Social Security and Medicare

Posted on June 28th, 2018

One of the bigger benefits of being found “disabled” by SSA, sometimes even more important than the monthly disability check, is the entitlement to Medicare. Most claimants, who have their health insurance through work, frequently lose their health insurance soon after they stop working, whether they quit or are fired, even if for health reasons.

Medicare beings with the 25th month of entitlement to Title II or regular Social Security disability benefits. There is also a 5 full month waiting period after “disability” commences, before monthly benefits commences. In essence, there is a 29 month waiting period. As an example, if John Doe becomes “disabled” January 2, 2018, the 5 months of his waiting period would be February to June. The first disability check would for July, which is paid the second, third, or fourth Wednesday of the month, depending on his birthday, is paid in August. SSA always pays one month behind. The 25th month of entitlement would be July 2020, which would be when Medicare commences.

Individuals who receive SSI benefits receive Medicaid, not Medicare. Medical has no waiting period and there is not monthly premium. Generally, Medicaid has more limited coverage than Medicare.

In 2018, the monthly Medicare premium for Bart B is $134.00. Part B is for doctor bills, tests, etc.. Part A is for hospital bills and there is no premium. A claimant can decline Part B and still get Part A, obviously depending on other insurance from a spouse, as a veteran, etc.. In general, it is usually not a good idea to decline Part B. When entitled to Medicare, SSA will send you a form to sign to authorize them to automatically deduct the monthly premium from your check.

For individuals who had higher incomes, SSA charges a higher monthly Medicare premium. In 2017, if your MAGI (adjusted gross income and tax exempt interest income) is greater than $170,000.00, Medicare premiums are surcharged. This is for married, filing jointly. If filing using any other status, (i.e. single, married filing separately, etc.) the surcharge exists when the MAGI exceeds $85,000.00.