Offered Medicare as part of SSDI benefits - should I decline it?

[ej0820]

Lauren,

before I got the medicare/ssdi, I was on medicaid, as I was approved for ssi. The medicaid was GREAT. Once I started getting ssdi payments though, I was told I make too much money to qualify for medicaid anymore. The only medicaid program I qualify for now is the medicaid spenddown-which means I would pay the amount for medicaid that the state seems to think I can afford. Right now, they think I can afford to pay $500 a month for medicaid. That's ridiculous. I can't even afford half of that a month, so I'm left with just medicare. I also get qmb, where medicaid pays the medicare premium, but that feels like such a lousy coverage...almost unnecessary. I mean, if you think I can afford $500 a month, why are you paying my $110 a month premium??

Ugh. Good luck to you.

 

[ej0820]

Lauren,
<br />
<br />before I got the medicare/ssdi, I was on medicaid, as I was approved for ssi. The medicaid was GREAT. Once I started getting ssdi payments though, I was told I make too much money to qualify for medicaid anymore. The only medicaid program I qualify for now is the medicaid spenddown-which means I would pay the amount for medicaid that the state seems to think I can afford. Right now, they think I can afford to pay $500 a month for medicaid. That's ridiculous. I can't even afford half of that a month, so I'm left with just medicare. I also get qmb, where medicaid pays the medicare premium, but that feels like such a lousy coverage...almost unnecessary. I mean, if you think I can afford $500 a month, why are you paying my $110 a month premium??
<br />
<br />Ugh. Good luck to you.

 

[LouLou]

Yes, yes definitely one of those things to run by Beth. What a freckin' can of worms. I contacted her and I'm hearing things so far that are contradictory to what you all are telling me about Medicare being my secondary in my case. I'm going to get to the bottom of it and then get back to you all with what I am doing and why. Thanks for sharing what you do

 

[LouLou]

Yes, yes definitely one of those things to run by Beth. What a freckin' can of worms. I contacted her and I'm hearing things so far that are contradictory to what you all are telling me about Medicare being my secondary in my case. I'm going to get to the bottom of it and then get back to you all with what I am doing and why. Thanks for sharing what you do

 

[LouLou]

Yes, yes definitely one of those things to run by Beth. What a freckin' can of worms. I contacted her and I'm hearing things so far that are contradictory to what you all are telling me about Medicare being my secondary in my case. I'm going to get to the bottom of it and then get back to you all with what I am doing and why. Thanks for sharing what you do

 

[Landy]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>LouLou</b></i>

Yes, yes definitely one of those things to run by Beth. What a freckin' can of worms. I contacted her and I'm hearing things so far that are contradictory to what you all are telling me about Medicare being my secondary in my case. I'm going to get to the bottom of it and then get back to you all with what I am doing and why. Thanks for sharing what you do </end quote></div>

Does your spouse work for a company with under 100 employees? <i>I think </i>that makes a difference in whether Medicare is primary or secondary.

Also, to ammend my statement above: I guess Medicare did pay for the home health nurses since I had IVs in April & have yet to be billed for any copays for the nurses?

 

[Landy]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>LouLou</b></i>

Yes, yes definitely one of those things to run by Beth. What a freckin' can of worms. I contacted her and I'm hearing things so far that are contradictory to what you all are telling me about Medicare being my secondary in my case. I'm going to get to the bottom of it and then get back to you all with what I am doing and why. Thanks for sharing what you do </end quote>

Does your spouse work for a company with under 100 employees? <i>I think </i>that makes a difference in whether Medicare is primary or secondary.

Also, to ammend my statement above: I guess Medicare did pay for the home health nurses since I had IVs in April & have yet to be billed for any copays for the nurses?

 

[Landy]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>LouLou</b></i>
<br />
<br />Yes, yes definitely one of those things to run by Beth. What a freckin' can of worms. I contacted her and I'm hearing things so far that are contradictory to what you all are telling me about Medicare being my secondary in my case. I'm going to get to the bottom of it and then get back to you all with what I am doing and why. Thanks for sharing what you do </end quote>
<br />
<br />Does your spouse work for a company with under 100 employees? <i>I think </i>that makes a difference in whether Medicare is primary or secondary.
<br />
<br />Also, to ammend my statement above: I guess Medicare did pay for the home health nurses since I had IVs in April & have yet to be billed for any copays for the nurses?

 

[blindhearted]

Yes Landy, they do pay for Home Care nursing. I was just on IVs and the home care only took my Medicare info, when I asked why, the nurse told me that medicare pays for home nursing visits.

 

[blindhearted]

Yes Landy, they do pay for Home Care nursing. I was just on IVs and the home care only took my Medicare info, when I asked why, the nurse told me that medicare pays for home nursing visits.

 

[blindhearted]

Yes Landy, they do pay for Home Care nursing. I was just on IVs and the home care only took my Medicare info, when I asked why, the nurse told me that medicare pays for home nursing visits.

 

[cf4life]

One question to ask. If you lost your husbands insurance for some reason, would that qualify as a special event so that you can then apply for part B and D? If not, you would need to wait for open enrollment at the end of the year. I believe this would qualify as a reason to sign up for part D, but not sure about part B.

I think some things depend on the state you work/live in with regards to gaps in your insurance and pre-existing condition waiting periods. You need to make sure you have a way to cover any potential gaps should you need to change insurance. If he did lose your insurance, you should be able to elect to use Cobra to cover any waiting period on a new job start, or you can use medicare part A and B to cover a waiting period. Then there is the worst case he loses his job and can't find another one. You have at least 18 months to use Cobra (maybe longer since you are disabled) which would give you time to wait for medicare open enrollment should you need to.

This is only my understanding/experience with the "system".

 

[cf4life]

One question to ask. If you lost your husbands insurance for some reason, would that qualify as a special event so that you can then apply for part B and D? If not, you would need to wait for open enrollment at the end of the year. I believe this would qualify as a reason to sign up for part D, but not sure about part B.

I think some things depend on the state you work/live in with regards to gaps in your insurance and pre-existing condition waiting periods. You need to make sure you have a way to cover any potential gaps should you need to change insurance. If he did lose your insurance, you should be able to elect to use Cobra to cover any waiting period on a new job start, or you can use medicare part A and B to cover a waiting period. Then there is the worst case he loses his job and can't find another one. You have at least 18 months to use Cobra (maybe longer since you are disabled) which would give you time to wait for medicare open enrollment should you need to.

This is only my understanding/experience with the "system".

 

[cf4life]

One question to ask. If you lost your husbands insurance for some reason, would that qualify as a special event so that you can then apply for part B and D? If not, you would need to wait for open enrollment at the end of the year. I believe this would qualify as a reason to sign up for part D, but not sure about part B.
<br />
<br />I think some things depend on the state you work/live in with regards to gaps in your insurance and pre-existing condition waiting periods. You need to make sure you have a way to cover any potential gaps should you need to change insurance. If he did lose your insurance, you should be able to elect to use Cobra to cover any waiting period on a new job start, or you can use medicare part A and B to cover a waiting period. Then there is the worst case he loses his job and can't find another one. You have at least 18 months to use Cobra (maybe longer since you are disabled) which would give you time to wait for medicare open enrollment should you need to.
<br />
<br />This is only my understanding/experience with the "system".