will medicare suppliment privat insurance

by sterlingcjr » Wed Apr 22, 2009 08:02 pm

I am still working and have health coverage. Will medicare supplement doctor visit co-pays if I have a PPO?

Total Comments: 21

Posted: Wed Nov 30, 2011 03:22 pm Post Subject:

Your physician is not entirely correct. To be eligible for Medicare as a disabled person, you must meet Social Security's definition of disability and have received Social Security Disability payments for 24 consecutive months. Simply being "on full disability" is not good enough.

If you are disabled, and you cannot perform "any substantial gainful activity" (anything in the American economy that, with your disability, could provide you with -- in 2011 -- more than $1000 per month in gross income -- even if no such jobs are available where you live) you may qualify for SSDI payments, and after 24 months of those payments, will be eligible for the Medicare program. SSDI payments will end at age 65, and be replaced with your Social Security retirement benefit.

All of this assumes that, at your age, you are "fully insured" under Social Security (that you have earned your 40 credits). A younger person must be at least "currently insured" (a sliding scale of credits required based on age).

But, to be eligible for disability payments, you must also meet the rest of the disability definition: have a disability that will last at least 12 months or will result in your premature death. And your payments could not begin any sooner than when you have been disabled five "full" months, or retroactively to the date you applied for the benefit, whichever is later.

Either way, you must go to your local Social Security office and file an application for Social Security Disability Income benefits.

If you're like 80% of all disability applicants, your initial application will be DENIED. At that point, you can appeal their decision. If you appeal, and you're like 90% of all appellants, your application will be APPROVED. That process can easily take a year or more (I've known persons who fought and won, after almost 3 years of trying). By then, you'll be age 61 or 62; it will take two full years from that point to be eligible for Medicare, so sometime between 63 and 64 you'll get an early entry into the system.

If you're one of the fortunate 21% of first-time applicants for SSDI payments whose application is approved on that first attempt, you'll enter the Medicare system as early as age 62-63 -- at least two years from now.

So thank your physician for alerting you, then inform him of your outcome with Social Security, and the reality of SSDI and Medicare.

In the meantime, you might be eligible for entry into the Medicaid program to cover hospital and doctor bills if you have no insurance. For that, you would go to your local County Public Social Services department (or whatever it's called in your state) to apply.

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