Social Security Disability Income

SSDI is for people who are under the age of 65 and can no longer work due to a physical or mental condition. 

SSDI and Medicare—What You Need To Know

Under 65 and on Medicare: Yes you can be under 65 and receive Medicare coverage.  As a matter of fact, I’ve had clients as young as 20 on Medicare Advantage plans.

Qualifying or Waiting Period: You will receive Medicare coverage after a 24-month qualifying period. For those diagnosed with ESRD or ALS, then there is no 24-month waiting period.

Insurance Options While Waiting For Medicare: What health insurance options do you have while waiting for your Medicare to start?

1. On-Exchange: These are the Affordable Care Act plans available to individual and families within certain income limits. This is the best place to start to see if you qualify for an On-Exchange plan. If you do, you may receive a tax credit and a subsidy to help cover the costs of the premiums. Go here to find out more.
2. Off-Exchange: These are traditional major medical policies. You would only select one of these if there were no other more affordable option.
3. Group Policy: Does your spouse have Group Insurance through his employer, business or union? If so, find out if you can be added to their policy and how much it will cost compared to an On-Exchange plan.
4. Short-Term Health Insurance: These policies are typically offered for 1-6 months at a time. You will find that they can cover the same benefits as a traditional major medical policy. And you may find that they are less expensive. 
5. Medicaid: If your income is below a certain level, then you may qualify for Medicaid. Contact your states Medicaid office and/or your local social services department to find out more.

Plan Options: Once you are on Medicare, you will have the same plan options available to you as any traditional Medicare beneficiary…except for a Medicare Supplement policy in most states. 

Once your Medicare coverage starts, you are usually automatically enrolled into a Part D drug plan. But, you also have the option to take advantage of enrolling in a Medicare Advantage plan. If you or someone you know is receiving SSDI and you or they don’t have a Medicare Advantage Plan, then please contact me right away.

Be careful: In some states, some insurance companies do sell Medicare Supplements or Medicare Supplement type policies for those under 65. In Virginia, effective January 1, 2021, the state now “requires each insurer, health service plan and health maintenance organization that issues Medigap plans in Virginia to offer the option to buy at least one of its Medigap plans to individuals who meet the above criteria for eligibility.”

However, in my experience, these premiums are very, very high and simply not worth it. You would be much better off on a Medicare Advantage plan even if you hit your Maximum Out Of Pocket limit.