let alone SEE any doc. Period.

    I’m 45 years old and I want my insurance back. NOW. Isn’t this a violation of my civil rights to deny me the right to choose my own healthcare?

    I’m so angry I could scream. I was supposed to have surgery TOMORROW for excruciating herniated disc and it’s been cancelled. I’ve waited NINE YEARS to find a surgeon who would repair 6 THORACIC herniations…. medicaid says 4 monthmonth waiting list just to see a reg doc… then referrals would take up to 2 years.

    PLEASE PLEASE PLEASE HELP ME… SOMEONE TELL ME HOW GET MY ‘REAL’ INSURANCE BACK

    • Kay Derochie

      Dear Peggy,

      I suggest that you read the insurance policy that you had to see whether the policy included provisions that gave the insurance company the right to cancel your policy. You could also contact the Florida State Insurance Commissioner’s office to see if you have any recourse. Also, perhaps if you get copies of your medical records to your new doctor you can short-circuit some of the wait.

      Sincerely,
      Kay

  • Marguerite

    I get ssi and I have to sign up for medicare will my benefits increase

    • Kay Derochie

      Dear Marguerite,

      Supplemental Security Income (SSI) does not change in amount because someone purchases medical insurance. I wonder whether you mean that you receive Social Security Disability (SSDI) and will be enrolling in Medicare. If that is the case, your check will be reduced because the Medicare premium will be withheld unless you have both Medicaid and Medicare in which case the Medicaid program will pay the Medicare premium..

      Sincerely,
      Kay

  • claudia

    My mother has cancer and needs kimo. Therapy every week. But she did not receive. Medicare does she quilify she gets social security

    • Kay Derochie

      Dear Claudia,

      Unless your mother is age sixty-five or older or has received twenty-four months of Social Security Disability benefits, she is not eligible for Medicare. Depending on her income, she might be eligible for Medicaid. I suggest that she contact the health and human services department of your state. She might also talk with the insurance/financial counselor at the hospital where she is to receive chemotherapy. Most hospitals are required to provide a certain amount of free care per year; she might qualify.

      Sincerely,
      Kay

  • Edward

    I am age 57, disabled, on SSI and Medicaid. When I reach full retirement age of 65, do I have to buy Medicare or will I continue to get Medicaid?

    Thanks,
    Edward

    • Kay Derochie

      Dear Edward,

      Assuming that you are still receiving SSI and Medicaid and that the law doesn’t change, at age sixty-five you will enroll in Medicare and continue on Medicaid with Medicaid paying your Medicare premiums.

      Sincerely,
      Kay

      • Jay

        If on SSI and turning 65, can one get medicare part B and C as well as athe automatic part A? Can a person on SSI also get Part F and other supplemental coverage without losing their SSI? Can someone help a person on SSI pay the premium for part D or any other part of medicare premium that medicaid does not pay?

        If a person on SSI turning 65 signs up with an insurer
        For medicare parts A, B, D, and F and they decline Part F, does one have to make a new appkication to get approved for parts A, B and D? Is there an advocate who can help get the insurance comoany to correct mistakes

        • Jay

          Correction to comment, am asking if person on sdi can get medicare part A, B, and D. Also if can get medicare part F or other supplemental coverage.

          Alsi, if the insurance company makes a mistake! Eg doesnt send a csrd becsuse get address wrong and mixed up the coverage, who can one contact to get sonethung in writing from the insurance company that they correct so that the person on SSI will not experience a break in coverage?

          Its really hard for people on SSI to work through the bureaucracy. Appreciate this blog and all of your very usrful information thank you.

          • Kay Derochie

            Dear Jay,

            SDI is State Disability Insurance and is offered by California and a few other states. Receipt of SDI benefits does not qualify a person for Medicare. A person receiving SSDI (Social Security Disability) becomes eligible for Medicare after receiving twenty-four months of benefits including back pay.

            I suggest that you contact the insurance company that made the mistake and request a letter of coverage listing the months in which the person did not get the card on time.

            Sincerely,
            Kay

        • Kay Derochie

          Dear Jay,

          An individual receiving Supplemental Security Income (SSI) can purchase Part B and D Medicare. “Part C” and “Part F” are not basic Medicare; they are Medicare Advantage and Medigap policies. They cover some of what Medicare A and B do not. Medicaid is not likely to pay a premium for these policies, but it would be best to check with the Medicaid office to find out.

          A third party can pay the premiums on any kind of health insurance for an SSI recipient and not affect SSI benefits as long as the premium is paid directly to Medicare or the insurance company.

          I would think only one application would be needed, electing certain coverages and declining others; however, to find out for sure, I suggest that you call Medicare at 1-800-633-4227 to be sure. Check with your state’s insurance commissioner to find out about possible advocacy.

          Sincerely,
          Kay

  • Peggy

    I currently have medicaid. I have applied for SSI. Yesterday I was informed I have been approved for Disability and would be able to have medicare in two years after waiting period. Can I still keep the medicaid until the two year waiting period is up for medicare?

    • Kay Derochie

      Dear Peggy,

      If you are eligible for ongoing Supplemental Security Income (SSI) disability in addition to Social Security Disability (SSDI), you will probably continue to be eligible for Medicaid. If you are not eligible for ongoing SSI, whether or not you continue to be eligible for Medicaid will depend on the amount of your Social Security. As soon as you are paid Social Security, you should report your income change to the Medicaid office, which will determine whether you are still eligible for the insurance.

      Sincerely,
      Kay

  • Karen

    I am on social security disability ( 1st benefit paid 3/2013). I am 63. I have insurance and wonder if can keep that or will I have to go on Medicare in March of 2015?

    • Kay Derochie

      Dear Karen,

      I suggest that you chat with an insurance agent who is familiar with Medicare and Medicare supplements in your state. Your best, most affordable coverage may be to accept Medicare Part B and maybe Part D (Part A is automatic) and change your other insurance to a Medicare supplement. Also, I suggest that you look at your policy; it may require you to accept Medicare if you are eligible for it. If you refuse Medicare now and decide you want it later, it will cost more. Also, you would have to wait for an open enrollment period in the last quarter of the year and then Medicare coverage would start the following July.

      Sincerely,
      Kay

  • Tiffany

    Will my disability back pay be mailed payable to my representative payee or to me the disabled?

    • Kay Derochie

      Dear Tiffany,

      Your back pay will be paid to your representative payee. It would be a good idea to get together with him or her and make a plan for its use.

      Sincerely,
      Kay
      S

  • odis

    My ex wife was in prison for two years when she got out she was told that she would have to pay medicare back a month that she was locked up because somebody did not let them know she was in prison. what if anything can she do besides a appeal to stop this?

    • Kay Derochie

      Dear Odis,

      Your wife can apply for a waiver of collection of the overpayment if she can’t repay and feels that she was not at fault. A waiver may or may not be granted Otherwise, she can request a monthly repayment plan.

      Sincerely,

      Kay

  • Maryjo bailey

    I receive SSD in the amt of $516.00 I need Medicaid but I don’t know where to apply just for Medicaid and not all the other insurances that come up. Who do I call to apply? I have been on SSD for 7 years

    • Kay Derochie

      Dear Maryjo,

      You may be eligible for Supplemental Security Income (SSI), which in most states results in automatic Medicaid coverage. If you do not want to apply for SSI, you can check with your state health and human services department to see what your options are.

      Sincerely,

      Kay

  • owen wootten

    I am both Medicare and Medicaid approved and am disabled and under 65. What coverage do I need? I live in the state of Texas. I receive survivor benefits from Social Security. Thank you

    • Kay Derochie

      Dear Owen,

      It sounds as if you have full health insurance coverage; however, you could consult a medical insurance broker to confirm.

      Sincerely,

      Kay

  • Robin M.

    My mother is on Medicade and SSI. She gets help with rent also. She has been on this for 6 years. She just rececived a retirement letter from years ago that she thought she had cashed in. My question is should she just give this up? Its $6800.00. I do not want her to cash it and loose her benefits but on the other hand she deserves it. What should we do? She does not have a car or a drivers lience. Can I purchase a car for me to drive her to docotor appts? Or is this legal?

    • Kay Derochie

      Dear Robin.

      Your mother has access to the $6,800 so she needs to report it to the Social Security Administration. If she were to refuse it when she could receive it, the money would likely be counted against her SSI anyway. If she were to buy you a car, it would be like giving away the money, which could also result in loss of benefits. If she wants to purchase a car to make visiting the doctor easier, she could purchase a car in her own name (even if she doesn’t drive) and the car would be an excluded resource. Whatever is done with the money, it should be reported as soon as it is received. Other options would be to use some of it for other things she needs (dental care, clothing, etc.), and keep an amount under the resource limit for future unknown needs.

      Sincerely,

      Kay

  • Ruth Ann

    I am receiving Disability Income and medicare premium deducted before payment and Extra help with perscriptions. I have insurance with BC/BS and make my monthly premiums but have less than 2000.00 in assets and 7500.00 in outstanding credit card payments. Should I be looking into Medicaid?

    • Kay Derochie

      Dear Ruth Ann,

      You do not say how much your Social Security Disability benefit is before reduction for Medicare premiums. If it is below $741 and you do not have other income, I suggest that you apply for Supplemental Security Income by contacting the Social Security Administration. In many states, Medicaid eligibility is automatic with SSI eligibility. If your Social Security is $741 or above, then I suggest that you contact your local health and human services department to find out how to apply in your state. Requirements for non-SSI Medicaid eligibility vary from state to state.

      Sincerely,

      Kay

  • adam

    i receive disability benifits,but have to wait 2 years for insurance,what can i do in the mean time,i am supposed to see a pain specailist,a phyciatrist and a phycolagist,help me please what can i do?

    • Kay Derochie

      Dear Adam,

      I suggest that you investigate enrolling in the federal Affordable Care Act (Obamacare). You may qualify for a financial subsidy to pay part of the insurance premiums.

      Sincerely,

      Kay

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