Topic: what is your health insurance if you go on SSDI?

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Posted on: May 1, 2011 07:30PM

Posted on: May 1, 2011 07:30PM

Fearless_One wrote:

Do you then go on Medicare?  Medicaid?   Or does SSDI automatically cover you for health insurance?

Sorry if this is a dumb question - I am trying to familiarize myself with these things and am confused about the health insurance portion of it.

lump/chemo/rads/hyster-ooph/mastectomy/implants
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May 1, 2011 07:33PM - edited May 1, 2011 07:34PM by Chickadee

If you are approved for SSDI then you will be eligible for Medicare 2 years from your disability date.

If you were on SSI, which is income based, then Medicaid would come into play.

Not dumb.  Lots of folks are confusing SSI and SSDI.   The Social Security webpage is really excellent and you should read as much as you can to understand it.

On edit: Insurance during the two years is your responsibility.  Hopefully you have something from work to tide you over like LTD?

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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May 1, 2011 07:34PM Alpal wrote:

You're eligible for Medicare 2 years after you start drawing SSDI. Medicaid is income dependent, so you may or may not be eligible for it. Medicare has nothing to do with income.

Allison Dx 7/2008, IDC, Stage IV, mets, ER+/PR+, HER2-
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May 1, 2011 07:36PM Alpal wrote:

If you have to go on Cobra, it should last 24 instead of the usual 18 months, if you're on SSDI and waiting for the 2 year period to end. I don't think Health Care Reform has changed that, but not sure.

Allison Dx 7/2008, IDC, Stage IV, mets, ER+/PR+, HER2-
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May 1, 2011 07:45PM Fearless_One wrote:

No, I have no LTD.   If I am no longer able to work full-time at some point, I would have to carry Cobra for the 2 years, I guess.  

lump/chemo/rads/hyster-ooph/mastectomy/implants
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May 1, 2011 07:46PM Fearless_One wrote:

I don't know what the medicaid income limit is, but I suspect I may qualify.  

lump/chemo/rads/hyster-ooph/mastectomy/implants
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May 1, 2011 07:51PM Fearless_One wrote:

yes, I just checked the Medicaid eligibility requirements for my state, and I would qualify.  Not sure how that figures into things...so then I could be on Medicaid during that 2 year waiting period?

lump/chemo/rads/hyster-ooph/mastectomy/implants
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May 1, 2011 07:52PM nurse-ann wrote:

My brother was on Medicaid during the time that he was waiting for Medicare.  Now he actually has both.  Look into it - the Medicaid benefits can vary from state to state - he is in NY and the benefits there have been good.  Also depends on how long you have lived in your state.  My brother has stayed in NY rather than moving to PA or CO because the benefits are better there.

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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May 1, 2011 07:53PM nurse-ann wrote:

Forgot to add that my brother is in a subsidized apartment - I believe that this is tied to his income and Medicaid.

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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May 1, 2011 07:56PM petjunkie wrote:

I'm on SSDI and am making COBRA payments to my former employer to cover my medical insurance until I hit the 2-year-mark and get Medicare.

You might want to get a consult at the SS office in your area, or even with an attorney that specializes in disability cases. Stage IV breast cancer is an automatic approval, but other stages are not, so I think you have to do quite a bit of work to get them all the documentation to show you are unable to work. I've heard that it is a difficult process.

To prepare, I might even suggest that every time you meet with your oncologist you discuss your difficulty in working full-time. That will give you a history in the chart notes of having trouble working, which the doc can then use when writing the letter to SS and submitting your medical records. 

After you are approved, there is a 6-month waiting period before you start to get disability checks from SS. So you could start planning for that now, too, and trying to build some savings if you can. The downside of that is that any savings are counted against you for SSI, the one that is income based. At least in my state of WA, they considered any amount in savings as well as retirement accounts, etc. 

Dx 10/2007, DCIS, 6cm+, Grade 3, 0/5 nodes, ER+/PR-, HER2+ Dx 10/2009, IDC, Stage IV, Grade 3, mets, ER+/PR-, HER2+
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May 1, 2011 08:03PM Fearless_One wrote:

Petjunkie, you are right- I am only stage IIA so it will be difficult ( I am glad stage IV is automatic SSDI - it should be).    I don't think it impossible, though - I do have some legitimate issues that I do wish to discuss with my onc.    I just was concerned about the insurance issue and wasn't sure how it all came together.

lump/chemo/rads/hyster-ooph/mastectomy/implants

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