It’s something we may not want to think about; however, we have to. What would you do if you could no longer work because you suffered an injury or were diagnosed with an illness? You still have bills, maybe a mortgage, and your family to take care of.
The good news, there are Medicare plans for disabled people under 65.
According to the Center for Medicare Advocacy, people under 65 with disabilities comprise 8.4% of the general U.S. population, nearly doubling among Medicare recipients. Disabilities can lead a person to have a lower income, require more health care, and it can be more difficult for a disabled person to pay for and get care compared to Medicare beneficiaries over 65.
Disabilities that Qualify for Early Medicare
Let’s make one thing clear; there is disability insurance. This insurance is a form of income protection that goes into effect if you become ill or injured. Disability insurance protects your loss of income for a period of time and belongs to the policy owners regardless of where they work. Here’s where Medicare can come in. Once you have been disabled continuously for 24 months, you may be eligible for Medicare insurance. You can choose Medicare or a Medicare Advantage plan. For many people under 65, an Advantage plan is the most cost-effective option.
When you’re under 65, you become eligible for Medicare if:
*You’ve received Social Security Disability Insurance (SSDI) checks for at least 24 months. After 24 months, you’ll automatically enroll in Parts A and B.
*You have End-Stage Renal Disease (ESRD) and need dialysis or a kidney transplant. You need to apply at your local Social Security office to get benefits with no waiting period.
*If you have Lou Gehrig’s Disease, you’ll automatically be enrolled when you begin receiving disability benefits.
If you’re on Social Security Disability, you may also qualify for your state’s Medicaid program. If you’re on Medicare and Medicaid, you can still sign up for an Advantage plan. The two programs together will usually cover almost all your healthcare costs.
Medicare Advantage Plans for Disabled Under 65
Most Social Security Disability Advantage plans typically combine Medicare coverage with other benefits like prescription drugs, dental, and vision coverage. In addition, Medicare Advantage can be either HMOs or PPOs.
You may have to pay a monthly premium, an annual deductible, and copays or coinsurance for each healthcare visit. However, there are quite a few plans that are $0 to the member. These costs will vary depending on your chosen plan and your insurance company. It is advisable to use a broker to assist you in finding the plan that fits your budget and covers your healthcare needs.
Medicare Supplement Plans for Disabled Under 65
The reality is that Medicare pays a large portion of the cost; however, it doesn’t cover all of it. This is where a Medigap plan can help cover what Medicare doesn’t. Unfortunately, sometimes it can be hard to find an affordable Medigap plan if you are under 65.
Also, Medigap plans vary by state. Some states require companies to offer at least one Medigap plan to people under age 65, and others do not. In some states, Medigap plans are only available to certain types of beneficiaries, such as people with end-stage renal disease.
In several states, you can’t even buy a Medigap plan if you’re under 65, and rates often go up from one year to the next. So, Medigap can be both challenging to get and pricey if you’re under 65. Usually, the best solution is an Advantage plan. When working with me, we can determine the requirements of the state you live in.
Medicare Part D for Disabled Under 65
If you choose Medicare, you should consider a Part D drug plan. To get Medicare drug coverage, you must join a plan run by an insurance company or another private company approved by Medicare. Each plan can vary in cost and which drugs are covered. Prescription drug plans are required to cover most prescriptions for Medicare beneficiaries.
Many people on Social Security Disability qualify for Extra Help with Part D costs. Extra Help eligibility is based on income and assets. Remember, if you’re on Medicaid, you automatically qualify for Extra Help.
Medicare for Disabled Youth
Suppose children are 20 years old or younger with ESRD. In that case, they can qualify for Medicare if they need regular dialysis treatment and at least one of their parents is eligible for or receives Social Security retirement benefits.
If a child is over 20, they will qualify for Medicare after receiving SSDI benefits for at least 24 months. If a child was disabled before turning 22, is unmarried, and one parent receives Social Security retirement benefits, work history is not required for SSDI.
Medicare Advantage Special Needs Plan
There is a chance you may be eligible for a Medicare Advantage Special Needs plan. However, you must meet specific criteria such as a disabling or chronic health condition or being eligible for both Medicare and Medicaid.
It’s important to note that a Special Needs Plan fits the healthcare needs of the people in the policy, and the availability of this type of policy varies by location.
Enrollment Period for Medicare for People Under 65
If you’re under 65, here’s when you can enroll in Medicare Advantage Plans:
*During your Initial Enrollment Period. This period begins three months before you enroll in Medicare and ends three months after the month your benefits start.
*During the Annual Enrollment Period from October 15th through December 7th (each year). If you want to switch from one Advantage plan to another or drop coverage, you can do so during the Medicare Advantage Open Enrollment Period from January 1st to March 31st (each year).
Contact Your Local Medicare Insurance Agent for More Information
If you are under the age of 65 and are disabled or have a child who is disabled, there are Medicare plans for disabled people available to you. Contact me for a free appointment to see what benefits are available to you.