Is Medicare Optional for SSDI Income Recipient, when the 24 Mo. is Up?

[LostDollar]

Thanks for your patience with me. I have just learned something in thinking hard about your posts and managed to erase what was probably a stupid comment before you saw it!

 

[Caryn Montague]

ROFL I have successfully fulfilled my Mommy obligations for the day!!! Hey, I really love how the private and entitlement benefits coordinate, the rules, how to make them work for our clients. I remain open to discussion, learning from you, and furthering the discussions.

 

[somarco]

Retirees cannot disenroll from Medicare Part A without also losing their Social Security benefits and refunding all the money paid to them, a federal judge has ruled.

You Can't Opt Out of Medicare Without Losing Social Security, Judge Rules

 

[Caryn Montague]

For the few people who may be impacted, specifically some Federal Employees with entitlement to benefits as federal employee and under SSA, what benefit would there be to your advising your client to give up Medicare, especially "knowing" they lose Social Security Retirement? If they lose the Retirement, they lose the Disability, their dependents' benefits, etc.

For the few who may have entitlement to both Federal (or state, government) and Social Security, this link may be helpful. https://www.ssa.gov/pubs/EN-05-10045.pdf

The answer to the original question remains (assuming you are not counselled to give up your SSA benefits), that, after Social Security determines you are disabled, your Medicare begins in your month 25 of disability ...not after disability claim is made, but month disabled. (Unless you are end stage renal. Then your Medicare kicks in earlier.)

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[somarco]

Personally I would never advise someone, regardless of their situation, to forfeit something they have paid into for most of their life.

In the FWIW department, I try to avoid giving even the appearance of offering legal or accounting advice. That is way above my pay grade.

 

[jensing0406]

If you call late at night, there's no wait. They're open all night.

I've had this situation with a client. We called Social Security and they advised us that the client could not get a Private health plan. Only a group plan from an employer or spouses employer. The guys opted out of B so we had to wait til July for him to have an Effective part B. He is also being permanently penalized for this. If a client is on SSDI and has medicare they CANNOT go on ACA

 

[TN_agent]

what benefit would there be to your advising your client to give up Medicare, especially "knowing" they lose Social Security Retirement? If they lose the Retirement, they lose the Disability, their dependents' benefits, etc.


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It isn't about what we as agents are advising, its about what happens to clients/what they do without our knowledge when they rely on their own understanding of this complicated mess or the bad advice of others.

There are A LOT of clients like the OP who want to keep the Obamacare rather than the Medicare because it is WAY cheaper than Medicare, especially if they are less than 200% FPL.

1. U65 and awarded disability and it is back dated because they have been fighting for it for 2 years, they may be eligible for Medicare mid-year and we as agents have no idea of that if they don't tell us. Like the OP, they turn B down because paying for part B + drug coverage premiums (and copays) is way more expensive than $20 Obamacare premium and $600 MOOP for the year and they want the cheaper option, they conveniently forget that we have told them it isn't a good idea or we had no idea they were applying for disability to begin with. That doesn't catch up with them until the next Obamacare open enrollment, at which point they are out of their Medicare open enrollment and have to get B through the GEP.

2.Or a friend/family member (who has to pay for their Medicare part A because they are 65 without enough quarters and not disabled) has told them wrongly that it IS an option because that family member did not sign up for Medicare upon becoming 65. Two completely different scenarios.

3. Or they are 65.5 years old and on Social security and some ignorant person told them they could decline the B and enroll in Medicare A only and still get an Obamacare subsidy and that doesn't catch up with them until Obamacare open enrollment, at which point they are out of their Medicare open enrollment and have to get B through the GEP. Oh, and they have never been your clients and only asked an "expert" when it became clear Obamacare wasn't going to be an option but waited until December 10th, so they are also SOL for Part D drug coverage for a year and have to pay the permanent Part B and Part D penalties. Married couple making $30,000 a year, not eligible for LIS either.

4. Or some clients change addresses, phone numbers, 2-3 times a year and we can't reach them as they approach 65 to explain how it works (even if we told them when we signed them up for the Obamacare that they need to call us to discuss what happens when they become eligible for Medicare).

I have come across all kinds of these scenarios in the last three years.

Now, I have fulfilled my babysitting duties for the day, signing off to make some money...

 

[Caryn Montague]

You raise some interesting and very valid, timely points. We are NOT doing a good job of communicating the options. Even when policyholders, claimants, beneficiaries receive notices, they often opt to ignore this data.

Perhaps working with NAHU and local orgs, programs that deal with insureds, leaving info at doctors offices, etc. may be a scratch at a PR campaign.

Someone going on SSDI should be coached as to transitioning off ACA because they will no longer qualify. Someone reaching age 65 gets lots of mail from Medicare - and every insurer, supp, interrelated plan out there.....and their phones ring relentlessly!

We need to do better, point taken. Thank you. If you wish to brainstorm as to interdisciplinary approaches for PR, I will gladly help out with my resources.

Happy holidays.