Medicare Options For the Disability Recipient

One of the greatest benefits of receiving Social Security Disability is that recipients are eligible to draw Medicare benefits early. This helps them maintain medical care and treatment. Our office thinks it’s important to help our clients through this confusing process. Our in-house licensed health insurance agent works with our clients to clearly explain what to expect and options available to them. Medicare includes Part A (hospital insurance) and Part B (doctor coverage). However, it is not full coverage nor does it include prescription drug coverage.

To supplement the charges that Medicare doesn’t pay, you will need to choose between three options:

• Enroll in a Part D prescription drug plan. This plan will have a monthly premium but will provide coverage for prescription drugs. It’s important to confirm that the plan covers your specific medications! The benefit of this option is that you can see any doctor without having to worry about networks. The downside is that this does not offer any medical coverage and you are still responsible for what Medicare doesn’t cover (20% of Part B medical charges).

 

• Enroll in a Medicare Advantage plan. These plans typically have very low monthly premiums that range from $0-$100 but many include prescription drug, dental, vision, and hearing coverage as well as many other extras. These plans allow you to pay smaller copays for each medical service instead of the higher Medicare coinsurance. The downside is that they are offered through private insurance carriers and are HMOs or PPOs, meaning it could be difficult to stay with your treating physicians because of network issues.

 

• Enroll in a Medigap policy. These plans work with Medicare Part A and B to cover what Medicare doesn’t, but do not require you to stay in a network. This may be a good option for someone who has frequent medical appointments or needs to see specific doctors. The monthly premiums are higher on these plans and depend on the state you live in. Some states do not offer Medigap to individuals under 65. Pennsylvania does offer these plans and the premiums are not any higher than they are for individuals at retirement age. This option does not include prescription drug coverage or dental, vision or hearing. Premiums for those benefits would be additional.

 

There are plenty of Medicare agents out there who know which option to push before they even speak to you. Medicare enrollment is not a one-size-fits-all approach. Everyone has unique healthcare needs and should explore all of these options to see which makes the most sense to them. We are happy to help our clients navigate Medicare enrollment and supplemental options so that they get the best healthcare coverage for them.

To speak with someone about your Medicare options, please complete this short form: