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    #16
    Originally posted by SCI-Nurse View Post
    You automatically get Part A and Part B after you get disability benefits from Social Security for 24 months, but keep in mind that Medicare only pays 80% of "reasonable costs". So for example, if you have a procedure where the charge is $1000, Medicare may say that their "reasonable cost" for this procedure is $540, and they would then pay $432, and you would be obligated to pay the remaining $108 out of pocket, unless you have a secondary insurance that pays the 20%.

    It also does not include Part D (medications) so you would have to pay for those out of pocket unless you pay for a Part D plan, or get a supplemental Medicare insurance plan that includes Part D.

    If you qualify for Medicaid, then for many this becomes their secondary insurance and included (usually with limits) medications.

    You can find tons of information on this website: www.medicare.gov

    (KLD)
    Original Medicare has no limit on your out of pocket expenses (your 20% of the payment). Therefore, you must have a supplemental plan or else you are rolling the dice.

    Alternatively, you can chose a Medicare Advantage plan, part C. It offers better coverage than parts A, B, and D combined. The out of pocket expenses are limited so you don't need a supplement. As a result, you get better coverage (some plans include dental and vision) at a lower cost. Two other nice things about Medicare Advantage is that you never get a bill, and you can ask for a case manager. With original Medicare, you will have to sort through bills, which can get complicated. If you have questions, you call an 800 number and wait an hour to talk to someone you have never spoken to before.

    Medicare Advantage is the clear choice for me. The only drawback is that I have to select service providers within my group. Original Medicare let's me select doctors anywhere in the country. Unless you need that option, you are overpaying for Original Medicare.
    Last edited by August West; 31 Jan 2017, 8:08 PM.

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      #17
      Really like my retiree health plan at $212/month. But I think they will stop paying claims once I am eligible for Medicare even if I decline part B. Does that sound right?

      Guess I need to pay both premiums and use part B even though the retiree plan would cover everything I need?
      "Never turn your back on fear. It should always be in front of you, like a thing that might have to be killed." - Hunter Thompson
      T5/6 complete

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        #18
        Has anyone worked for a long time being in a wheelchair and then been turned down when applying for SSDI? I have a lot of problems with my shoulders and hands along with other issues. Lots of things catching up with me now. Was wondering if I would run into a lot of problems when applying and having my SSDI claim accepted.

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          #19
          Per the last SSDI "insider handbook" I saw, someone with paralysis is a shoo-in for SSDI. Why? Because. Have you noticed how hard it is for a paralyzed person to find and maintain gainful employment? Doesn't happen too often. The goal of SSDI is to help a disabled person "return" to employment and pay taxes when they recover. If you are successfully employed and then retire (even with a pension), you are STILL paralyzed, still eligible for SSDI.
          So....retire as soon as you want to. Your personal reason: 'my shoulders are giving out'. Social Security doesn't care about your shoulders! If you are still paralyzed, you qualify.

          P.S. You may want to consider the current political situation in terms of potential changes to programs like SSDI.
          Suggest you look into continuing any health insurance you have even after your Medicare kicks in.

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            #20
            Just for general information for all SSDI recipients. If you are an SSDI recipient and receive vocational rehabilitation services then return to work, the state vocational rehab department is reimbursed by the Social Security Administration for all your voc rehab costs.

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              #21
              It does concern me what will be happening with health insurance in the future and what it will cost me going forward. I'm sure there will be changes and not for the better. SSDI and Medicare will probably change in the future too. Been working as long as I possibly can but didn't want to quit and apply for SSDI and have them say that I wasn't qualified for SSDI for some silly reason. Thanks for the info.

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