Questions about how to use the forum?

Visit our new Frequently Asked Questions (FAQs) section.

Welcome, Guest. Please login or register.
Did you miss your activation email?

September 28, 2022, 01:34:39 am

Login with username, password and session length

Recent

Members
Stats
  • Total Posts: 246138
  • Total Topics: 24580
  • Online Today: 106
  • Online Ever: 1127
  • (January 16, 2020, 04:17:02 pm)
Users Online
Users: 0
Guests: 75
Total: 75

You are no longer alone ...

Author Topic: SSDI and retired public worker health insurance?  (Read 7919 times)

moekuk

  • ~ Copper ~
  • *
  • Posts: 15
  • People helped 0
SSDI and retired public worker health insurance?
« on: May 25, 2022, 08:14:26 am »
 I was Just recently approved for SSDI, under the age of 65
I collect a public worker pension and full employer paid family health insurance.  (covers wife and two teens)
I have no idea on how health insurance works once on SSDI. I have yet to receive paperwork mentioning it. I'm ignorant to Medicare and parts and all that.

I read some post online that my state insurance becomes secondary for me.

MisplacedTexan

  • ~ Platinum ~
  • *
  • Posts: 1141
  • People helped 39
  • Joined Forum early 2010 and approved in 2012
Re: SSDI and retired public worker health insurance?
« Reply #1 on: May 25, 2022, 09:52:21 am »
I am a disabled former government worker from a major east coast city and My former employer still pays my BCBS premiums every month. I asked the HR department  if I had to take Medicare or what the requirement was and they told me the choice was mine but they did not require me to take Medicare and I would still be covered until I became 65. At that point the would pay for a Medicare supplement. When I spoke to my HR person they informed me that as long as I did not take Medicare they would cover me 80/20 just like they always did. If I were to take Medicare they would only cover the 20 percent part. I declined Medicare because I had few medicare participating providers in the area I was living in and my Dr would no longer see me as a patient if I took Medicare. The downside is if you decline medicare and then decide to take it later their is a financial penalty of 10% for each year you were not covered by medicare in the time you were eligible for Part B. Or at least that was they way it was back then in 2012 when I was approved. I no longer reside in the USA and Medicare only works in the USA. I have a private policy that covers me overseas when I am not in the US.
Wise Old Texas Cowboy saying  "Never Squat With Your Spurs On"

I have CDO. It's like OCD, but the letters are in order like they should be.

Caregiver to 4 wonderful rescued dogs.

newdawn

  • Global Moderator
  • ~ Platinum ~
  • ****
  • Posts: 3858
  • People helped 516
Re: SSDI and retired public worker health insurance?
« Reply #2 on: May 25, 2022, 10:04:21 am »
I am a disabled former government worker from a major east coast city and My former employer still pays my BCBS premiums every month. I asked the HR department  if I had to take Medicare or what the requirement was and they told me the choice was mine but they did not require me to take Medicare and I would still be covered until I became 65. At that point the would pay for a Medicare supplement. When I spoke to my HR person they informed me that as long as I did not take Medicare they would cover me 80/20 just like they always did. If I were to take Medicare they would only cover the 20 percent part. I declined Medicare because I had few medicare participating providers in the area I was living in and my Dr would no longer see me as a patient if I took Medicare. The downside is if you decline medicare and then decide to take it later their is a financial penalty of 10% for each year you were not covered by medicare in the time you were eligible for Part B. Or at least that was they way it was back then in 2012 when I was approved. I no longer reside in the USA and Medicare only works in the USA. I have a private policy that covers me overseas when I am not in the US.

I think turning 65 could count as a new enrollment period so one might not have to pay the big penalty if they can wait from the time they are disabled until age 65 but I'm not 100% sure on that. Just mentioning this for others.
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Applied: 11/2013
First Denial: 03/2014
Reconsideration Denial: 11/2014
Hearing: 11/13/15 (Friday the 13th!)
ALJ Approval: 01/15/16 Fully Favorable
Back Pay: 02/13/16
Award Letter: 02/17/16
1st monthly benefit: 03/21/16

MisplacedTexan

  • ~ Platinum ~
  • *
  • Posts: 1141
  • People helped 39
  • Joined Forum early 2010 and approved in 2012
Re: SSDI and retired public worker health insurance?
« Reply #3 on: May 25, 2022, 10:25:03 am »
I am a disabled former government worker from a major east coast city and My former employer still pays my BCBS premiums every month. I asked the HR department  if I had to take Medicare or what the requirement was and they told me the choice was mine but they did not require me to take Medicare and I would still be covered until I became 65. At that point the would pay for a Medicare supplement. When I spoke to my HR person they informed me that as long as I did not take Medicare they would cover me 80/20 just like they always did. If I were to take Medicare they would only cover the 20 percent part. I declined Medicare because I had few medicare participating providers in the area I was living in and my Dr would no longer see me as a patient if I took Medicare. The downside is if you decline medicare and then decide to take it later their is a financial penalty of 10% for each year you were not covered by medicare in the time you were eligible for Part B. Or at least that was they way it was back then in 2012 when I was approved. I no longer reside in the USA and Medicare only works in the USA. I have a private policy that covers me overseas when I am not in the US.

I think turning 65 could count as a new enrollment period so one might not have to pay the big penalty if they can wait from the time they are disabled until age 65 but I'm not 100% sure on that. Just mentioning this for others.

You raise a good point I had not considered.
Wise Old Texas Cowboy saying  "Never Squat With Your Spurs On"

I have CDO. It's like OCD, but the letters are in order like they should be.

Caregiver to 4 wonderful rescued dogs.

Just Me

  • Administrator
  • ~ Platinum ~
  • ****
  • Posts: 14232
  • People helped 1051
  • Nice Administrator
Re: SSDI and retired public worker health insurance?
« Reply #4 on: May 25, 2022, 05:06:44 pm »
They go from when you become eligible for Medicare 
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

Just Me

  • Administrator
  • ~ Platinum ~
  • ****
  • Posts: 14232
  • People helped 1051
  • Nice Administrator
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

moekuk

  • ~ Copper ~
  • *
  • Posts: 15
  • People helped 0
Re: SSDI and retired public worker health insurance?
« Reply #6 on: May 26, 2022, 08:23:58 am »
Thank you.
You seem to have a similar experienc.

I worked for a county in NJ. I also have Horizon BCBS Direct 10. I just dont know where I fit in with all of this.
 

I emailed the benefits coordinator and should hear back within a week.

I am a disabled former government worker from a major east coast city and My former employer still pays my BCBS premiums every month. I asked the HR department  if I had to take Medicare or what the requirement was and they told me the choice was mine but they did not require me to take Medicare and I would still be covered until I became 65. At that point the would pay for a Medicare supplement. When I spoke to my HR person they informed me that as long as I did not take Medicare they would cover me 80/20 just like they always did. If I were to take Medicare they would only cover the 20 percent part. I declined Medicare because I had few medicare participating providers in the area I was living in and my Dr would no longer see me as a patient if I took Medicare. The downside is if you decline medicare and then decide to take it later their is a financial penalty of 10% for each year you were not covered by medicare in the time you were eligible for Part B. Or at least that was they way it was back then in 2012 when I was approved. I no longer reside in the USA and Medicare only works in the USA. I have a private policy that covers me overseas when I am not in the US.

darkpurple

  • SSDFacts Supporter
  • ~ Platinum ~
  • *
  • Posts: 473
  • People helped 54
Re: SSDI and retired public worker health insurance?
« Reply #7 on: May 26, 2022, 02:25:51 pm »
quote   The downside is if you decline medicare and then decide to take it later their is a financial penalty of 10% for each year you were not covered by medicare in the time you were eligible for Part B.   quote


I thought you can avoid the penalty if you show medicare that you already have health insurance.  does anyone know?

newdawn

  • Global Moderator
  • ~ Platinum ~
  • ****
  • Posts: 3858
  • People helped 516
Re: SSDI and retired public worker health insurance?
« Reply #8 on: May 26, 2022, 04:42:44 pm »

I thought you can avoid the penalty if you show medicare that you already have health insurance.  does anyone know?

I honestly do not know. I thought the only way to avoid the penalty MIGHT be for those who decline medicare while disabled under 65 but then decide to take medicare once they turn 65 since at that point it would be like any person reaching medicare age at the point they turn 65. If one is thinking about declining medicare, I would definitely double check because as mentioned, the penalty is very steep.

As a somewhat related aside, remember that medigap/supplemental premiums DROP once you turn age 65 (for those of us with medigap and are under age 65)--one thing to look forward to...
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Applied: 11/2013
First Denial: 03/2014
Reconsideration Denial: 11/2014
Hearing: 11/13/15 (Friday the 13th!)
ALJ Approval: 01/15/16 Fully Favorable
Back Pay: 02/13/16
Award Letter: 02/17/16
1st monthly benefit: 03/21/16

Just Me

  • Administrator
  • ~ Platinum ~
  • ****
  • Posts: 14232
  • People helped 1051
  • Nice Administrator
Re: SSDI and retired public worker health insurance?
« Reply #9 on: May 26, 2022, 05:29:20 pm »
The link below might answer some questions about having other insurance and waiting to enroll in Medicare and the late.enrollment penalty. If you still have questions. It would be a good idea to talk with a SHIP Counselor in your area. They are free, specially trained to help those with Medicare and are not employed by any insurance company. So what is best for you and your situation is their only concern 

https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-can-i-sign-up-for-medicare

SHIP-
https://www.shiphelp.org/
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

moekuk

  • ~ Copper ~
  • *
  • Posts: 15
  • People helped 0
Re: SSDI and retired public worker health insurance?
« Reply #10 on: May 27, 2022, 10:01:08 am »
So I emailed My former employer. 
Still a little confused if my family will be covered under my state health benefits once I'm in the Medicare Advantage Plan.
Whatever that is.

Also
ALJ said I was disabled as of July 28th 2020. So when does the two year clock start? 5 months after this date?

This is the reply from my former employer.

"Since you were approved for SS Disability you will need to apply for Medicare once you are close to two years on SSI.  Your family will remain on your current coverage but once you are on a disability for two years or turn 65 which ever comes first, you must be enrolled into a Medicare Advantage Plan.   The State will ask you for a copy of the Medicare Card with Parts A and B on it when you are eligible for B"

I am a disabled former government worker from a major east coast city and My former employer still pays my BCBS premiums every month. I asked the HR department  if I had to take Medicare or what the requirement was and they told me the choice was mine but they did not require me to take Medicare and I would still be covered until I became 65. At that point the would pay for a Medicare supplement. When I spoke to my HR person they informed me that as long as I did not take Medicare they would cover me 80/20 just like they always did. If I were to take Medicare they would only cover the 20 percent part. I declined Medicare because I had few medicare participating providers in the area I was living in and my Dr would no longer see me as a patient if I took Medicare. The downside is if you decline medicare and then decide to take it later their is a financial penalty of 10% for each year you were not covered by medicare in the time you were eligible for Part B. Or at least that was they way it was back then in 2012 when I was approved. I no longer reside in the USA and Medicare only works in the USA. I have a private policy that covers me overseas when I am not in the US.

Just Me

  • Administrator
  • ~ Platinum ~
  • ****
  • Posts: 14232
  • People helped 1051
  • Nice Administrator
Re: SSDI and retired public worker health insurance?
« Reply #11 on: May 27, 2022, 01:19:57 pm »
Your Medicare will kickin' Dec 2022 or Jan 2023. By the way, you receive SSDI. Not SSI as your previous employer stated. Medicare comes with SSDI. SSI has Medicaid not Medicare.

Medicare Advantage Plans are networks. You might want to double check and be sure you are being forced into a Medicare Advantage Plan. You have to see one of their doctors in order for Medicare to pay. There are often more hoops for you and your doctor to jump through with Medicare Advantage Plans. They also have more limits and restrictions than Original Medicare. Original Medicare, you can see any doctor that accepts Medicare.

https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

darkpurple

  • SSDFacts Supporter
  • ~ Platinum ~
  • *
  • Posts: 473
  • People helped 54
Re: SSDI and retired public worker health insurance?
« Reply #12 on: May 27, 2022, 06:58:56 pm »
Yeah I was correct.  You can be on your spouses work insurance and decline medicare and avoid the penalty

quote     Job based insurance is insurance offered by an employer or union for current employees and family members. Job based insurance allows you to delay Medicare enrollment. However, you may want to enroll in Medicare depending on whether your jobbased insurance pays primary or secondary. In most cases, you should only delay Part B if your job-based insurance is the primary payer meaning it pays first for your medical bills and Medicare is secondary.
If you are eligible for Medicare due to a disability meaning you are collecting Social Security Disability Insurance and are covered by your your spouses or in some cases a family members jobbased insurance, you have a Special Enrollment Period SEP to enroll in Part B up to eight months after you no longer have coverage from current work. This means that you are not required to enroll in Part B when you first become eligible for Medicare but you must have Part A to keep SSDI.    quote

I can not include the link because I keep getting a error message

DisabledInWI

  • SSDFacts VIP
  • ~ Platinum ~
  • *
  • Posts: 471
  • People helped 68
Re: SSDI and retired public worker health insurance?
« Reply #13 on: May 28, 2022, 06:33:24 pm »
Medicare Advantage Plans work a lot like an HMO where you have a copay for most services. Original Medicare only pays 80% of the expenses you incur. Many Advantage Plans also include prescription drug coverage as part of the plan. Original Medicare does not include drug coverage. You would need to enroll in a drug-coverage plan (known as Medicare Part D).

Medicare.gov is a great resource that allows you to compare costs of plans available in your area.
Location: Wisconsin
Age at Application: 48 (Currently 59)
Disability: Patellofemoral osteoarthritis both knees; Osteoarthritis left hip
Applied: 04/2012
Approved: 07/2012
Award Letter Received: 08/2012
First Payment Received: 09/2012

moekuk

  • ~ Copper ~
  • *
  • Posts: 15
  • People helped 0
Re: SSDI and retired public worker health insurance?
« Reply #14 on: May 29, 2022, 06:08:51 am »
Thank you.
I have to make sure I have all of this figured out before December.

Your Medicare will kickin' Dec 2022 or Jan 2023. By the way, you receive SSDI. Not SSI as your previous employer stated. Medicare comes with SSDI. SSI has Medicaid not Medicare.

Medicare Advantage Plans are networks. You might want to double check and be sure you are being forced into a Medicare Advantage Plan. You have to see one of their doctors in order for Medicare to pay. There are often more hoops for you and your doctor to jump through with Medicare Advantage Plans. They also have more limits and restrictions than Original Medicare. Original Medicare, you can see any doctor that accepts Medicare.

https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage