Introduction
One of the most common statements I hear from my clients is, “I’m more concerned with getting health insurance than I am with how much money I will receive.” Unfortunately, in the state of Tennessee, there is a high number of uninsured people, thanks in part to the state’s refusal to accept federal assistance to expand Medicaid benefits. At least half of my clients have no health insurance whatsoever because although they meet the income requirements for Medicaid, they do not have minor, dependent children. Lack of health insurance is devastating for people with disabilities because it bars access to the treatment they need just to survive, let alone thrive.
SSDI & Medicare
One of the big benefits of receiving Social Security Disability Insurance (SSDI) benefits is access to Medicare prior to the age of 65. Medicare was originally established as a health insurance program for Americans aged 65 and over, but the program was expanded to cover SSDI recipients in 1973. People under age 65 are eligible for Medicare once they have received SSDI benefits for twenty-four months. The key to figuring out when an SSDI recipient will be Medicare eligible is the term “received” because there is a five-month waiting period before monthly payments begin. Are you confused yet? If so, here is an example to help you sort out how to determine when you will become Medicare-eligible if you have been approved for SSDI benefits:
Jane filed an application for disability benefits on June 9, 2022, alleging disability beginning March 30, 2022. Her claim was recently approved with an onset date of disability of March 30, 2022. Jane’s benefits for April, May, June, July, and August 2022 will be withheld to account for the five-month waiting period, and her monthly benefits will begin in September 2022. She will become Medicare eligible twenty-four months later, in September 2024.
Exceptions to the Waiting Period
Fortunately, there are exceptions to the Medicare waiting period for individuals with end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), but many disability advocates like me believe that both the five-month initial waiting period and the twenty-four-month Medicare waiting period are unfair and unduly burdensome to disabled people. Although there are advocacy groups actively lobbying Congress to change the laws to eliminate these waiting periods, there has been no movement yet.
Conclusion
An experienced disability attorney like me helps her clients navigate the unfamiliar waters of Medicare and can even assist with applying for assistance with premiums and drug costs if the client meets certain income requirements. This is one of the big benefits of hiring a local attorney with a disability-focused practice: hands-on experience handling all aspects of a disability case, even Medicare.