Medicare is often associated with people over the age of 65.
But you may be surprised to learn that this federal health insurance program is also available to people with certain disabilities and End Stage Renal Disease, regardless of age.
Learn more about Medicare disability qualifications below.
The qualification for Medicare on the basis of a disability includes the following scenarios:
If you qualify for Original Medicare because of a disability, you may be eligible to enroll in a Part C or Part D plan. Those with End Stage Renal Disease usually can’t enroll in a Medicare Advantage plan.
A Medicare SNP is a certain type of Medicare Advantage plan that is designed for people who have a specific health condition or qualify for both Medicare and Medicaid.
For example, a Special Needs Plan designed for beneficiaries with congestive heart failure provides coverage for the type of prescription medication used to treat heart failure and will include a network of doctors who specialize in treating the condition.
To qualify for a Special Needs Plan, you must have Medicare Part A and B and meet one of the following qualifications:
The list of health conditions that may qualify you for a Special Needs Plan include:
Medicare Supplement Insurance, or Medigap, helps cover out-of-pocket costs that Original Medicare doesn't cover.
These costs include things like deductibles, copayments and coinsurance.
Insurance companies are not required to sell Medigap to anyone under the age of 65 in most states, but some Medigap insurance companies may do so voluntarily.
Insurance companies that sell Medigap in the following states are required to make at least one Medigap plan available to people under 65 who qualify for Medicare because of a disability.
Yes, you may keep your Medicare coverage for as long as you are still considered medically disabled, even if you return to work.
If you obtain employer health insurance upon returning to work and your employer has fewer than 100 employees, Medicare will be the primary payer for your care.
That means Medicare will pay up to the limits of its coverage first, and then your employer insurance will contribute its share as the secondary payer.
If your employer has more than 100 workers, the employer insurance will serve as the primary payer and Medicare will be the secondary payer.
If you have any additional questions or wish to learn more about qualifying for Medicare because of a disability, call to connect with a licensed insurance agent today.
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