Medicare, Disability Benefits and Obamacare

The big political news during the last week of June was of course the decision from the US Supreme Court upholding the majority of the Patient Protection and Affordable Care Act (“PPACA”) (commonly referred to as “Obamacare” by both critics and supporters of the legislation). The one change that the Supreme Court demanded was to the expansion of Medicaid under the PPACA. While the legislation originally conditioned all Medicaid funding on a state’s acceptance of the expansion, the Supreme Court ruled that only the expansion could be conditional; that is, states can stick with their original Medicaid program without fear of losing it if they do not accept the expansion.

How Does Medicaid and Medicare Work with Disability Benefits?

Remember that Medicaid and Medicare are two different programs. Medicare is a form of federal health insurance; it is mostly for Americans aged 65 and older, but younger Americans with disabilities can also qualify for it. Medicaid is a health program that depends on your income and assets (similar to SSI benefits eligibility). We will discuss Medicaid later in the week.

If you receive SSDI benefits, the Social Security Administration automatically enrolls you in Medicare after two years of benefits. You should receive information from Social Security a few months before you are eligible for Medicare coverage, and you can get health coverage through all of the parts of Medicare. Part A covers hospitalization costs and follow up care, and, because it is funded through your tax contributions while you were working, you do not have to pay anything for Part A coverage.

Part B of Medicare is similar to traditional health insurance, as it covers doctor visits and outpatient medical care. After two years as an SSDI beneficiary, you are eligible for Part B coverage, but you do have to pay a monthly premium for it.

You are also eligible for the other parts of Medicare coverage. Part C includes private company insurance options. Part D provides prescription drug benefits. Parts B, C and D all require monthly premiums for coverage. On Wednesday, we will discuss the impact of the PPACA for disability beneficiaries and Medicare coverage.

Have you recently suffered a disability or medical condition that prevents you from working or obtaining health insurance coverage? Speak to one of our Tulsa Oklahoma Social Security disability attorneys to learn whether you might qualify for SSDI or SSI benefits.

Troutman & Troutman, P.C. – Tulsa Social Security disability attorneys



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6 Responses to Medicare, Disability Benefits and Obamacare

  1. I am a 59 year old male. I am on disability, so I get Medicare. I have read several articles about how Obamacare will affect me, and I am still confused. Can you tell me how this works.

    Thanks

    • Steve A. Troutman says:

      Jerry,

      You posted a question on our blog about Medicare and how it would be affected by Obamacare. You indicated that you are on disability and that you get Medicare. I do not know of anything in Obamacare that will decrease your medicare benefits. I believe that the provisions in Obamacare will improve the medicare system and will likely increase the benefits to you. It would be very difficult to explain all of the effects of Obamacare in this e-mail. However, I think the most comprehensive web site on the subject is the following:

      http://www.pennlive.com/living/index.ssf/2013/07/post_6.html

      I suggest you read that web site. I hope it answers the questions you may have. Thank you again for posting your question on our blog.

      Steve A. Troutman

  2. Davida Warren says:

    I am disabled and have been on Medicare A&B for almost 3 years. I am also on my husband’s insurance, Anthem, through his work. His is primary and Medicare is secondary. I live in a town that is 1 1/2 hours from a large city to the south and 2 hours to the north. With my health issues I am under several specialists. One of my biggest fears about obamacare is having to change doctors. The neurologist I have here specializes in the main condition I have. It’s a relatively a new disease that even a huge percent of doctors still don’t know much, if anything, about it. It took me 4 1/2 years working with a lawyer to start getting disability because of it. It’s also an extremely painful condition and I see a pain specialist who monitors all of my meds, including narcotics for the pain. My condition will continue to get worse. I’ve had too much damage done in my body for even an ounce of hope for even a remission. My pain specialist is the only one in town that will prescribe narcotic pain medicine and even he makes sure that any or all other avenues have been tried and was unsuccessful. Under obamacare, will I be able to keep my doctors that I’m seeing now or are there any possibilities that I’m going to be forced to change doctors? I’m also bedbound and it’s extremely difficult to ride the 15 minutes to my doctor appointments. It will be nearly impossible for me to have to ride to one of the large cities that are the closest cities to us. Any info. you can give me will be greatly appreciated. Thank you.

    • Steve A. Troutman says:

      Davida,

      I am not aware of anything in Obamacare that would require Medicare recipients to change doctors. There is a lot of misinformation and fear about Obamacare that is unfounded, and fear of changes to Medicare is certainly one of them. The changes to Medicare in Obamacare will only help the recipients, like the elimination of the donut hole in Medicare part D. There is always a possibility that some doctors will decide to stop taking Medicare patients, but that was the case before Obamacare, and it will continue to be the case after Obamacare is fully implemented. Unless your doctor decides to stop treating Medicare patients, you will be able to continue using the same doctor.

      Steve A. Troutman

  3. angelina says:

    hi I receive ssi ssa and medicare and Medicaid i’m hearing a lot about the obamacare suppose to be to cut people off their ssi and ssa and medicare and Medicaid i’m a mother of 2 girls and I was born with spinia bifdia and I have a tralior my kids and I live in I can’t really even pay my rent cause I can’t work and I depend on my checks because that’s my only source of income and I receive tanf will that be affect also I put in for section 8 and housing authority but I been on the waiting list now for 8 years need a low income house but need help I just need to know about this obamacare sounds strange I need help in will this obamacare help me to get in a low income house and do obamacare affect what I stated early I really need some advice or anything someone know will help me very much anyone can respond soon as possiable please I need to know all of this

    • cassie says:

      You recently posted a comment on our blog in which you asked about the effect of Obamacare on your Medicare and Medicaid benefits. Please do not listen to the people who are telling you that your Medicare and Medicaid benefits will be cut off. Some people are attempting to scare others about Obamacare by saying things about it that are simply not true. There is absolutely nothing in Obamacare that would cause your Medicare or Medicaid to stop.

      Steve A. Troutman
      Troutman & Troutman, P.C.

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