As I recently wrote, Medicaid comes along with your approval for Supplemental Security Income. Medicare comes along with Disability Insurance Benefits. If you are receiving both types of benefits, you can receive both types of medical benefits. But what if you are one of the many people who only receive on-going Disability Insurance Benefits?* It means that you only get Medicare benefits and that brings up one of the most important things to know about your Medicare benefits. You must wait 24 MONTHS after the month you first became eligible for monetary benefits before you are eligible for Medicare. That means that you will become eligible for Medicare 29 months after your onset date (5 month waiting period for DIB + 24 month waiting period for Medicare). I’ll lay that out in a simple timeline so it makes it a little easier to see what happens:
Onset date is January 2, 2009 + 5-month waiting period for Disability Insurance Benefits (benefits/back pay will start July 2009 – January doesn’t count as a waiting period; it has to be 5 full months) + 24-month waiting period for Medicare = your Medicare eligibility will begin in July 2011.
Here’s another example:
You stopped working and became disabled on July 13, 2007, but you didn’t apply for Social Security disability until January 2009. You were denied and had to appeal your claim. You’re just now getting a favorable decision in April 2011. Let’s do the math:
Onset date of July 13, 2007 + 5-month waiting period = January 2008. You applied in January 2009 so you’re going to get the maximum amount of backpay (a full 12 months prior to your application date). Good for you! Add 24 months for your Medicare and it turns out you actually became eligible for Medicare in January 2010.
This is great news – you have Medicare now! But what about all that retroactive time? Well, you have a decision to make. Medicare will give you the opportunity to go back and pay all those past-due Medicare premiums. In fact, they will take the lump sum right out of your disability backpay. Is it worth to have those retroactive benefits? Well, that decision is up to you. Something important to think about is your outstanding medical bills. If you have a huge hospital bill that could be paid, then it may be worth it to pay the past-due premiums. You will have to look at your circumstances and decided whether it’s worth it to you.
If you have any questions about your Social Security Disability claim and Medicare, an experienced Social Security Disability attorney can help answer those questions.
* For reasons why you might only receive one type of benefits, click here.