medicare eligibility

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entropy

Guest
I have medicaid already, but some of the services I need are only covered by medicare.

I know some or many of you have medicare. Are there any specific requirements for medicare eligibility? If one already receives SSI (not SSDI), are they automatically eligible for medicare? Does one have to be a certain age? To be eligible for medicare, would I have to have officially documented prior work experience/tax records?

I have no official 'work experience.' i.e., I have never worked a normal 9-5. At 14 I started a successful online business. I'm 22 now and still make money online, but not nearly enough to cover medical expenses.

My specific situation is that I need to get into pain management but none accept medicaid, but many accept medicare. I'm tired of living in pain all the time and because my pain is quite bad and vastly undertreated, I've been having thoughts about killing myself. So, I really need to get something figured out.

I live in Florida, if that makes a difference.

Thanks.
 
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RytheStunner

Guest
Medicare and SSDI go hand in hand. If you become eligible for SSDI, you become eligible for Medicare (effective 2 1/2 years after you become eligible for SSDI). You need work experience in order to be eligible for those because your income taxes help pay into that system. Some people are able to collect off of their parents' work experience though, but you're over 18, so that's probably not an option.
Medicare is a Federal program, so the rules don't vary state by state, they're the same nationwide.
 
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jbrandyn

New member
Medicare is unavailable until you are 65.

You will have to do pain management through your hospital probably. Hopefully they also do outpatient, if you cannot find anything then call your Social Security office and make an appointment to talk to someone they should be able to help you navigate the system, probably refer you to a case manager or Social Worker who can help.

I am not sure about Florida's state policy as each state's policy can vary. The finding is federal, but administered by the state government, so different states have different allotments and rules for who can provide services. Pain management stuff is a hot button because of the types of meds often used so it has become routine for only hospitals to administer pain management to medicaid patients, inpatient and out.

If you call 211, a national social service information and referral helpline they should be able to do a search for pain clinics that take medicaid or for case managers you could call for help in getting access and navigating the system. Your CF center should have social worker to help you though.

Best of luck.
 
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RytheStunner

Guest
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>jbrandyn</b></i> Medicare is unavailable until you are 65. You will have to do pain management through your hospital probably. Hopefully they also do outpatient, if you cannot find anything then call your Social Security office and make an appointment to talk to someone they should be able to help you navigate the system, probably refer you to a case manager or Social Worker who can help. I am not sure about Florida's state policy as each state's policy can vary. The finding is federal, but administered by the state government, so different states have different allotments and rules for who can provide services. Pain management stuff is a hot button because of the types of meds often used so it has become routine for only hospitals to administer pain management to medicaid patients, inpatient and out. If you call 211, a national social service information and referral helpline they should be able to do a search for pain clinics that take medicaid or for case managers you could call for help in getting access and navigating the system. Your CF center should have social worker to help you though. Best of luck.</end quote>

Not true. Medicare is also available if you are deemed disabled and eligible for Social Security Disability Insurance. There are SEVERAL CFers who are on Medicare.
 
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Incomudrox

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>RytheStunner</b></i> <div class="FTQUOTE"><begin quote><i>Originally posted by: <b>jbrandyn</b></i> Medicare is unavailable until you are 65. You will have to do pain management through your hospital probably. Hopefully they also do outpatient, if you cannot find anything then call your Social Security office and make an appointment to talk to someone they should be able to help you navigate the system, probably refer you to a case manager or Social Worker who can help. I am not sure about Florida's state policy as each state's policy can vary. The finding is federal, but administered by the state government, so different states have different allotments and rules for who can provide services. Pain management stuff is a hot button because of the types of meds often used so it has become routine for only hospitals to administer pain management to medicaid patients, inpatient and out. If you call 211, a national social service information and referral helpline they should be able to do a search for pain clinics that take medicaid or for case managers you could call for help in getting access and navigating the system. Your CF center should have social worker to help you though. Best of luck.</end quote> Not true. Medicare is also available if you are deemed disabled and eligible for Social Security Disability Insurance. There are SEVERAL CFers who are on Medicare.</end quote>
This.
 
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jbrandyn

New member
http://www.medicare.gov/MedicareEligibility/Home.asp?dest=NAV|Home|GeneralEnrollment#TabTop

Most people cannot, there are programs available, but Medicare is only for those who have somehow earned it through retirement benefits or special and very specific employment histories... or if you were married to someone receiving medicare and are disabled then sometimes you can get it as well.

it is a complicated and convoluted system. Just because some CFers have it before age 65 does not mean we can all get it. However their are programs available and I would suggest that Mr. Entropy access his personal and community resources to get more area specific help and probably help applying for or finding clinics, hospitals, etc who can help him.
 
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Incomudrox

New member
So you agree that you can get it, but yet you say its and quote "Medicare is unavailable until you are 65. ". So which is it? (I know) but way to contradict yourself. As long as you have enough working credits when you become disabled you can get it. <a href="http://www.ssa.gov/retire2/credits3.htm" target="_blank">http://www.ssa.gov/retire2/credits3.htm</a> << You earn 4 credits for every $4,xxx you earn per year, you can earn 8 credits per year.
 
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RytheStunner

Guest
I didn't say everyone can get it. But if you are deemed disabled and eligible for SSDI, then you automatically become eligible for Medicare 2 1/2 years after you gain SSDI eligibility. And yes, MOST CFers can get it. As a matter of fact, the majority of the CFers I know in the community are on SSDI/Medicare.
These days, they're being a lot stingier with their restrictions and it often takes a couple appeals before you're finally accepted, but I've been on SSDI/Medicare since I was in college...and I had only worked menial part-time jobs at that point.
 
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jbrandyn

New member
You are right that was a bad choice of words. However, on the whole it is mush easier and faster to try and find something else for more immediate care then applying for Medicare before you are 65 or have been employed in specific places. He can try to apply for it, but it will take time. There are to many caveats and subtleties to eligibility before age 65 for it to be practical for a younger person to apply before trying other resources.

In addition, had he been eligible when he applied for Medicaid he would most likely have been granted Medicare at the same time and it is very unlikely that he has earned enough work credits while on SSI and Medicaid.

The reason most people do not start medicare until age 65 when you become automatically eligible is because they do not have enough work credits... after 45 years of working.
 
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jbrandyn

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>RytheStunner</b></i> I didn't say everyone can get it. But if you are deemed disabled and eligible for SSDI, then you automatically become eligible for Medicare 2 1/2 years after you gain SSDI eligibility. And yes, MOST CFers can get it. As a matter of fact, the majority of the CFers I know in the community are on SSDI/Medicare. These days, they're being a lot stingier with their restrictions and it often takes a couple appeals before you're finally accepted, but I've been on SSDI/Medicare since I was in college...and I had only worked menial part-time jobs at that point.</end quote>

There is that. I though he looked young though. Whatevs
 
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RytheStunner

Guest
He said he was 22, so it's not a bad age to get started. I was 19 when I first started and they backdated my eligibility by 2 years when I signed up for SSDI, so I didn't have to wait 2 years for Medicare.
In some instances, it's a good idea to get on, especially if you expect to work in the future. You don't want to have that 63-day gap in health insurance coverage on your record or it'll be difficult to get insurance in the future.
 
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jbrandyn

New member
Wow you msut have a good social security officer for them to count back years. I know it is an automatic thing that the social security administration just does without you having to apply if you are already on SSI and Medicaid then as soon as you have 24 months done.

I made the mistake of working so I would have my 24 months done now, but I had a paycheck 19 months ago... the system is so stupid.

@Entropy- http://www.211.org/ this website is good for finding help in you community. The databases 211 uses are updated daily and m,most resources are available to help even if you are waiting for your Medicare application to go through.
 
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julie

New member
^^^ counting back the two years as "rythestunner" stated is actually quite common if that is when the determine the ONESET of the DISABLING condition began.

And to clear this all up since it seems to have become mighty convoluted, there are ONLY two ways a person can qualify for MEDICARE....

1. RETIRE AT 65
2. 24 MONTHS AFTER THEY QUALIFY FOR SSDI (not ssi) BENEFITS (OR 24 MONTHS AFTER DISABILITY ONSET DATE)
 
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julie

New member
Entropy, I'm sure you've alreayd looked into this but just in case, does your hospital have a pain mgmt clinic within the hospital?
 
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AnnieT

New member
Medicare is avail. to those on Social Security Medical..I'm on it. And it comes out of my Social Security check each month. You don't have to be just 65...everyone pretty much explained it well. I hope you get some help soon to relieve your pain.
 
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julie

New member
You have to be on SSDI or over 65 to get medicare...

You can be on SSDI AND get medicare and medicaid depending on family size and income
You can be on SSI and medicaid, but you do NOT qualify for medicare unless you are 65 or over.
 
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lilro

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>julie</b></i> You have to be on SSDI or over 65 to get medicare... You can be on SSDI AND get medicare and medicaid depending on family size and income You can be on SSI and medicaid, but you do NOT qualify for medicare unless you are 65 or over.</end quote>

Not true, I'm on SSI and receive Medicare and I'm only 22.
 
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