Guide For Social Security and Medicare

Understand the difference between social security disability insurance, SSDI and Medicare with this guide. This article provides basic information on SSDI and Medicare eligibility and advantages. In addition, this guide will show you the way to apply for and obtain the correct advantages for your situation.

Find out if your insurance covers your medical equipment and learn how to make sure your claims are approved by your Medicare or insurance provider.

Figuring out how the Social Security Disability Insurance (SSDI) and Medicare programs are related could be confusing to anyone who isn’t currently enrolled in these programs. This article provides basic information on SSDI and Medicare eligibility and advantages. In addition, this guide will show you the way to apply for and obtain the correct advantages for your situation.

Defining the Programs

SSDI is really a payroll tax-funded, federal insurance plan program that was established in 1954. A portion of the FICA taxes taken out of the paycheck are set aside for this disability insurance plan, which offers month-to-month earnings to people who are unable to work as a result of a severe disability.

Medicare is an additional federal insurance plan program, but is health insurance rather than disability insurance plan. It is available to all individuals age 65 and older too as those who have been receiving SSDI cash advantages for 24 months. The program is made up of numerous elements – Medicare Component A consists of hospital advantages; Medicare Part B is medical benefits; Medicare Part C (Medicare Advantage) offers extra protection and is provided by private insurance plan companies; and Medicare Part D is voluntary prescription drug coverage.

Determining Eligibility

– The way to See if you’re Entitled to Advantages

Eligibility for each program depends on several factors. For SSDI, you will find three general qualifying criteria: 1) you must have worked and paid into the program (via your payroll taxes) for five of the last 10 years, 2) you also must have been disabled prior to reaching the full retirement age of 65-67, and 3) you must meet Social Security’s definition of “disability.” The Social Protection Administration (SSA) has a procedure to determine who’s eligible for benefits. By evaluating your income, limits of your disability, past job history and a lot more, the SSA determines whether or not you’re qualified to obtain disability insurance plan.

You will find a number of ways people can become eligible for Medicare. Anyone who turns 65 is automatically eligible for benefits. If you get Social Security retirement advantages or obtain advantages from the Railroad Retirement Board (RRB), you’ll be considered eligible too. Additionally, if you’re awarded SSDI benefits for something other than Lou Gehrig’s disease (ALS), you will become eligible for protection 24 months following the date of entitlement to cash advantages. If you are awarded SSDI and have ALS, you will automatically be eligible for Medicare once you begin receiving SSDI advantages, and if you have kidney failure, you’ll be able to enroll in Medicare three months following starting dialysis.

Particular Advantages You can Obtain

Social Security Disability Insurance allows you to obtain a regular monthly income, results in eligibility for Medicare advantages (as explained earlier), and permits feasible extension of the COBRA advantages, protects your retirement and long-term disability advantages, plus allows for dependent benefits and return-to-work incentives.

Medicare has numerous parts to cover particular healthcare costs. Medicare Part A covers inpatient care in hospitals and provides patients having a stay inside a semi-private room, complete with meals, general nursing, and drugs. Part A also covers the cost of a blood transfusion if the hospital must purchase blood for you, up to 100 days per each benefit period in a skilled nursing facility, and hospice care for individuals with a life expectancy of six months or less as a result of a terminal illness. Part A protection costs nothing, except for the deductibles or copayments, and protection gaps must be paid by you or covered by other insurance plan.

Medicare Component B covers doctors’ visits and providers, outpatient care, rehabilitative attention under a physical therapist, occupational therapist, or speech-language pathologist, and some preventative providers like flu shots and mammograms. The month-to-month cost (or premium) for Component B coverage is tied to your annual income and adjusted each year. Most will pay the standard Part B premium of $96.40 per month in 2009 (if your annual earnings is not more than $85,000 as a single taxpayer or $170,000 if filing a joint tax return).

Medicare Benefit (Part C) plans at a minimum cover everything offered by traditional Medicare (Parts A and B). They also might provide additional advantages not covered by traditional Medicare like dental care, vision screening, prescription drugs and other providers that would otherwise need to be supplied under a supplemental insurance plan policy (Medigap).

Your out-of-pocket expenses are likely to be much less with a Medicare Advantage plan than should you use traditional Medicare and a Medigap policy. Everybody inside a Medicare Benefit plan pays at least the same monthly premium as those enrolled in Medicare Part B. Your premiums may price a lot more depending on the advantages supplied by the strategy.

Medicare Component D (prescription drug coverage) provides brand-name and generic prescription drug coverage. These plans are provided by private firms which are approved by Medicare. Part D protection is optional and available to individuals enrolled in conventional Medicare (Parts A and B) or Medicare Benefit plans that don’t offer prescription drug coverage. Costs, additional benefits and details vary by plan.

Function With a SSDI & Medicare Advisor Service to Maximize Your Advantages

Don’t stay confused trying to figure out the complex rules of these programs on your own – let those who understand it best help you maximize your advantages. Medicare & SSDI programs could be confusing with all from the different program requirements, eligibility criterion and disability claims process. Working with an SSDI expert and Medicare Advisor Service can help you determine the best coverage for your particular needs to ensure you get all from the benefits you’re entitled to obtain.

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