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Does being on SSDI automatically put you into Medicare?

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    #31
    Make sure that you ask them for a copy of the 'Plan Document". This is not the handout from the carrier but a legal document that the "Plan" files with the Dept. of Labor. This is where it is spelled out when Chad will be dropped from the group plan. Most plans are written so that this drop happens when medicare kicks in. This means that his time line is ticking now. Once they find out that medicare has picked him up, they can drop him retroactively. This means that if he has declined medicare in favor of his group plan and his group plan drops him, he is left with nothing. How scary is that?

    If finances allow, I would go so far as to get him more coverage than you think he needs (medicare, supplemental policy) until the dust settles. It is much easier to drop redundant coverage than it is to get coverage when you have none.--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

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      #32
      Ok, then that puts him in the same grey area as Cass ..... I find that it is poorly written. It covers people like me, not working, but covered under a working spouse. Or working and disabled and covered by their own insurance (must be a very small group of people to fit this criteria). It just seems to skirt around disabled and no longer working but covered under their health plan from work.

      Good luck w/ HR. I hope you get it figured out.

      (And you started this a long time ago, didn't you? I seem to remember discussing this w/ you in the past ..... so it has taken a long time already to get it straightened out to this point.)

      ps ..... Cass ...... don't worry, I took it that you were calling b/s to Medicare, not anyone here.

      DD ... I hadn't gone further, it figures. The first info I found just ignores that category.
      T7-8 since Feb 2005

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        #33
        Yes, it appears that those who are disabled themselves who worked, but can't now work are an invisible minority. We haven't declined Medicare, and based on this info here we certainly won't decline it.

        Thank you eak, I will also for a copy of that document. I might need a large stash of vodka to try to get through it .... and to find out what it says!!
        Wife of Chad (C4/5 since 1988), mom of a great teenager

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          #34
          i am getting LTD as well. they deduct my SSDI. does not affect my medicare status. i had COBRA for 36 months, the max i could have it. you know, these LTD/COBRA policies differ with different employers, which makes comparing notes amongst us difficult!

          my LTD only lasts 10 yrs, for example. zilla, i'd check on chad's. i paid extra out of my paycheck w/o knowing it would only pay 10 yrs. and it isn't the employer paying but the contracted ins. company. if chad's LTD is not deducting his SSDI payment, i'd look into that. my LTD was supposed to be 60% as well, but is nowhere near that because of SSDI.

          jean, ty! i was worried i sounded like i was saying bs to you when i reread this after dd's input

          thank you, dd, for your input. i find it always helpful as well as most ppl here. what a mess the system is, esp. when dealing w/diff employers and ins companies. each have diff rules/plans.

          my LTD kicked in last July but 10 yrs from now will no longer pay. my teen's ins. thru my employer i can have until he's 26, but it is over 400/month! so....as a person who worked most of her life, i am quite surprised/scared over the cost of ins. i didn't even know medicare would cost me. :O am learning.

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            #35
            Zilla,

            If you need help understanding the "Plan Document", let me know. I have written these things and am very familiar with the language. I agree that you will need serious alcohol to get through it. Think of it like a word problem in advanced math class. My dad (who taught advanced math) told me when I was in HS that you have to figure out the part that does not matter first so that you can concentrate on what matters. He was right. There is 80%+ that you do not need to worry about or care about. The problem is figuring out the parts you need to know and respond to.

            You are right to not decline medicare at this time. I would also start investigating medicare supplements. You can get the least expensive one now with the knowledge that he can change every year at "open enrollment" time. This way, when his group plan ends, you know you can get him a supplement that will meet his needs. The supplement may not be available when his group coverage is terminated and medicare alone is probably not enough.

            Ask for the document in an electronic version, if possible and I will be happy to look at it for you.--eak
            Elizabeth A. Kephart, PHR
            mom/caregiver to Ryan-age 21
            Incomplete C-2 with TBI since 3/09

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              #36
              Eak - I will take you up on that when I get the document. Thank you so very much for all the help so far.
              Wife of Chad (C4/5 since 1988), mom of a great teenager

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                #37
                Originally posted by darkeyed_daisy View Post
                Last I checked NC did not have a high Risk insurance pool but maybe things have changed...we seem to be the last to get things other states have.
                Since 2009 we have a high risk insurance pool as a result of legislation passed by the NCGA in 2007. Info can be found at http://www.inclusivehealth.org/
                Daniel

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                  #38
                  Originally posted by dan_nc View Post
                  Since 2009 we have a high risk insurance pool as a result of legislation passed by the NCGA in 2007. Info can be found at http://www.inclusivehealth.org/

                  Thanks Dan. I did not have this info.

                  Ami...I have found there is small print in EVERY document the government sends out. If one could reach through the phone...there would be suffocated customer service representatives left to die when I hang up. I had to read the bottom of a letter to one today which said 30 days in print and she still argued it was 10 days. I finally said "I don't give a shit"...you have to go by what the letter says that you sent me and since it says 30 days. I had 30 days and I filed it within 30 days. You received it because I mailed it certified and it was signed by ****@*** which was well before the 30 days stipulated in the letter.

                  The customer service representative then admitted that they had indeed received my information. She then said it is in the processing center and has been there since March 31.

                  We are of course talking about some time sensitive information that I had to return to them at the social security office. They still can't guarantee me that I will get my benefits on May 3.
                  T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

                  My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

                  Comment


                    #39
                    Originally posted by dan_nc View Post
                    Since 2009 we have a high risk insurance pool as a result of legislation passed by the NCGA in 2007. Info can be found at http://www.inclusivehealth.org/
                    Wow, this is exactly what I needed to know!! Thank you!!
                    Wife of Chad (C4/5 since 1988), mom of a great teenager

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                      #40
                      Well, they called me today but had to leave a msg - and they said his health care will continue but medicare will become primary. So now I just have to find out when he will be dropped in the future .... the saga continues.
                      Wife of Chad (C4/5 since 1988), mom of a great teenager

                      Comment


                        #41
                        Send them a letter requesting a copy of the "Plan Document". If this is a group plan, they are required by the Department of Labor to provide you with this. That document will tell you what the provisions are for LTD and medical coverage. You should also request the document for the LTD plan to make sure there are no conflicts (one document says one thing and the other says something else).

                        The plan must be a small group where medicare is primary. It really should make any difference to you since between the two, expenses should be mostly covered. I would not spend much energy worrying about who is primary, the feds know if it is a small or large group and will go after the group themselves for anything they spent. I know this because I complete the paperwork for our group every year. I understand that meds are not an issue at this point but I would still look into the cheapest supplement you can get so that in the future, you can change it to one that provides coverage for meds, especially if group coverage is lost. Ask the carrier for the supplement if you get to make a change if group coverage ends or if you have to wait until the end of the year.
                        Elizabeth A. Kephart, PHR
                        mom/caregiver to Ryan-age 21
                        Incomplete C-2 with TBI since 3/09

                        Comment


                          #42
                          So are there more than one "The Plan" documents? One for LTD and one for medical coverage?
                          Wife of Chad (C4/5 since 1988), mom of a great teenager

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                            #43
                            Yes, each policy is a different plan to the DOL. Each has its own plan document and is required to file tax returns each year. They may try to satisfy you with a "Summary Plan Description". While that is nice, you need the full "Plan Document" which goes into much more detail. You are entitled to these documents as well as the form 5500 (tax return). A written request protects your rights and gives you a recourse in the event that they are uncooperative and you have to write to the DOL. --eak
                            Elizabeth A. Kephart, PHR
                            mom/caregiver to Ryan-age 21
                            Incomplete C-2 with TBI since 3/09

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