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Cook County Social Security Disability Insurance (SSDI) Disability Benefits Attorney

Lawyer for Medicare Coverage Questions in Illinois

Medicare is the country’s health insurance program for people age 65 or older and for people who are receiving Social Security Disability Insurance (SSDI) disability benefits. That’s right, Medicare isn’t just for the elderly and retirees over 65, individuals under the age of 65 can qualify for Medicare under certain circumstances.

Medicare Coverage is Available for Some Individuals Receiving SSDI

Medicare coverage is a wonderful perk for those who have successfully been approved for Social Security Disability Insurance. SSDI recipients become eligible for Medicare 24 months after being entitled to Social Security disability benefits. It should be noted that because there is a five-month waiting period from the start of the disabling condition for SSDI recipients, Medicare coverage cannot start before the beginning of the 30th month after the start of the qualifying disability.

Applying for Medicare can be a daunting experience. There are numerous parts and plans that are available to you. Choosing the right plan is crucial and should optimize what you can afford with the coverage you require.

Medicare has four primary parts:

  1. Hospital Insurance
  2. Medical Insurance
  3. Medicare Advantage
  4. Prescription Drug Coverage

When considering which plan is the best coverage for you or your loved ones, you should be aware that Medicare does not cover all of the costs of health care. Many medical expenses are not covered by the program. Find doctors covered by your plan and find a covered hospital on the Medicare website.

Don’t worry if you have questions about Social Security Disability and Medicare. We are available to answer your questions. Contact our office today at 312-999-0999.

Medicare History

Medicare was created in 1965 to provide health insurance for the nation’s seniors beginning in the following year, 1966. The legislation was first signed by President Johnson. Meanwhile, President Truman was actually the very first person to enroll in the program. The cost of enrolling in the program was a modest $40 a year deductible for Truman at the time, far removed from the current monthly figures.

One of the most expansive changes to Medicare occurred in 1972, allowing individuals who become disabled through the Social Security Administration to gain access to the program before the age of 65. Since President Nixon signed the amendment into effect, Medicare has continued to cover thousands of individuals who apply for and obtain Social Security Disability Insurance (SSDI) benefits. In fact, one of the biggest perks of obtaining SSDI benefits is the ability to have future access to Medicare.

If you have questions about Medicare or Social Security disability benefits, feel free to contact our office today at 312-999-0999

Part A: Hospital Insurance

Medicare Is A Major Benefit When You Are Receiving Disability Benefits

Medicare Part A, also known as Hospital Insurance, helps individuals cover their inpatient (at least overnight) care in hospitals, skilled nursing facilities, hospice, and home health care. Along with Part B: Medical Insurance, Part A was one of the components of the medicare program when it was first created.

There are two primary types of Part A insurance: premium-free and premium. Premium-free Part A is the type that does not require the individual to pay a premium because he or she paid medicare taxes while working and meets the specific requirements.

Part A Premium medicare is an insurance coverage that the individual has to buy into. Periodic payments must be paid into the program to be covered, the 2015 monthly premium is $407. If you were approved for Social Security disability benefits you may be entitled to Medicare Part A insurance. You can buy into Part A premium coverage if you meet the following criteria listed on the government website:

  • You’re 65 or older, your entitled to (or enrolling in) Part B, and you meet the citizenship or residency requirements.
  • You’re under 65, disabled, and your premium-free Part A coverage ended because you returned to work. (If you’re under 65 and disabled, you can continue to get premium-free Part A for up to 8.5 years after you return to work

Part B: Medical Insurance

Are You Collecting Social Security Disability Benefits?

If you are already getting Social Security disability benefits you do not have to worry, you will automatically get Part B: Medical Insurance coverage. You will be entitled on the first day of the 25th month after your Social Security begins. You will know that you are covered by Part B if the center of your medicare card states “Part B: Medical Insurance.”

What Does Part B Cover?

Part B covers preventive services. In other words, most services that are used to either detect or prevent illness is covered. Some of the more common services include but are not limited to: flu shots, HIV screenings, prostate cancer screening, and glaucoma tests. For a more thorough analysis of the preventive services covered by Part B,click here.

Part B also covers medically-necessary services or supplies needed to diagnose or treat a medical condition. Certain laboratory tests, x-rays, and therapies are covered. Additionally, some examples of supplies that are covered are canes, walkers, wheelchairs, artificial limbs, oxygen among others.

Part B, like Part A, was one of the very first parts of the original medicare program.

Part C: Medicare Advantage

Social Security Disability Benefits And Medicare Advantage: What Is Medicare Part C?

Medicare Part C is the healthcare plan choice you have as part of Medicare. Unlike other segments of Medicare, this part gives a plethora of options similar to when you choose a non-Medicare healthcare plan. Part A and Part B will both be included in the plan you choose. Service choices are completely different depending on the plan.

What Are The Different Medicare Advantage Plans?

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNP)

What Is The Cost Of Getting Part C Coverage?

Every plan has different costs depending on the out of pocket expenses and coverage. Your deductible, co-payments, and premium all effect your monthly charges.

Part D: Prescription Drug Coverage

Social Security Disability Benefits And Medicare Prescription Drug Coverage: What Is Medicare Part D?

Medicare Part D is the prescription drug coverage for everyone getting Medicare. Unlike other parts, prescription drug coverage is run by private companies and insurance providers approved by Medicare. One of the major benefits of getting Social Security disability benefits is the medication coverage. A claimant awarded SSDI benefits can get Part D coverage during the 7-month period that begins 3 months before the 25th month of disability. It includes the 25th month of disability and ends 3 months after your 25th month of disability. If you win your disability case outside of this period, you can also join 3 months before the month you turn 65 and ends 3 months after the month you turn 65.

What Is The Cost Of Getting Part D Coverage?

Like Part B, most prescription drug coverage plans charge a monthly fee pertaining to the specific plan. It should be noted that Part C holders may have Part D included in their plan. In other words, the premium that you pay for Part C may cover Part D so that you do not have to pay any extra money for the prescription drug coverage. If you have Medicare Advantage you should check with your provider for coverage issues pertaining to Part D.

What If You Do Not Like Your Plan?

If you are receiving disability benefits and joined a Part D Medicare plan that you are not satisfied with, you can always call 1-800-MEDICARE to drop the plan.

For additional help, contact Pearson Disability Law, LLC at 312-999-0999.

You are not alone. Call us now for a FREE consultation 312-999-0999

Unable to travel to one of our offices? No problem! No office visit required.

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