Is Medicare Optional for SSDI Income Recipient, when the 24 Mo. is Up?

[yorkriver1]

Caught up with an ACA client who hadn't responded to my mailer or email about renewing. Client reports getting a packet early fall from Social Security stating that there was an option now that 24 months had gone by to enroll in Medicare. I didn't realize that enrolling was optional for SSDI recipients who qualify after 24 months on SSDI. Is it optional? Regular Medicare makes you drop your SS income if you refuse Medicare A.

"Oh, I just decided to turn down Medicare in September because it would cost more than my insurance now".
Now, what a fine mess, Ollie. Client's job, call Social Security and see what options are now.
Not sure, even if if already in Part A that there is a SEP for, say, PDP, if has A now but doesn't know it.
Would still have to apply for Part B, if not both, and maybe/probably have the wait until July 1 for effective date.
Would qualify for a CSNP MAPD, but has to have Part A & B.
Paying back over $300/month tax credit was a motivator to get going.
Resolved, I create some kind of notice that is big print that if you are eligible for Medicare, it's not a smart money move to keep the plan with the tax credit.

 

[Fisher]

I'm not 100% positive that I can follow all of your post but I can answer the initial question (I think) and one other --

After 24 months of receiving SSDI Part A and Part B kick in automatically with the Part B premium coming out of the SSDI check. Part B COULD be opted out of but I have no SSDI clients that have ever chosen that option.

As to the ACA aspect, if a person has Medicare - even just Part A - they are not eligible for a tax credit subsidy. So could they have an Obamacare plan? Yes, but they would get dinged for the entire amount of subsidy they received when taxes are filed the following year.

 

[G.Gordon]

No, it is not optional and turning off A requires not just doing without ssdi, but also paying back all benefits received. If Sept. is the eligibility date then they can enroll in part B right now and it will be effective three months from now.

When someone times out (24 months) they do not have the option to keep getting a tax credit under ACA.

 

[yorkriver1]

Do any of you have a warning letter or other system for not missing SSDI clients going on Medicare?

Above answers helpful. I am clear about tax credit issues. That's what motivated client to follow my instructions, stop the possible $ consequences.

You state if September is Medicare eligibility month, can get Part B if applying before end of December. 3 months after 25th month of SSDI. Just looked it up, was in time crunch yesterday, appreciate good answers.

Monday, client is tasked to call Social Security and hold however long it takes, find out what is in place, and what to do to get Part B if not in place. I was mostly convinced client has A, and may have B, or turned it down.

Client could apply for a PDP (only needs A or B for PDP) through Medicare site/phone for 1/1/17 worst case, and then get an MAPD CSNP for 2/1/17, once Part B is verified. Definitely qualifies for a chronic condition MAPD. I have had one or more carriers also say they will pend the MAPD app if they know the client is signed up for Medicare, just waiting to show in system--so possible MAPD for 1/1/17.

Unless I see an award letter, won't know for sure when is their 25th month. Some get it "early" based on when their case started, not on when their 1st check was received. I have run into that situation, too. I called another client in April as an early reminder, for supposed September start date of Medicare. It had already started 4/1.

 

[LostDollar]

I can't remember if one gets immediate access creating a my social security account. If so, that could be another way the client could check coverage types.

For checking coverage, should have read mymedicare account, not my social security.

 

[yorkriver1]

I can't remember if one gets immediate access creating a my social security account. If so, that could be another way the client could check coverage types.

I have to be away, or could maybe find this, now, will check later. I may be remembering there is a mail back deal involved. Retirement related access seems to have more firewalls--like pension custodian requiring the bank's signature on auto draft form--, but I get it, someone stealing your benefits is no joke.

 

[goillini52]

Do any of you have a warning letter or other system for not missing SSDI clients going on Medicare?

Above answers helpful. I am clear about tax credit issues. That's what motivated client to follow my instructions, stop the possible $ consequences.

You state if September is Medicare eligibility month, can get Part B if applying before end of December. 3 months after 25th month of SSDI. Just looked it up, was in time crunch yesterday, appreciate good answers.

Monday, client is tasked to call Social Security and hold however long it takes, find out what is in place, and what to do to get Part B if not in place. I was mostly convinced client has A, and may have B, or turned it down.

Client could apply for a PDP (only needs A or B for PDP) through Medicare site/phone for 1/1/17 worst case, and then get an MAPD CSNP for 2/1/17, once Part B is verified. Definitely qualifies for a chronic condition MAPD. I have had one or more carriers also say they will pend the MAPD app if they know the client is signed up for Medicare, just waiting to show in system--so possible MAPD for 1/1/17.

Unless I see an award letter, won't know for sure when is their 25th month. Some get it "early" based on when their case started, not on when their 1st check was received. I have run into that situation, too. I called another client in April as an early reminder, for supposed September start date of Medicare. It had already started 4/1.

If you call late at night, there's no wait. They're open all night.

 

[LostDollar]

If you call late at night, there's no wait. They're open all night.

Think that's just medicare, not soc sec.

 

[goillini52]

Think that's just medicare, not soc sec.

Ooops! You're right LD, I was trying to walk and chew gum at the same time.

 

[yorkriver1]

If you have experience handing off a client to a local agency on aging for assistance, I am interested in compliantly backing away. Turns out the client is showing signs of dementia. Community resources to help folks with their insurance issues will be welcomed. I gave her their number and suggested she contact their insurance counseling department.
She did waive Part B, and is, luckily eligible for Part A 1/1/2017. I was able to cancel the Marketplace coverage for 12/31/16.
Getting her to understand the urgency of applying for Part B was so difficult with the kind of child like resistance to understanding and doing what was needed, I realized I can't help her directly. I would like a community advocate to step in. I am fine with her enrolling directly to the carrier or through Medicare.gov.