Medicare for people below 65, with disabilities

  • July 9, 2018     About this blog:  click here

Medicare for people under 65, with disabilities

Many people assume that Medicare is just for “old people” – that is, folks age 65 and up.

Not true!   There are a lot people younger than 65 who are on Medicare.  That’s because they have significant disabilities.

It’s connected to a different federal program, which is Social Security Disability.  It makes sense, if you think about it:

“Regular” Social Security provides retirement income to people 62 and up, while Medicare provides health coverage to people 65 and up – mostly the same group of people.

In a parallel way, both Social Security and Medicare help people below 65 who have disabilities:  Social Security Disability provides the income (to make up for inability to earn living wages), while Medicare provides health coverage to those same people.

If someone gets on Social Security Disability below age 65 — or even age 62 — she/he will automatically switch to regular Social Security at the time he/she reaches the Full Benefits age for Social Security.  (The age for this varies according to when you were born.)

Here’s the bureaucratic alphabet soup:  Social Security Disability is officially known as Social Security Disability Insurance, or SSDI for short).  “Regular” Social Security, in contrast, is known as Old Age, Survivors and Disability Insurance, or OASDI for short.

Time delay

There is a special time delay, however, for disabled people to get on Medicare.  When a person becomes disabled enough to get on Social Security Disability, he/she does NOT get Medicare right away.

Instead the person has to wait for two years while on Social Security Disability, and then she/he can finally get on Medicare.

Why the two year wait?

When Congress created Social Security Disability in 1972, they thought it was a good idea to put in the two-year wait, on the theory that most disabled workers were likely to keep getting some health care benefits for a while from their employer.  Maybe that was the case, way back then — but not now.

Many people who are in the waiting period typically have large medical expenses, and many of them have trouble affording adequate health coverage. There have been attempts in Congress to phase out the waiting period, but so far no dice

About 1.8 million people nationally are stuck in the waiting period, in any given year.

How many people below 65 are on Medicare?

The grand total of people below 65 who are on Social Security Disability and on Medicare is about 7 million.

That’s about 15 percent of everyone on Medicare, which is 46 million Americans.  That means 39 million people (85 percent) of the Medicare population are the 65-and-overs.

Do people below 65 get the same Medicare coverage as 65 year olds?

Yes, the government’s Medicare benefits are the same for both groups.

What about Medicare insurance policies?

There are some important things to know about this.

* Medicare Advantage policies are required to take anyone who applies, regardless of their health.

* In contrast, Medicare Supplement policies (also known as Medi-Gap) do NOT have to take on people below 65, in most states. If they do offer coverage at all, it is extremely expensive.

*  The reason to refuse people below 65 is precisely because they have disabilities and big medical expenses which the insurance companies don’t want to pay for.

* BUT – when you finally turn 65, good news! You can get on a Medicare Supplement policy, if you want to, within 6 months of turning 65 – with no questions asked.

* If you do this, and later switch to a Medicare Advantage policy, be warned that you will NOT be able to get back onto a Medicare Supplement policy if you want to.

* One big difference between the two kinds of policies is that with Medicare Supplement policies, you can visit any doctor or hospital you want. With Medicare Advantage policies, you are restricted to certain ones, unless you shell out a lot more money yourself. To learn more about the two types of Medicare insurance policies, see our earlier posts.

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