Medicare Blog

why is there a two year waiting period for medicare

by Prof. Domenica O'Keefe MD Published 2 years ago Updated 1 year ago
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The original purposes of the 24month waiting period were to limit costs to the Medicare trust funds at a time when many workers might have other health insurance coverage and to ensure that Medicare protection is extended only to persons whose disabilities are severe and long lasting.

Full Answer

When's the best time to file for Medicare?

A: The best time to enroll is during the open enrollment window around your 65th birthday - preferably in the three months before the month you turn 65, so that you'll have Medicare coverage by the time you turn 65.

When is the best time to enroll in Medicare?

When Should I Enroll in a Medicare Supplement Plan?

  • When to enroll in a Medicare Supplement plan. ...
  • Enrolling in Medicare Supplement plans if you’re under 65. ...
  • Enrolling after your Medicare Supplement Open Enrollment Period is over. ...
  • Finding Medicare Supplement plans. ...

When can I start getting Medicare?

You may apply for Medicare at any age if you meet one of the following criteria:

  • your receive Social Security disability or Railroad Retirement Board (RRB) disability insurance
  • you have specific medical conditions, such as amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD)
  • a family member is enrolled in Medicare

Does Medicare have a waiting period?

There is no Medicare waiting period if you’re over 65. You can apply for other types of coverage during the waiting period. People who receive Social Security Disability Insurance (SSDI) are eligible for Medicare. In most cases, you’ll be automatically enrolled in Medicare after a two-year waiting period.

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What is the Medicare waiting period?

The Medicare waiting period is a 2-year period that people need to wait before they're enrolled in Medicare coverage. The waiting period is only for those receiving SSDI, and doesn't apply if you're 65 years old or older. Americans are eligible to enroll in Medicare up to 3 months before their 65th birthday.

What is the earliest a person can get Medicare?

Remember, Medicare benefits can begin no earlier than age 65. If you are already receiving Social Security, you will automatically be enrolled in Medicare Parts A and B without an additional application. However, because you must pay a premium for Part B coverage, you have the option of turning it down.

Is there a waiting period for Medicare Part B?

The first 24 months of disability benefit entitlement is the waiting period for Medicare coverage.

What happens to my Medicare if I lose SSDI?

If you go off SSDI when you return to work you can continue Medicare coverage for 93 months after completing the 9 months work period. Combined with the trial work period, therefore, you can receive Medicare Part A coverage premium-free for a total of 8 and half years.

Is it better to take Social Security at 62 or 67?

The short answer is yes. Retirees who begin collecting Social Security at 62 instead of at the full retirement age (67 for those born in 1960 or later) can expect their monthly benefits to be 30% lower. So, delaying claiming until 67 will result in a larger monthly check.

Do you automatically get a Medicare card when you turn 65?

You should receive your Medicare card in the mail three months before your 65th birthday. If you are NOT receiving benefits from Social Security or the RRB at least four months before you turn 65, you will need to sign up with Social Security to get Parts A and B.

How long before you turn 65 do you apply for Medicare?

3 monthsYour first chance to sign up (Initial Enrollment Period) It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

Why is my first Medicare bill so high?

If you're late signing up for Original Medicare (Medicare Parts A and B) and/or Medicare Part D, you may owe late enrollment penalties. This amount is added to your Medicare Premium Bill and may be why your first Medicare bill was higher than you expected.

How do I get my $144 back from Medicare?

Even though you're paying less for the monthly premium, you don't technically get money back. Instead, you just pay the reduced amount and are saving the amount you'd normally pay. If your premium comes out of your Social Security check, your payment will reflect the lower amount.

Which pays more SSDI or SSI?

In general, SSDI pays more than SSI. Based on data from 2020: The average SSDI payment is $1,258 per month. The average SSI payment is $575 per month.

How can I increase my Social Security disability payments?

You can increase Social Security Disability payments by working at least 35 years before retiring, understanding the benefits of working past retirement age, and avoiding Social Security's tax consequences. If you are married, married applicants can maximize their disability payments by claiming their spousal benefits.

What other benefits can I get with Social Security disability?

If you get SSI, you also may be able to get other benefits, such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP). For more information about SSI, read Supplemental Security Income (SSI) (Publication No. 05-11000). After you receive disability benefits for 24 months, you'll be eligible for Medicare.

How long does Cobra last?

COBRA plans generally last 18 months, but can be extended if the insured is disabled. Obamacare expanded Medicaid eligibility in many states, but not in Texas. To make matters worse, Texas has some of the hardest-to-meet eligibility criteria in the union.

How long does it take to get Medicare after being approved for Social Security?

Author Attorney Lloyd Bemis: After you have been approved for Social Security Disability Insurance, there is usually a two year waiting period before you will be eligible to receive Medicare. Many people think that they will get Medicare upon receiving Social Security Disability benefits and are caught by surprise when they learn there is ...

How long is the waiting period for Medicare?

Many people think that they will get Medicare upon receiving disability benefits and are caught by surprise when they learn there is a two year waiting period. This waiting period can seem to be arbitrary and unfair. There are rare exceptions to the waiting period- if you have End Stage Renal Disease or Lou Gehrig’s Disease- ...

What is the meaning of being disabled?

Being disabled by definition restricts your ability to earn a living and support yourself. It is difficult to find affordable and suitable insurance if you have a serious medical condition and are not working. Additionally, if you are not able to afford medication, the fact you are not taking it may be used as evidence against your disability claim. Because of the long waiting period, it is highly recommended you try to maintain whatever coverage you had when you became disabled.

Why did the American Medical Association oppose Obamacare?

The American Medical Association opposed his plan on the grounds that it was “socialized medicine”. If today’s heated debate over Obamacare is any indication, healthcare has long been a controversial issue in America. Under private insurance, people over the age of 65 found it difficult to find a plan that would work for them. Private insurers don’t want to take on customers who are chronically ill or have low incomes. Lyndon B. Johnson championed Truman’s ideas and Medicare began with the Social Security Amendments of 1965. Harry S. Truman and his wife were the first to be enrolled in the new Medicare program.

What age did private insurance start?

Under private insurance, people over the age of 65 found it difficult to find a plan that would work for them. Private insurers don’t want to take on customers who are chronically ill or have low incomes. Lyndon B. Johnson championed Truman’s ideas and Medicare began with the Social Security Amendments of 1965.

How long do you have to wait to file for disability?

The two-year waiting period begins on the first month you are eligible for benefits, not from your date of disability or when you actually start receiving benefits. Because many disability applicants do not actually begin receiving disability benefits on the day they become eligible, it may be less than two years between when you get your first ...

How long is Medicare coverage?

Medicare coverage is available to people under age 65 who receive Social Security disability benefits. Most people are automatically enrolled after a 2-year waiting period. If you have ESRD or ALS, the 2-year waiting period will be waived. You can take advantage of programs such as Medicaid, COBRA, or the Health Insurance Marketplace ...

How long do you have to wait to get Medicare if you have SSDI?

Most SSDI recipients need to wait 24 months before Medicare coverage begins. However, there are exceptions. For some life-threatening conditions, the waiting period is waived and coverage begins sooner. You won’t need to wait the full 2 years if you have ASL or ESRD.

How long do you have to be on Medicare to get disability?

Takeaway. You’ll be automatically enrolled in Medicare once you’ve received Social Security disability benefits for 24 months. The waiting period is waived if you have amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD). There is no Medicare waiting period if you’re over 65. You can apply for other types ...

How long do you have to wait to get dialysis?

You’ll likely need dialysis treatments when you have ESRD, and you may be considered for a kidney transplant. You don’t need to wait the full 2 years to receive Medicare coverage if you have ESRD. Your Medicare coverage will begin the first day of the fourth month of your dialysis treatment.

When does Medicare start paying for dialysis?

Your Medicare coverage will begin the first day of the fourth month of your dialysis treatment. You can get coverage as soon as your first month of treatment if you complete a Medicare-approved training program to do your own at-home dialysis treatment.

When can I apply for medicare if I am 64?

This means that if you apply for SSDI benefits and are approved when you’re 64, your Medicare benefits will begin at 65, just like they would have if you didn’t receive SSDI.

Does Medicare cover dialysis?

For example, if you’re receiving dialysis at a medical center and apply for Medicare during your seventh month of treatment, Medicare will retroactively cover you dating back to your fourth month.

Groups Press Congress To End Patients' Wait For Medicare

Under federal rules, most people with disabilities who are younger than 65 aren’t eligible for Medicare until more than two years after they qualify for Social Security disability income. A coalition of more than 65 organizations led by the Medicare Rights Center has been pushing Congress to do away with the waiting period.

Comment

When Congress expanded Medicare to cover individuals under 65 with long-term disabilities, they specified a two year waiting period to be certain that only those with truly permanent disabilities would be admitted to the program. Obviously this creates a hardship for precisely those for whom the eligibility was established.

How long does it take for Medicare to cover ESRD?

People with ESRD do not need to wait for 2 years before Medicare coverage begins. The waiting period is shorter, and Medicare begins on the first day of the fourth month of the person’s dialysis treatment. Medicare coverage may start up to a year before someone applies. Medicare calls this retroactive coverage.

How long do you have to work to qualify for SSDI?

To qualify for SSDI benefits, an individual must have worked in a job that Social Security covers. They must also have a medical condition that meets the SSA disability definition and be unable to work for a year or more. The Medicare waiting period starts after the SSA approve an application. A qualifying individual receives their Medicare cards ...

How long is the waiting period for Medicare?

People who receive SSDI benefits and are under the age of 65 can benefit from Medicare. However, there is a 2-year waiting period for most people before their healthcare coverage begins. Medicare waives the waiting period for those who have ESRD or ALS. People can find alternative healthcare coverage during the waiting period through Medicaid, ...

How long do you have to wait to get medicare for SSDI?

Although most people with SSDI benefits have to wait for 2 years before their Medicare coverage begins, there are certain exceptions. For example, if someone has end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), Medicare waives the waiting period so that the person can get their healthcare benefits sooner.

How long does Medicare coverage last?

Medicare coverage may start up to a year before someone applies. Medicare calls this retroactive coverage. For example, if someone starts dialysis in a clinic on November 1 and they delay signing up for Medicare until the following June, Medicare backdates their coverage to February 1.

What is the best Medicare plan?

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan: 1 Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments. 2 Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%. 3 Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

How much is the Medicare premium for 2021?

If someone does not have enough work credits, in 2021, they need to pay a premium of $471 per month. If they have 30–39 credits, the premium is $259. People must also pay the first $1,484 in costs as the deductible before Medicare will contribute.

Question

I have a 27-year-old severely handicapped daughter who I take care of 24 /7. She qualifies for Social Security Disability Income (SSDI) under her father. My question is that she lost her insurance and I was told that she has a 2 year wait. Why would they do this to an adult child who is handicapped, not to give her insurance coverage?

Response

There’s a two-year wait for Medicare coverage after beginning to receive Social Security Disability Income (SSDI). But I wonder whether some or all of the two-year waiting period has already passed for your daughter, since it should have begun as soon as your daughter began receiving SSDI.

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