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Originally Posted by bobinjeffmo
Welcome to the gates of hell known as SSI. Here you are 4 years into the process and still getting the run around. Well I'm sorry to say, you're far from done with it and one of the areas is regarding Medicare.
Even after you finally do get your SSI through, I think you'll find that your local state Medicaid program will be your only medical insurance solution for no less than the first 2 years. Only after being on disability for 2 years does a person qualify for Medicare and then you'll have the $110 payment for Part B coverage plus if you don't buy a supplement during the brief 7 month window (3 months before Medicare kicks in, the month Medicare kicks in and 3 months after it kicks in) you have no guarantee of ever being able to get any kind of Medicare supplemental from then on which you're going to need badly since Medicare is usually 80/20, meaning you'll still owe 20% of the bill. Actually after January the 1st, because of Medicare dropping down the amount they're paying the doctors, the supplement also kicks down meaning most patients now owe an additional 3rd bill for the difference the first two insurance plans didn't pay. In other words, once you're on Medicare you can plan on paying $110 for Part B, plus a supplement for around $150 plus Medicare Part D that costs around $35 a month with a $310 deductible (averaged out together that means most are now paying around $65 a month for Part D drug plan coverage). There's a lot of people who now have both Medicaid and Medicare together. If you want more info, contact either SHIP (a nationwide Medicare help organization that's simply wonderful) or me and I'll help you through this part of your challenges at hand.
The average person is paying around $300 just for their insurance and there's still things that Medicare won't pay for which you'll be left financially on the hook for. The fact that Medicare won't kick in till after you've been on full disability for 2 years is the other thing that hurts most people the most.
On a positive note, even without SSI, you might be able to qualify for Medicaid right now.
As far as why you were denied one more time, I'd like to think it's just another slight accident on their part, but I've become to cynical in my old age. The reason you've had so many roadblocks is not because your wife isn't disabled, it's because of there being so many people who've abused the system to death and now they've run out of money plain and simple.
I'm so sorry that you couldn't apply for SSD instead of SSI because it would have made a world of difference in both the amount your wife will eventually get plus there are so many restrictions regarding assets and total monthly income for those who are on SSI.
Best of luck. Contact me if you need more info on the insurance side of your problems. Bob.
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Thanks for the response Bob. I'm a little confused with the terminology. In my state when filing for SSDI one has to apply for both SSDI and SSI at the same time. We knew going in that she would not qualify for SSI or medicaid because we have too many assets. She worked nearly 30 years, and paid into the system. Our monthly out of pocket monthly health insurance bill was around $150 per month through my wife's company. When she was terminated I picked my insurance from my work at $1000 per month out of pocket. With the ecomomy slowly crumbling my kind of specialty work was being outsourced more and more the last 5-6 years, my income dropped 40%. Soon my employer went chapter 7. My wife and I have worked our butts off for decades, we lived the american dream. Within a couple of years we now live the modern american nightmare because it is only here in the states that if a member of a family, where it takes two now to sustain a home in expensives areas where we were born and raised, when a company goes bankrupt COBRA coverage is not and never will be available. My only choice was to cover her through Hipaa at $2600 a month or $1600 per month through BCBS with no coverage for 10 months. We could not afford this. Our savings are gone and selling the house is very difficult with this economy.
So, my point Bob is even with those medicare co-pays and suplements its much better than what my wife has now which is no insurance. I'm employed and cover her out of pocket which is less out of pocket costs than picking up traditional insurance. To me an extra $400 per month through medicare is a bargain.
As far as the two year wait for medicare, I've been led to believe by my wife's representitive is the two year wait is retroactive. Another words if one applys for SSDI over two years ago then is approved, its retro, you'll qualify immediately.