SSDI & Medicare - A Beginner's Guide

iv id="body">dependent benefits and return-to-work incentives.
Figuring out how the Social Security DisabilityMedicare has many parts to cover specific
Insurance (SSDI) and Medicare programs arehealthcare costs. Medicare Part A covers inpatient
related can be confusing to anyone who isn'tcare in hospitals and provides patients with a stay
currently enrolled in these programs. This articlein a semi-private room, complete with meals,
provides basic information on SSDI and Medicaregeneral nursing, and drugs. Part A also covers the
eligibility and benefits. In addition, this guide willcost of a blood transfusion if the hospital must
show you how to apply for and receive the rightpurchase blood for you, up to 100 days per each
benefits for your situation.benefit period in a skilled nursing facility, and
Defining the Programshospice care for those with a life expectancy of
SSDI is a payroll tax-funded, federal insurancesix months or less due to a terminal illness. Part A
program that was established in 1954. A portioncoverage costs nothing, except for your
of the FICA taxes taken out of your paycheckdeductibles or copayments, and coverage gaps
are set aside for this disability insurance program,must be paid by you or covered by other
which provides monthly income to people who areinsurance.
unable to work due to a severe disability.Medicare Part B covers doctors' visits and
Medicare is another federal insurance program, butservices, outpatient care, rehabilitative care under
is health insurance instead of disability insurance. Ita physical therapist, occupational therapist, or
is available to all individuals age 65 and older asspeech-language pathologist, and some
well as those who have been receiving SSDI cashpreventative services like flu shots and
benefits for 24 months. The program is made upmammograms. The monthly cost (or premium)
of many parts - Medicare Part A consists offor Part B coverage is tied to your annual income
hospital benefits; Medicare Part B is medicaland adjusted each year. Most will pay the
benefits; Medicare Part C (Medicare Advantage)standard Part B premium of $96.40 per month in
provides extra coverage and is provided by2009 (if your annual income is not more than
private insurance companies; and Medicare Part D$85,000 as a single taxpayer or $170,000 if filing a
is voluntary prescription drug coverage.joint tax return).
Determining Eligibility - How to See if You AreMedicare Advantage (Part C) plans at a minimum
Entitled to Benefitscover everything offered by traditional Medicare
Eligibility for each program depends on several(Parts A and B). They also may offer additional
factors. For SSDI, there are three generalbenefits not covered by traditional Medicare like
qualifying criteria: 1) you must have worked anddental care, vision screening, prescription drugs
paid into the program (through your payroll taxes)and other services that would otherwise need to
for five of the last 10 years, 2) you also mustbe provided under a supplemental insurance policy
have been disabled before reaching the full(Medigap).
retirement age of 65-67, and 3) you must meetYour out-of-pocket costs are likely to be less
Social Security's definition of "disability." The Socialwith a Medicare Advantage plan than if you use
Security Administration (SSA) has a process totraditional Medicare and a Medigap policy. Everyone
determine who's eligible for benefits. By evaluatingin a Medicare Advantage plan pays at least the
your income, limits of your disability, past jobsame monthly premium as those enrolled in
history and more, the SSA determines whetherMedicare Part B. Your premiums may cost more
or not you're qualified to receive disabilitydepending on the benefits provided by the plan.
insurance.Medicare Part D (prescription drug coverage)
There are several ways people can becomeprovides brand-name and generic prescription drug
eligible for Medicare. Anyone who turns 65 iscoverage. These plans are provided by private
automatically eligible for benefits. If you get Socialcompanies that are approved by Medicare. Part D
Security retirement benefits or receive benefitscoverage is optional and available to those enrolled
from the Railroad Retirement Board (RRB), youin traditional Medicare (Parts A and B) or Medicare
will be considered eligible as well. Additionally, ifAdvantage plans that don't offer prescription drug
you're awarded SSDI benefits for somethingcoverage. Costs, extra benefits and details vary
other than Lou Gehrig's disease (ALS), you willby plan.
become eligible for coverage 24 months after theWork With a SSDI & Medicare Advisor
date of entitlement to cash benefits. If you areService to Maximize Your Benefits
awarded SSDI and have ALS, you willDon't stay confused trying to figure out the
automatically be eligible for Medicare once youcomplex rules of these programs on your own -
begin receiving SSDI benefits, and if you havelet those who understand it best help you
kidney failure, you'll be able to enroll in Medicaremaximize your benefits. Medicare & SSDI
three months after starting dialysis.programs can be confusing with all of the
Specific Benefits You Can Receivedifferent program requirements and eligibility
Social Security Disability Insurance allows you tocriterion. Working with an SSDI expert and
receive a regular monthly income, results inMedicare Advisor Service can help you determine
eligibility for Medicare benefits (as explainedthe best coverage for your specific needs to
earlier), and allows possible extension of yourensure you get all of the benefits you are entitled
COBRA benefits, protects your retirement andto receive.
long-term disability benefits, plus allows for