I have a client who is turning 26 and has been on this is parents Group insurance for a number of years. He has also been totally disabled for a number of years , at least three or more. His dad is only 58 and his mom is not eligible for Social Security at either, does anyone have any insight on how or why he is not eligible for Medicare?
Medicare and Disability
- Thread starter kstein
- Start date
- 6,455
i dont have time right now to go do all the reading again, but I believe disabled medicare is tied to SSDI
- Thread starter
- #4
- 6,455
medicare ohone lines are open 24 hrs-make a list of questions and talk with them.
- Thread starter
- #6
Is it possible that the client has Part A and delayed their Part B enrollment since they were on a group health plan? When someone is on SSDI for 24 months - they should get their initial enrollment package 3 months prior to their 25th month on SSDI, and can delay their part B.
- 6,455
just scanning articles a little bit, short term solution while yall work out other solutions, Cobra.
Then I see mention of Medicaid.
If you have him get a mymedicare account, they should be able to check the question of whether he has part a.
If he does, in fact, have over 2 years of SSDI, but is not qualified for Medicare, I would guess it has something to do with dependent relationship to his parents and he will have to start accruing eligibility as a separate adult. I will assume that would just be 24 months and not 29, but don't know. I have absolutely no knowledge of Medicaid and how MO works in relation to getting federal help with the program, but that may be another area in which you will have to develop some expertise for this one.
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maybe useful link:
http://pealcenter.org/images/EP-insur._age_out.pdf
Then I see mention of Medicaid.
If you have him get a mymedicare account, they should be able to check the question of whether he has part a.
If he does, in fact, have over 2 years of SSDI, but is not qualified for Medicare, I would guess it has something to do with dependent relationship to his parents and he will have to start accruing eligibility as a separate adult. I will assume that would just be 24 months and not 29, but don't know. I have absolutely no knowledge of Medicaid and how MO works in relation to getting federal help with the program, but that may be another area in which you will have to develop some expertise for this one.
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edit:
maybe useful link:
http://pealcenter.org/images/EP-insur._age_out.pdf
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- 2,370
I would call Social Security over Medicare. Social Security is the one that triggers the Medicare eligibility.
Or if they have a local office, I would tell the client to go there.
Here is another article that reviews some more info about it:
Social Security Disability Benefits (SSDI) | ElderLawAnswers
Or if they have a local office, I would tell the client to go there.
Here is another article that reviews some more info about it:
Social Security Disability Benefits (SSDI) | ElderLawAnswers
- 1,735
If the loss of coverage due to eligible dependent status ending (age 26) is coming right up, the child will be eligible for COBRA & it looks like 36 months, you can Google that. Medicaid is a program for those who are aged, blind or disabled. It is income/asset based, for the child, over 18. They should apply for Medicaid right away, and also look into SSDI. If this looks to be a lifetime situation, the family may want to consult a disability planning attorney. My friends/clients who have kids disabled from young ages have SSI (Supplemental Security Income--for those who haven't worked long enough to earn full SSDI eligibility) and Medicaid. The parents create a special needs trust to take care of needs for the child that essentially impoverishes the child so they can keep their SSI and Medicaid, yet be taken care of. There's lots more if you look it up.
I also recommend Social Security for Dummies and Medicare for Dummies. Lots of good detail.
This may not turn out to be a Medicare or individual health insurance sale, at least not right away, depending if it's SSI, where the child will most likely qualify for Medicaid. If it is SSDI, the wait is 24 months, usually.
If you are in a Medicaid expansion state, the child (with no income) would not have to be disabled to qualify for Medicaid.
Most situations I see with early disability seem to be Medicaid qualified.
If the child was disabled before 18, and registered as such with the group carrier before age 18, they can, under current law, generally stay on the group insurance indefinitely while the parent is employed.
I also recommend Social Security for Dummies and Medicare for Dummies. Lots of good detail.
This may not turn out to be a Medicare or individual health insurance sale, at least not right away, depending if it's SSI, where the child will most likely qualify for Medicaid. If it is SSDI, the wait is 24 months, usually.
If you are in a Medicaid expansion state, the child (with no income) would not have to be disabled to qualify for Medicaid.
Most situations I see with early disability seem to be Medicaid qualified.
If the child was disabled before 18, and registered as such with the group carrier before age 18, they can, under current law, generally stay on the group insurance indefinitely while the parent is employed.
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