Social Security Disability’s Medicare Enrollment Rules
Learning how to enroll in the right Medicare and Part D prescription drug plan when someone has a serious health condition can be complicated! Here’s what those on Social Security Disability need to know!
Dear Toni,
My husband has met his 24th month of being on Social Security Disability, which qualifies him for Medicare. His disability is because of a severe case of Parkinson’s. On August 1st his Medicare Parts A and B will begin, but he is only 64. He will turn 65 next March and I am not sure what he should do.
With Paul’s serious Parkinson’s issues affecting his health, I am concerned with which Medicare option is for him to enroll in. Should he enroll in a Medicare Advantage plan or a Medicare Supplement?
I am concerned about whether he will enter the Medicare Prescription drug donut hole because his Parkinson’s medications are expensive. Please advise what we need to do to find what Paul’s best Medicare option should be!
Thanks,
Cynthia from Dallas, TX
Cynthia,
Learning how to enroll in the right Medicare and Part D prescription drug plan when someone has a serious health condition can be extremely complicated. Your current specialists and prescriptions are what to focus on! What those on Social Security Disability and qualifying for Medicare Parts A and B need to be aware of is that there are 2 Medicare enrollment times. Let’s discuss those!
Enrolling in Medicare Under Age 65
When one’s Social Security Disability’s 24th month passes, the individual is automatically enrolled in Medicare to begin on the 1st day of the 25th month, like your husband Paul’s Medicare, even though he has not yet turned 65. In Texas, when a person is under 65 and eligible for Medicare, there is only one Medicare Supplement plan which you are eligible for with most Medicare Supplement Insurance companies; and that plan is Plan A. Medicare Supplement Plan A works directly with Original Medicare and has more out of pocket than Medicare Supplement G. Different states have different Medicare Supplement plans available to those under 65.
Toni Says: When a person is under 65 and enrolling in Medicare for the first time, that person should discuss with medical professionals and facilities which Medicare Advantage plans they accept.
Medicare Advantage plans help cover the Medicare costs that Medicare does not pay for. The Medicare Advantage plan will have deductibles, copays, or maximum out-of-pocket costs that the Medicare enrollee will have to pay. When under 65, this may be an option to consider since Original Medicare has out-of-pocket. Always verify that your healthcare professionals and facilities accept and will bill the Medicare Advantage plan you’ve picked.
Turning 65 and On Social Security Disability
Cynthia, I have good news for you because when Paul turns 65 next March, he will have a second Medicare Supplement enrollment period which is called the Medigap/Medicare Supplement Open Enrollment period. He will not have to answer any health questions because he has turned 65, the same as anyone who is just turning 65 and has received both Medicare Parts A and B. Those on Social Security Disability will qualify during a “6-month period” that begins the month one turns 65 for Medicare Supplement Plans A-N.
Toni Says: Don’t get stuck in the “donut hole!” Always check prescriptions on Medicare.gov to determine which Medicare Part D plan best fits your needs.
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Originally published November 20, 2023
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