Medicare questions
 

For those of you who have been approved for SSDI after an appeal (where SSA determines you to have been disabled as of a date up to several years in the past)

a) when did you start being eligible for Medicare -- was it 29 months after the date the ALJ determined you to have been disabled(January 2005, for example), or was it 29 months after the date that the ALJ's favorable decision was officially made (example: February 2008)?

b) once eligible for Medicare, how much time did you have to choose coverage options and Medicare insurance companies (part B, Medigap, etc.) after you became eligible?

I'm concerned about how soon I will have to deal with what looks like a confusing mess, at least judging from the Medicare literature I've looked at so far. Also, it at least appears to me like coverage under Medicare is worse than the PPO health insurance I still have from my employer under COBRA (and maybe not that much cheaper). :(

Thanks,

ThreeForOne

SSDI is a mess. I did not deal with an ALJ, but I can give you "some" idea about Medicare.

I applied May 2006. They lost my paperwork, then called me in Sept 2006 to bring in a copy. My wife took me up there, I spoke to a lady and I had a check in my hands less than 4 months later. I was rated as being 100% disabled since a major multi-car pile up on US 50 in June 2001.

I got notification and the check for back pay, it went a year back, so May 2005 was my "date". My medicare was started 2 years from the May 2005. I hate it, I want out, but there is NO WAY OUT. Well, death might work, but medicare IS better than death -- most of the time.

I had 30 days to decide about part B. It was VERY confusing at first, because I am retired military and my Tricare was much better than medicare. I had a private insurance supplement to my Tricare Medical Coverage. Now, I have 3 medical coverages. But I need it.

My prescriptions are through Tricare, not medicare. Medicare pays 80% and Tricare pays 20% --- IF they cover whatever you need.

I just learned a major lesson about medicare. I sleep on a ventilator and have severe Respiratory and Lower Back problems.
My Durable Medical Equipment (DME) told me Medicare would not cover Heliox for Vocal Cord Dysfunction. I made some calls and found out the DME preferred dealing with me, so they lied about medicare. Grrrrrrrrrr. OR the bookkeeper was going to get me to pay, then file with medicare --- pocketing my payment. Who knows. I am trying to say medicare gets a bad rap sometimes when they may not deserve it.

I hope this helps a little bit. You are probably stuck with medicare, but learning how it operates and being proactive will help you a lot.

I think you have something like 30 days to apply for Medicare and Medi-gap policies without medical underwriting after you become eligible for Medicare. If you delay, you can get much higher premiums because of the medical underwriting and there are some additional fees in Medicare for getting it after you are first eligible.

You are first eligible two years after you apply or two years after the decision you are disabled. Usually the first criteria is used but if the administrative person who took your application didn't put down that you had a protected filing date I think sometimes the latter applies.

CORBA benefits are only for a limited period of time so generally it's better to get Medicare while you can. You can try and negotiate with your employer that COBRA is the primary and Medicare the secondary which get you better benefits but that depends on your employer. I do know one person who got CORBA long term but that's an exception to the usual rule.

I wrote a response to you in the TOS forum about what Medicare covers for TOS.