Medicare Disability Coverage And Help Paying The Costs A Medicare Supplement Covers
If you are under age 65 and approved to receive Social Security Disability Insurance (SSDI) benefits, you automatically become eligible for Medicare Part A (hospital insurance) and Part B (medical insurance). Medicare will enroll you after you receive disability benefits for 24 months.
Along with a number of services and items that Medicare doesn't cover, even after Medicare pays its portion, unless you have Medicare supplemental insurance, you will be responsible for paying certain out-of-pocket expenses. Since you are required to pay an annual deductible and coinsurance for Part A and monthly premiums, a yearly deductible, and 20 percent of the Medicare-approved amount for medical services and equipment under Part B, you need to know what assistance is available to help cover these costs.
What is a Medicare supplement?
Supplemental insurance purchased from a private insurance company is intended to cover medical expenses, including copayments and deductibles, that original Medicare Parts A and B plans don't cover. Unfortunately, not everyone – especially if you are disabled and unable to work – can afford to buy a supplemental insurance policy.
Even if you can afford to pay for Medicare supplemental insurance, insurance companies aren't required by federal law to sell Medigap policies to individuals who aren't yet age 65, regardless of whether they qualify for Medicare coverage. But while the insurance may cost you more, the laws in some states require insurance companies to offer at least one type of Medigap policy to Medicare recipients under the age of 65.
What happens if you can't afford or get Medicare supplemental insurance?
If you need financial assistance with paying your Medicare premiums, copayments, deductibles, and coinsurance, you may qualify to receive help from your state or a Medicare Savings Program. You must be eligible for Medicare Part A to apply. Monthly income limits – which are higher in some states than in others – resource limits, and the costs each program contributes toward paying vary.
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Qualified Medicare Beneficiary (QMB) Program. This program helps to pay for Medicare Part A and Part B premiums. In addition, if you receive services or medical supplies from a Medicare-approved provider, that provider may not charge you for deductibles, copayments, or coinsurance. However, a pharmacy can charge you a nominal fee – not to exceed a certain amount – for prescription drugs that Medicare Part D covers.
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Specified Low-Income Medicare Beneficiary (SLMB) Program. If you qualify, this program helps pay for your monthly Medicare Part B premiums.
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Qualifying Individual (QI) Program. If you are low-income and eligible for Medicaid benefits, you won't qualify for this program. But if your income isn't low enough to qualify you for Medicaid benefits, you can apply to the QI program each year that you need assistance. Although applications are approved on a first-come, first-served basis, your application is given priority consideration if you were approved for QI benefits for the previous year. The program helps pay your Medicare Part B premiums.
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Qualified Disabled and Working Individuals (QDWI) Program. If you qualify for any of the other Medicare Savings Programs, you automatically qualify for aid in paying for Medicare Part D – a program that helps to pay for the cost of your prescription drugs.
To learn more, contact a company like Shifflett Insurance Services Ltd.
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