SSDI Benefits

Under 65 and on SSDI? What You Don't Know May Be Costing You.

Did you know that if you or your loved one is under the age of 65 and on Social Security Disability Income (SSDI) for 24 months or more, you or they may qualify to apply for Medicare? And if you or your loved one is on Medicaid as well, you may be missing out on additional benefits above and beyond what the states provides?

Medicaid and something better?

Medicaid is a joint federal and state program that, together with the Children's Health Insurance Program (CHIP), provides health coverage to more than 72.5 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States.    

Medicare is the federal health insurance program for:

• People who are 65 or older
• Certain younger people with disabilities
• People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

Those who are on Medicaid and qualify for Medicare because of the time spent collecting SSDI are called Duals and qualify for Dual Special Need Plans (D-SNP). Qualification into a D-SNP plan will depend on the level of Medicaid qualification.

Why would you care about enrolling on a D-SNP Plan?

Consider if any of the following sounds like an improvement over your current situation.

• Are you tired of waiting on the phone with Medicare or Medicaid? There is a plan that will take on the servicing and administration of the plan.
• Have ability to be assigned a case manager who has a smaller case load which gets you more personal service.
• Expanded network access to include high quality doctors, specialists and facilities not found in state Medicaid network
• Stability to the network
• Care Coordination designed to increase client's quality of life and overall health

You may also have access to valuable extra benefits which may include:*

• Acupuncture and Chiropractic
• Dental
• Fitness
• Foot Care
• Hearing
• Meal Programs
• Nurse Line
• Over-the-Counter Items
• Personal Emergency Response System
• Transportation
• Virtual Doctor Visits
• Vision
• Much more

*Benefits vary by plans offered in your area.

What if I don't have Medicaid but I am on SSDI and have met my 24 months?

You can still apply for Medicare and will be able to enroll in a plan that best suits your needs. The plan may have a $0 premium and have value added benefits.

I have a young child collecting SSDI, can they qualify for Medicare?

Yes, they can. Medicare is for certain younger people with disabilities.

When can I sign up for a Dual plan?

Once you have been receiving SSDI for 24 months, you will need to head to your local Social Security Administration office to apply for Medicare Parts A & B.

When you receive your Medicare card, speak with Lewin & Gavino, or a licensed independent broker to find a plan(s) in your area suited to your needs.

Effective date will be the 1st day of the month following the receipt of your election.

Can I change plans if I don't like the plan?

Depending on the circumstances, you may be granted a Special Enrollment Period.

Individuals currently eligible for Medicare Savings Plan or Low Income Subsidy are granted one election per calendar quarter for the first 9 months of the year as follows:

• Q1 –January thru March
• Q2 –April thru June
• Q3 –July –September

Effective date will be the 1st day of the month following receipt of election This election period can be used to enroll in a Medicare Advantage or Prescription Drug Plan

Can I enroll in a Medicare insurance plan or D-SNP Plan on my own?

Because plans and offerings differ by counties and states, each case is unique. It would be wise to speak with a seasoned independent broker or call Lewin & Gavino today for a consultation.

Who should I contact?

Elizabeth Gavino is the founder of Lewin & Gavino, a firm helping people make sense of Medicare and planning for healthcare in retirement. Come by Booth #745 at the Abilities Expo in New York Metro May 3-5, 2019.

If you have SSID for 24 months and will not be at the expo, call her at (201) 659-7170 or email her at [email protected].

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