Doctors or lawyers please weigh in

[flatbutt]

I have a medical insurance issue. I've been on permanent disability for a year now. I do collect SSDI. I've been on my employers LTD insurance since day 1 but they are telling me I must now go on Medicare. However I am supposed to be covered by that plan as part of the LTD insurance I have paid for.

I am only 63 years old so I don't qualify for Medicare. And applying for Medicare under the age of 65 is usually denied, or at least takes up to two years.

So I essentially have no health care insurance, can anyone suggest a course of action?

[wdfifteen]

I'll be interested in seeing the responses to this. None of the LTD policies ever offered to me included health insurance. Are you sure health insurance was part of LTD or was is offered along with LTD?
You can get your own health insurance. You might even be eligible for subsidized insurance if your only income is LTD.

[flatbutt]

Originally Posted by wdfifteen

I'll be interested in seeing the responses to this. None of the LTD policies ever offered to me included health insurance. Are you sure health insurance was part of LTD or was is offered along with LTD?
You can get your own health insurance. You might even be eligible for subsidized insurance if your only income is LTD.

Absolutely, I have it in writing that insurance is included. I t was why the premium was high.

[LWJ]

So the LTD pays your COBRA premium? I am not a LTD expert but I think WD15 may be correct. My LTD is simply a replacement for income. After X days, COBRA terminates and you need to go onto state continuation (in Oregon). It may have a different name in NJ.

Here is what I would do.

1. Read the LTD contract
2. Research the COBRA rules

This will make things clear.

Best of luck.
Larry

[Seahawk]

Flat I have nothing to offer of substance other than I'll help if you need any little thing...I don't do dishes but I can research the eyeballs out of anything.

Don't be shy here, you are playing for keeps.

[74-911]

After 2 years on SSDI you should automatically qualify for Medicare:

CMA*||* Medicare Coverage for People with Disabilities

Social Security should automatically enroll you at the 2 year point.

[fintstone]

If you're getting disability income from Social Security you’re eligible for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the 25th month you get the benefits.

Use this to determine your eligibility:
https://www.medicare.gov/eligibilitypremiumcalc/

Most LTD reduces benefits by the amounts you can get by the amount of SSDI and Medicare you are eligible for (so essentially, you have to apply when eligible to continue coverage).

Here is an article that simplifies it a bit:
Medicare Disability Coverage For Those Under 65

[Neilk]

Originally Posted by fintstone

If you're getting disability income from Social Security you’re eligible for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the 25th month you get the benefits.

Use this to determine your eligibility:
https://www.medicare.gov/eligibilitypremiumcalc/

Most LTD reduces benefits by the amounts you can get by the amount of SSDI and Medicare you are eligible for (so essentially, you have to apply when eligible to continue coverage).

Here is an article that simplifies it a bit:
Medicare Disability Coverage For Those Under 65

My SO went through all the this when she was diagnosed with stage IV cancer at age 37. One of her financial advisers had told her to get the maximum LTD the company offers and it paid off in her case. Her LTD insurer told her she had to apply for Medicare and they would provide a lawyer if Medicare declined her. In a way, it seems like a scam to shift part of the burden to someone else.

Ten years on, still fighting the battle.

[flatbutt]

Good stuff for me to read. The gripe I have is the lack of notice. The LTD people sent a non payment notice for my monthly supplies with no advance warning. I'd be happy to do the necessary paperwork but to drop a $2500 bill on me with no advance notice kinda sux.

Thanks all!

[flatbutt]

Originally Posted by Neilk

My SO went through all the this when she was diagnosed with stage IV cancer at age 37. One of her financial advisers had told her to get the maximum LTD the company offers and it paid off in her case. Her LTD insurer told her she had to apply for Medicare and they would provide a lawyer if Medicare declined her. In a way, it seems like a scam to shift part of the burden to someone else.

Ten years on, still fighting the battle.

My LTD told me I must apply for SSDI, no mention of Medicare. I'll do that reading and see if there is an automatic requirement between SSDI and Medicare. But I'm only 63 so that may be a factor too.

[flatbutt]

Originally Posted by afterburn 549

If you were ever in the military PM me

Thank you but I don't qualify for VA benefits.

[wdfifteen]

Originally Posted by flatbutt

... to drop a $2500 bill on me with no advance notice kinda sux.

I guess ! And they won't hesitate to complain if you don't happen to have the extra coin lying around.

[greglepore]

Age is not a factor. Its automatic after the 2 year mark. You can use the medicare part a premium to buy a Medicare Advantage plan (private insurance) that may make more sense for your situation.

PM me if you have a question.

[E Sully]

2 years after qualifying for SSDI you are automatically qualified for Medicare . I had to do this a few years ago at age 54.

[Tobra]

Not a lot to add, except that with the Medicare Advantage plans, you want to pick one that allows you to continue to go to your current doctor and a convenient hospital. Maybe run the choices by your primary doctor before making a decision.

[wdfifteen]

Looks like Flatbutt's got to get through another year to be eligible for medicare.