Received Approval BUT!
 

I received my approval today but there is a catch. According to their rules they have set my effective date as of 3/31/2008 but I have been receiving disability payments from insurance since June 22, 2006. Where this throws a monkey wrench into the works is with health insurance.

I will not be eligible for Medicare until Sept 2010 and I am in the process of getting a divorce. My insurance is through my wife and she wants me off of her policy.

Since I was approved I am not sure I want to appeal this decision since they then will review the entire case once more plus then I will have to pay an attorney and I did the first part on my own.

Any suggestions out there?

Mike

get legal advise as to wether your wife can force you off of her insurance before the divorce is finalized.

Mike,

Have you tried Virginia Medicaid??
http://www.dss.virginia.gov/benefit/me_famis/index.html


I wish you the best.

:)
Abbie

I know that my wife can not force me off of the policy until we either have a legal separation agreement which I will have this week in order to file for divorce.

Unfortunately I make too much money with the insurance disability check to be eligible for Medicaid have been down this route before as well.

Thanks Guys for the suggestions.

Mike

when did you file? how long have you been disabled? effective might mean that that is when your checks would start. also on the medicare stuff it is 23 months or 24 months so it would be april 2010. I know that isn't much but better than september. you can always call ss office to find out how far back they are going.

Congrats Mike...I had my hearing April first the judge did order that my date start in Feb of 06, but I still have not recieved a verdict!

thank you for your reply,

I have been on disability since June of 2006 and LTD since Sept 2006. I applied in late 2007 for SSDI and my check will not start until Oct of 2008. I have talked with SS and I am filing a dispute as to my start date for it makes no sense at all.

Yes I have spent time with them in the past and I make too much money with my disability check to qualify.

Does your wife want you off her insurance ASAP because it is a messy divorce or because she does not want the extra expense ? Could she be pursuaded to keep you on it until the divorce is final , which might take the 2 years, if you paid the difference between single and family coverage ?

Have you asked Medicare if it is the date you were approved for SSDI or the date of your actual disability ? It seems crazy that they would make us wait that long. What if you weren't married or were the one who carried the insurance ? I know private insurance is available for people who are not covered at work, but the coverage is usually minimal and/or deductables is high......both killer issues for those of us with disabilities.

[color="Blue"]No the divorce is not messy at all. The issue is the money that is being taken from her check every 2 weeks. As for paying the difference I have been paying 85% of the total insurance bill since she left which included my coverage as well as our savings plan. He belief is that she will have more money to live on with me off of her coverage policy which I believe to be a false assumption on her part. Because currently the deductions are done pre tax which made her check so low that she paid little or no federal income tax. Now her tax with holding will go up and she will lose money. She does not believe me she thinks I am trying to manipulate her.

Unfortunately the Medicare requirements are 2 years from the time that SS determines you to be disabled. To me the government believes that we all have access and the ability to have health insurance and in cases like this that I will be able to go on Cobra for 18 months and then get it extended to 24 months until the Medicare starts up. As for private insurance I can get it and I do so with whatever deductables I want but the cost is so prohibitive that most people can not do it even if they are not a high risk like I am because of my cancer, heart failure and lastly MS.

Wow, Mike! What a bag of mixed blessings! I am so glad you were approved.

I do not intend to pry but have you talked to anyone that deals with Adult Medicaid in your state? Where we are, they have a couple of options but of course, you have to jump through a bunch more hurdles. My Dad, who is in a local nursing home, made too much money for medicaid as well. We had to do some goofy stuff with setting up a trust acct that we pay out each month to the nursing home. It makes no sense to me at all but it worked to get him the benefits since we have been paying cash for his care for the past 16 mths.

It certainly won't hurt to ask about it or any other programs that might be available to have health care.

You would think that your wife would not mind letting you pay the premiums for your insurance. People are strange. Wait till she starts paying those taxes next year!

My best to you.

Call your local SS office! See what date is actually your date of disability not the date you were approved.

Hopefully it is when you first applied, that is the way it usually is with some kind of waiting period of just a month or so.

Maybe it was put in the computer wrong and is a simple fix..believe me I know of computer glitches with the SS office.

"If your application is approved, your first Social Security benefit will be paid for the sixth full month after the date we find that your disability began.

For example, if your disability began on June 15, 2007, your first benefit would be paid for the month of December 2007, the sixth full month of disability.

Social Security benefits are paid in the month following the month for which they're due. This means that the benefit due for December would be paid to you in January 2008, and so on." from the ssa.gov website

So...your SSDI should start when you were no longer working and your doctors deemed you disabled, right? And when you applied.

No I have not spoken with anyone about Adult Medicaid I did not even know that there was such a thing. I do know in order to qualify for some assistance programs you can not have any asset over $2000.

As for my wife I sat on her couch a couple of weeks ago and explained this to once more but she does not want me on her policy as she feels that she will be better able to manage her money if all comes in every two weeks. You see I pay her now for my insurance coverage as well as an additional sum to cover a savings medical savings plan that we had. So she received from me all but $200 of her Apt rent.

I hate to say it but she will be in for a rude awaking when this all changes as currently they are not taking out any money for the federal income tax. Her year to date with holdings have been $5.80. She will need to have an additional $140 per check taken out in order not to owe Uncle Sam money at the end of the year.

Plus I just bailed her out to the tune of $300 to get her power turned back on and cover overdrafts on her checking account.

Sassy,

Thank you for the info. I have filed a dispute with SS over the date and need to call and find out where that stands. I do understand how and when they pay and that I am not concerned about it is just that I do not wish to be on Cobra for 2 years when I could be on Medicare at less the 1/4 the cost.

Mike

Did you have a lawyer involved Putterfit ?

My SSDI hearing is coming up in June. I was just talking to my lawyer about it, and because of your post, asked specifically about Medicare for health insurance. I am currently on my husband's policy, but I'm not sure how much longer I can deal with being trapped in a crappy marriage :( My lawyer said not to worry about it.....they would assign a starting date that would determine when I get my first check (fingers crossed, God willing), but my disability date would go back to my injury date of June 2004, so I would be all set right away for Medicare.

Nothing "new" happened in March to worsen your condition, did it ?

And my curiosity has overcome me.....what does Putterfit mean ?

No I did not have a lawyer. The reason I did not was 2 fold first I did not wish to give any extra money that I would receive from SSDI to the lawyer and secondly I have a friend that works for SS and takes applications from people just like us who are applying for SSDI. He gave me great advice and I was approved on my first try. We both expected that the my disability date would go back to June of 2006 but somehow they came up with a disability start date of April 30th of 2008 which I am now fighting, still on my own.

As for my name. Most of my working life was spent in the golf industry and during that time I was one of about 100 people who were trained to custom fit putters in a totally unique manor.

Good luck with your SSDI case going through with out any hitches.



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Update
 

As I stated earlier I filed a dispute with SS over the beginning date of my disability.

Two weeks ago they changed my disability date from 4/30/08 to 12/22/06. I will get my first check at the end end of this month and I will be eligible for Medicare in Dec/Jan. That was good news and all of this was accomplished on my first time and with out getting a Lawyer involved.:)

Congratulations on getting your disability date fixed. They did pretty good. They can go back up to 12 months before the date you file.

Yeah for this getting straightened out! And without having to fight tooth and nail or hire a lawyer...

Hallelujah! :rolleyes:

Nope no lawyers and it was not much of a fight, just one form saying that they had to be out of their loving minds.

In order to qualify for Medicare, you need to have been a Social Security disability beneficiary for 24 months. That means that you have been receiving checks. It does not go back to your date of disability, I don't think.

~ Faith

Faith,

You are correct with what you have said.:)

If I am reading this right, I don't think that is correct Faith. You don't need to have been receiving checks for 2 years if when you are approved for SSDI they recognize that your date of disability was at least 2 years prior.

I was approved for SSDI last month and have not started getting checks yet. My disability began in 2004. I got my medicare card in the mail today

I'm glad that you were able to get it worked out PF !

not sure how everything is going for you right now but in some states women are ordered to pay alimony for disabled husbands. you might check into that. that might persuade her to keep you on for just a little while.

Thanks but based upon our incomes neither one of us is in titled to any money from the other and the change over took effect in June.

From the domestic cases I have been through with friends, the disabled person was given coverage for medical. With the plan that they will have to be covered until medicare takes effect, some also had to split the uncovered 50 50.
The spouse did not make that determination, it was agreeable as part of avoding someone else make a ruling, or ordered by the master/judge.

They received alimoney also because of disability.
Good luck,
di