Eligibility For SSDI And Medicare
Social Security Disability Insurance (SSDI) provides important benefits to people who are unable to work due
to an injury or illness. This money can help with expenses like rent or
mortgage payments, food and other essentials. In addition, most people
who have a disability often need extra medical treatment. While SSDI payments
can help offset these costs, if you lose your health insurance as a result
of being unable to work, these medical bills can grow quickly. However,
if you receive SSDI benefits, you will be eligible for Medicare coverage
after a set waiting period.
At Troutman & Troutman, P.C., our
Tulsa Social Security Disability attorneys have helped many Oklahoma residents get SSDI and Medicare coverage. Applying
for these federal programs can be difficult. However, with a qualified,
experienced lawyer by your side, you have the best chance of getting approval.
We can explain the entire process, including the waiting period for Medicare
benefits, to ensure that your application is complete and accurate.
What Kind of Health Insurance Can I Get with SSDI?
If you receive SSDI benefits, you will receive Medicare coverage as well (not Medicaid). However, there are some conditions. Most importantly, you are not eligible
for Medicare right away. Instead, your coverage begins two years after
your date of entitlement.
apply for disability benefits, the Social Security Administration (SSA) examines your medical history
and application to determine when your disability began. This may be the
date of a disabling accident or the onset of an illness. This is the established
onset date (EOD). The date of entitlement, on the other hand, is the EOD
plus five months, since there is a mandatory five month waiting period
for disability benefits. You are eligible for benefits starting from the
date of entitlement, which usually means you will receive
disability back pay.
Your Medicare coverage will start two years after the date of entitlement
established by the SSA during your application process. For some, this
means that you may be eligible for coverage as soon as you get approval for
SSDI benefits. This is especially true if you
appeal an initial denial of benefits. However, most applicants will have to wait at least a few months for
There are some exceptions to this two-year interval before Medicare begins.
If you have certain disabling medical conditions, your coverage may start
sooner. Kidney failure and amyotrophic lateral sclerosis (ALS) are two
common conditions that will exempt you from this waiting period.
What Are My Medicare Coverage Options?
Once you are eligible for both SSDI and Medicare, there are several different
parts to the coverage you may receive. Your enrollment in some of these
parts is automatic, while you may have to apply separately for others.
The different parts of Medicare are:
Part A – This is sometimes known as “hospital insurance.” It
covers care you receive in a hospital as well as some follow up procedures.
Your enrollment in Part A is automatic after your approval for SSDI benefits.
This part is paid for by payroll taxes, so the premium is usually free.
Part B – This helps cover the cost of regular visits to the doctor and
routine healthcare expenses. Your enrollment in Part B is also automatic.
However, you will have to pay a premium for this coverage, so you may
refuse it if you choose.
Part C – Also known as “Medicare Advantage,” this provides
additional benefits to help cover costs that Parts A and B do not. You
may also get the same kind of “gap coverage” from a Medigap
plan, which is provided by a private company rather than Medicare. You
must opt into this coverage, since your enrollment is not automatic.
Part D – This part helps cover prescription medication costs. However,
you will have to pay a premium for this part and your enrollment is not
Contact us online or call our office in Tulsa and
schedule a free evaluation of your case today.