Most people receive Medicare when they turn 65. However, disabled individuals may receive Medicare payments before that age.
At Dayes Law Firm PC, our compassionate Social Security Disability lawyers in Phoenix have decades of combined experience pursuing benefits for our clients. Below, we discuss when Medicare benefits that may be available to you. We can discuss the circumstances behind your claim to determine if you have a right to Medicare benefits. Contact us as soon as possible for a free, no-obligation consultation.
Medicare After Two Years of Disability Benefits
The SSA automatically enrolls those who receive disability benefits in Medicare after they have received benefits for two years. This includes the following types of insurance:
- Part A – Part A is hospital insurance that helps you pay for inpatient hospital bills along with certain follow-up care. There is no charge for this insurance because it is funded by the taxes you paid while employed.
- Part B – Part B is medical insurance that helps you pay outpatient hospital bills, doctors' bills and other medical treatment. Part B is often paid through a monthly premium that is deducted from your benefit amount.
There is no need for you to sign up for these benefits, as you will receive your Medicare card in the mail three months before your 25th month of receiving disability benefits. While most claimants should enroll in Part A as soon as they are eligible, some claimants may choose to delay Part B.
In addition to Parts A and B, you may opt for coverage under Medicare Part C and Part D. This coverage provides the following:
- Part C – This is the Medicare Advantage plan. People who have Medicare Parts A and B can choose to receive all of their health care services through private plans that are approved by Medicare.
- Part D – Part D is prescription drug coverage that helps you pay for prescription medications.
If you are considered low-income and receive Medicare, your state may pay your Medicare premiums. Whether you qualify for such benefits depends on the state where you live and your financial circumstances. The Medicaid agency in your state handles such claims.
Medicare for Certain Medical Conditions
Certain medical conditions may qualify claimants for Medicare benefits before they reach the age of 65 and before they have received disability benefits for two years. Some of these conditions include:
End Stage Renal Disease
A claimant who has End Stage Renal Disease (ESRD) can receive Social Security Disability benefits after a five-moth waiting period after the claimant is determined to be disabled. He or she becomes eligible for Medicare after three months of a course of regular dialysis or after receiving a kidney transplant.
Lou Gehrig's Disease
Claimants with Amtoytopic Lateral Sclerosis (ALS) or Lou Gehrig's Disease become eligible for Medicare immediately when they begin receiving Social Security Disability benefits.
Medicare for Working Individuals
If a person is disabled but working, he or she may still be eligible for Medicare benefits if he or she is in one of the following situations:
Trial Work Period
A claimant who is receiving Social Security Disability benefits can continue receiving these benefits and retain his or her Medicare coverage during a trial work period for a maximum of nine months. These nine months do not have to be consecutive. To qualify for this trial work period, the claimant must meet the following criteria:
- Have gross earnings of at least $850 in 2018; or
- Work more than 80 hours of self-employment each month
The trial work period allows a claimant to test his or her ability to return to the workforce without losing his or her disability benefits or Medicare benefits.
Extended Period of Eligibility
The extended period of eligibility is available after a claimant has completed a trial work period, is still disabled and has earned income that exceeds the substantial gainful activity (SGA) level. In 2018, the SGA is $1,180 per month for disabled individuals and $1,970 for blind individuals. The extended period of eligibility can last up to 93 months after the trial work period. Social Security Disability benefits may end, but the claimant maintains Medicare Part A.
Indefinite Access to Medicare
Indefinite access to Medicare can result after the extended period of eligibility if the claimant remains medically disabled. However, the claimant is responsible for the Medicare Part A premium unless he or she has limited resources and the state has a buy-in program for qualified disabled and working individuals.
Contact a Social Security Disability Lawyer
Having dependable access to health care and insurance is critical for individuals with disability. Our experienced Medicare attorneys can explain when Medicare benefits may be available to you. If you are having difficulty with your claim or your benefits, do not hesitate to contact our team for help.
Our Social Security Disability lawyers offer a free consultation to discuss your legal rights. Contact us today to schedule your free, no-obligation consultation.