Guest guest Posted April 18, 2005 Report Share Posted April 18, 2005 This brings me to another question ... I was told by family members (and I hope they are very wrong!) that since I will make $1359/monthly in SS once won and a little more than than in LTD once won, assuming both are won, that I will not qualify for Medicaid (or Medicare?)? because I am over the $800 threshold. Does anyone out there collect more than $800 in SS and still receive Medicaid or Medicare? If I don't receive that health insurance, I will have nothing after next May. This is wrong-- once you win your SSDI case, you will get MediCare (federal program)-- when you've been out of work for 2 full years. Depending on your income between you and your husband- you will either qualify for a "Share-of-cost) Medi-Caid (state program) or you will need to purchase a supplemental insurance to pick up what Medicare doesn't cover. Medicare is automatically hospital coverage- (Part A). This part has a $700+ deductible for an inpatient stay. If 90 days go by between stays, the deductible repeats itself. Medicare Part B is the MD coverage, it has a $110 annual deductible, and covers 80% of it's charges. You'll need supplemental or Medicaid to pay the 20%. When you get your SSDI approved, it should automatically make your LTD kick in-- and I know you get a match to your SSDI payment. You may also get your company health insurance as a secondary (supplement) to your Medicare. It will depend on your union contract. They have to go by the contract that you were hired under, not any new negotiations. It also goes back to the date that you applied for SSDI. So you will have retro SSDI, and retro LTD. And very possibly, they will have to reinstate your coverage for your company insurance, so all the premiums your folks are paying right now-- and the copays that you wouldn't have had-- will also have to be reimbursed to you. It takes time, but it will happen. Tracie PS. Sue sounds like one hell of a spirit-- thank you for sharing. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2005 Report Share Posted April 18, 2005 This brings me to another question ... I was told by family members (and I hope they are very wrong!) that since I will make $1359/monthly in SS once won and a little more than than in LTD once won, assuming both are won, that I will not qualify for Medicaid (or Medicare?)? because I am over the $800 threshold. Does anyone out there collect more than $800 in SS and still receive Medicaid or Medicare? If I don't receive that health insurance, I will have nothing after next May. This is wrong-- once you win your SSDI case, you will get MediCare (federal program)-- when you've been out of work for 2 full years. Depending on your income between you and your husband- you will either qualify for a "Share-of-cost) Medi-Caid (state program) or you will need to purchase a supplemental insurance to pick up what Medicare doesn't cover. Medicare is automatically hospital coverage- (Part A). This part has a $700+ deductible for an inpatient stay. If 90 days go by between stays, the deductible repeats itself. Medicare Part B is the MD coverage, it has a $110 annual deductible, and covers 80% of it's charges. You'll need supplemental or Medicaid to pay the 20%. When you get your SSDI approved, it should automatically make your LTD kick in-- and I know you get a match to your SSDI payment. You may also get your company health insurance as a secondary (supplement) to your Medicare. It will depend on your union contract. They have to go by the contract that you were hired under, not any new negotiations. It also goes back to the date that you applied for SSDI. So you will have retro SSDI, and retro LTD. And very possibly, they will have to reinstate your coverage for your company insurance, so all the premiums your folks are paying right now-- and the copays that you wouldn't have had-- will also have to be reimbursed to you. It takes time, but it will happen. Tracie PS. Sue sounds like one hell of a spirit-- thank you for sharing. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2005 Report Share Posted April 18, 2005 This brings me to another question ... I was told by family members (and I hope they are very wrong!) that since I will make $1359/monthly in SS once won and a little more than than in LTD once won, assuming both are won, that I will not qualify for Medicaid (or Medicare?)? because I am over the $800 threshold. Does anyone out there collect more than $800 in SS and still receive Medicaid or Medicare? If I don't receive that health insurance, I will have nothing after next May.This is wrong-- once you win your SSDI case, you will get MediCare (federal program)-- when you've been out of work for 2 full years. Depending on your income between you and your husband- you will either qualify for a "Share-of-cost) Medi-Caid (state program) or you will need to purchase a supplemental insurance to pick up what Medicare doesn't cover. Medicare is automatically hospital coverage- (Part A). This part has a $700+ deductible for an inpatient stay. If 90 days go by between stays, the deductible repeats itself. Medicare Part B is the MD coverage, it has a $110 annual deductible, and covers 80% of it's charges. You'll need supplemental or Medicaid to pay the 20%. When you get your SSDI approved, it should automatically make your LTD kick in-- and I know you get a match to your SSDI payment. You may also get your company health insurance as a secondary (supplement) to your Medicare. It will depend on your union contract. They have to go by the contract that you were hired under, not any new negotiations. It also goes back to the date that you applied for SSDI. So you will have retro SSDI, and retro LTD. And very possibly, they will have to reinstate your coverage for your company insurance, so all the premiums your folks are paying right now-- and the copays that you wouldn't have had-- will also have to be reimbursed to you.It takes time, but it will happen.TraciePS. Sue sounds like one hell of a spirit-- thank you for sharing. Oh, thank you so much for this info, Tracie!...I feel better! and yes, Sue was/is a very strong spirit! ... and oh, how she would love to know, as I'm sure she is watching, that I share her stories ... she didn't want to die ... yet, she felt lucky compared to me ...I say is still a very strong spirit because she is still so very much alive in my mind...her laughter was very unique and still very loud in my head...I hope it never goes away...I doubt it will ... I can still hear one of my dearest friend's laughter as well ... he actually died out in CA on xmas day in 1982 ... I didn't want him to go, but he did ... I just felt "something" ... he, and two other of our very good friends were sailing from LA over to Catalina ... Steve had a chocolate lab ... the winds picked up, the dog fell over board, Steve jumped over to get him and and Dave watched them both drown immediately; Dave was the only one with a life vest; hung on to the side of the boat for 8 hours. A Greek Vessel went by, and the wake took under. Steve's body washed ashore 3 days later; 's body was never found; we know all that happened because Dave survived. Anyway, I know is still with me ... he's sent many signs... We grew up in the ocean...it was so ironic to have 2 of them die in it... "I believe that friends are quiet angels who lift us to our feet when our wings have trouble remembering how to fly." Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2005 Report Share Posted April 20, 2005 I just got a letter in the mail with my Medicare Card saying that I was automatically enrolled in it. It says that Part A is Free, and Part B will cost me $78.20 a month. The problem is that right now under my x-husbands insurance, I don't pay anything per month and I only have $15 co- pays when I see my doctors. My X and I are only seperated still because I need the insurance. I don't know if it is worth divorcing him and paying $80 a month for insurance. Any thoughts on this by anyone who has Medicare. I worry that the good Drs won't take medicare insurance and my care will go down and it already sucks! I thought I have to re-qualify for SSDI next month, so I am surprised that I got this before I re-qualify. Any ideas would be helpful, First, let me explain that Medicare is federal insurance. Part A is hospital inpatient coverage, and because we worked, we don't pay for that. Part B is your doctor and outpatient coverage, and that you pay the monthly premium for. It automatically comes out of your SSDI check. MOST- private insurance, ie. your ex's policy, insists that if you qualify for Medicare- that you enroll in Part B. That becomes your primary (1st payor) coverage, and the coverage you have with your ex's-- becomes secondary for you. Medicare is good insurance- and almost every person over the age of 65 has Medicare. (Gov't employees have BCBS). It is NOT the same as Medicaid (Medi-Cal for Calif.). You won't have any problem with the MD's you see accepting your Medicare, and it won't effect the quality of care you get. Medicare kicks in when you've been off work for 2 years due to illness-- that's why we get before we are 65. (That is once the SSDI says you are disabled.) I honestly don't think you're going to have the option of not taking the Medicare B. You may want to have your ex check with the HR people at work, and see what you have to do. With Medicare= the 20% copay will most often be less than the $15 you pay now, and anything over $15 for office visits, his insurance will cover. Since you won't have drug coverage on Medicare (yet- next year starts the RX coverage) his ins. will continue to pay for your meds. Hope this helps, Tracie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2005 Report Share Posted April 20, 2005 It does say on there that I can deny the part B, but that if I do, the premium will go up the next chance I get to sign up for it. , You can deny Part B coverage FROM MEDICARE. And yes, you'll pay more of a premium when you can next enroll. My point is this: If you don't take the Medicare B-- then your ex's health coverage may not pay the charges that Medicare would have covered, if you'd been enrolled. You could end up paying the 80% that part B covers, instead of the normal copays. It is the coverage from his insurance that is at risk! Tracie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2005 Report Share Posted April 20, 2005 Okay, here is a odd thing...I qualified for SSDI last April. I get $1,100 for that, plus my children each get $280.00. ON top of that I get child support for each of the kids totalling about $1,100 per month. So that is a lot more than was mentioned at the $800 mark. Plus I was told as stated below that I wouldn't qualify for Medicare until I was on SSDI for 2 years. But I just got a letter in the mail with my Medicare Card saying that I was automatically enrolled in it. It says that Part A is Free, and Part B will cost me $78.20 a month. The problem is that right now under my x-husbands insurance, I don't pay anything per month and I only have $15 co- pays when I see my doctors. My X and I are only seperated still because I need the insurance. I don't know if it is worth divorcing him and paying $80 a month for insurance. Any thoughts on this by anyone who has Medicare. I worry that the good Drs won't take medicare insurance and my care will go down and it already sucks! I thought I have to re-qualify for SSDI next month, so I am surprised that I got this before I re-qualify. Any ideas would be helpful, Thanks, > > > In a message dated 4/19/2005 2:07:10 A.M. Eastern Standard Time, > tiodaat@a... writes: > > In a message dated 4/18/05 8:45:51 AM Pacific Daylight Time, > pickstands@a... writes: > > > > This brings me to another question ... I was told by family members (and I > hope they are very wrong!) that since I will make $1359/monthly in SS once won > and a little more than than in LTD once won, assuming both are won, that I > will not qualify for Medicaid (or Medicare?)? because I am over the $800 > threshold. Does anyone out there collect more than $800 in SS and still receive > Medicaid or Medicare? If I don't receive that health insurance, I will have > nothing after next May. > > > > > > This is wrong-- once you win your SSDI case, you will get MediCare (federal > program)-- when you've been out of work for 2 full years. Depending on your > income between you and your husband- you will either qualify for a > " Share-of-cost) Medi-Caid (state program) or you will need to purchase a supplemental > insurance to pick up what Medicare doesn't cover. > Medicare is automatically hospital coverage- (Part A). This part has a > $700+ deductible for an inpatient stay. If 90 days go by between stays, the > deductible repeats itself. Medicare Part B is the MD coverage, it has a $110 > annual deductible, and covers 80% of it's charges. You'll need supplemental or > Medicaid to pay the 20%. > When you get your SSDI approved, it should automatically make your LTD kick > in-- and I know you get a match to your SSDI payment. You may also get your > company health insurance as a secondary (supplement) to your Medicare. It > will depend on your union contract. They have to go by the contract that you > were hired under, not any new negotiations. It also goes back to the date > that you applied for SSDI. So you will have retro SSDI, and retro LTD. And > very possibly, they will have to reinstate your coverage for your company > insurance, so all the premiums your folks are paying right now-- and the copays > that you wouldn't have had-- will also have to be reimbursed to you. > > It takes time, but it will happen. > > Tracie > > PS. Sue sounds like one hell of a spirit-- thank you for sharing. > > Oh, thank you so much for this info, Tracie!...I feel better! > > and yes, Sue was/is a very strong spirit! ... and oh, how she would > love to know, as I'm sure she is watching, that I share her stories ... she > didn't want to die ... yet, she felt lucky compared to me ...I say is still a > very strong spirit because she is still so very much alive in my mind...her > laughter was very unique and still very loud in my head...I hope it never goes > away...I doubt it will ... I can still hear one of my dearest friend's laughter > as well ... he actually died out in CA on xmas day in 1982 ... I didn't want > him to go, but he did ... I just felt " something " ... he, and two other of > our very good friends were sailing from LA over to Catalina ... Steve had a > chocolate lab ... the winds picked up, the dog fell over board, Steve jumped > over to get him and and Dave watched them both drown immediately; Dave > was the only one with a life vest; hung on to the side of the boat for 8 > hours. A Greek Vessel went by, and the wake took under. Steve's body > washed ashore 3 days later; 's body was never found; we know all that > happened because Dave survived. Anyway, I know is still with me ... he's > sent many signs... We grew up in the ocean...it was so ironic to have 2 of > them die in it... > > " I believe that friends are quiet angels who lift us to our feet when our > wings have trouble remembering how to fly. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2005 Report Share Posted April 20, 2005 Thanks Tracie, It does say on there that I can deny the part B, but that if I do, the premium will go up the next chance I get to sign up for it. So, it sounds like I still shouldn't run out to get the divorce becasue I will benefit from his insurance on some things. The only reason we haven't signed is really because of the insurance. I am sure his company doesn't even know that I am disabled, and I am still not sure what will happen with my review next month. I was put on disability from my first accident because of the head injury and some of that cleared up but I still have some much other stuff...but the woman at SS said it makes it harder when you have more problems instead of making it easier! Go figure, it takes the government to think that way! Any way, thanks for the info, > In a message dated 4/20/05 8:58:16 AM Pacific Daylight Time, > mom22angels@t... writes: > > > > I just got a letter in the mail with my Medicare Card saying that I was > > automatically enrolled in it. It says that Part A is Free, and Part B will cost > > me $78.20 > > a month. The problem is that right now under my x-husbands > > insurance, I don't pay anything per month and I only have $15 co- > > pays when I see my doctors. My X and I are only seperated still > > because I need the insurance. I don't know if it is worth divorcing > > him and paying $80 a month for insurance. > > Any thoughts on this by anyone who has Medicare. I worry that the > > good Drs won't take medicare insurance and my care will go down and > > it already sucks! > > I thought I have to re-qualify for SSDI next month, so I am > > surprised that I got this before I re-qualify. > > Any ideas would be helpful, > > > > First, let me explain that Medicare is federal insurance. Part A is hospital > inpatient coverage, and because we worked, we don't pay for that. Part B is > your doctor and outpatient coverage, and that you pay the monthly premium for. > It automatically comes out of your SSDI check. > MOST- private insurance, ie. your ex's policy, insists that if you qualify > for Medicare- that you enroll in Part B. That becomes your primary (1st payor) > coverage, and the coverage you have with your ex's-- becomes secondary for > you. > Medicare is good insurance- and almost every person over the age of 65 has > Medicare. (Gov't employees have BCBS). It is NOT the same as Medicaid > (Medi-Cal for Calif.). You won't have any problem with the MD's you see accepting > your Medicare, and it won't effect the quality of care you get. > Medicare kicks in when you've been off work for 2 years due to illness-- > that's why we get before we are 65. (That is once the SSDI says you are > disabled.) > > I honestly don't think you're going to have the option of not taking the > Medicare B. You may want to have your ex check with the HR people at work, and > see what you have to do. > With Medicare= the 20% copay will most often be less than the $15 you pay > now, and anything over $15 for office visits, his insurance will cover. Since > you won't have drug coverage on Medicare (yet- next year starts the RX coverage) > his ins. will continue to pay for your meds. > > Hope this helps, > Tracie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2005 Report Share Posted April 20, 2005 Oh. So does SS let them know that I am eligible, or do I have to? Since we have been seperated so long, I don't think his company has a clue what is going on with me. I really appreciate all of this help because I would hate to get stuck in the end because I didn't know. I just didn't really want to pay out $80 per month when I already have good coverage, but I guess it is best that I do. Thanks again, > In a message dated 4/20/05 10:01:50 AM Pacific Daylight Time, > mom22angels@t... writes: > > > > It does say on there that I can deny the part B, but that if I do, > > the premium will go up the next chance I get to sign up for it. > > > > , > You can deny Part B coverage FROM MEDICARE. And yes, you'll pay more of a > premium when you can next enroll. > My point is this: If you don't take the Medicare B-- then your ex's health > coverage may not pay the charges that Medicare would have covered, if you'd > been enrolled. You could end up paying the 80% that part B covers, instead of > the normal copays. > It is the coverage from his insurance that is at risk! > > Tracie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2005 Report Share Posted April 20, 2005 laura, Medicare is retroactive...two years from onset of illness. I also had Medicare as soon as I was approved -- It took me three years though. You are lucky with the support--I was awarded only 65 dollars a week for two kids because I made twice as muce -- and i was a teacher and he graduated from Berkeley Cum laude! He just chose to be an under employed bartender. I've seen no child support at all for four years. three because my eldest was living there illegally, but since he graduated last June, he has no excuse. I just wish I were well enough to get a lawyer, cause if I call the man, the stress of his yelling just puts me under. Sound like the money trouble id okey for now. hooray! If we can't put up with each other, how can we put up with ourselves? (Uh... that's how it goes, right?) > > Okay, here is a odd thing...I qualified for SSDI last April. I get > $1,100 for that, plus my children each get $280.00. ON top of that > I get child support for each of the kids totalling about $1,100 per > month. So that is a lot more than was mentioned at the $800 mark. > Plus I was told as stated below that I wouldn't qualify for Medicare > until I was on SSDI for 2 years. But I just got a letter in the > mail with my Medicare Card saying that I was automatically enrolled > in it. It says that Part A is Free, and Part B will cost me $78.20 > a month. The problem is that right now under my x-husbands > insurance, I don't pay anything per month and I only have $15 co- > pays when I see my doctors. My X and I are only seperated still > because I need the insurance. I don't know if it is worth divorcing > him and paying $80 a month for insurance. > Any thoughts on this by anyone who has Medicare. I worry that the > good Drs won't take medicare insurance and my care will go down and > it already sucks! > I thought I have to re-qualify for SSDI next month, so I am > surprised that I got this before I re-qualify. > Any ideas would be helpful, > Thanks, > > > > > > > > In a message dated 4/19/2005 2:07:10 A.M. Eastern Standard Time, > > tiodaat@a... writes: > > > > In a message dated 4/18/05 8:45:51 AM Pacific Daylight Time, > > pickstands@a... writes: > > > > > > > > This brings me to another question ... I was told by family > members (and I > > hope they are very wrong!) that since I will make $1359/monthly > in SS once won > > and a little more than than in LTD once won, assuming both are > won, that I > > will not qualify for Medicaid (or Medicare?)? because I am over > the $800 > > threshold. Does anyone out there collect more than $800 in SS > and still receive > > Medicaid or Medicare? If I don't receive that health insurance, > I will have > > nothing after next May. > > > > > > > > > > > > This is wrong-- once you win your SSDI case, you will get > MediCare (federal > > program)-- when you've been out of work for 2 full years. > Depending on your > > income between you and your husband- you will either qualify for > a > > " Share-of-cost) Medi-Caid (state program) or you will need to > purchase a supplemental > > insurance to pick up what Medicare doesn't cover. > > Medicare is automatically hospital coverage- (Part A). This part > has a > > $700+ deductible for an inpatient stay. If 90 days go by between > stays, the > > deductible repeats itself. Medicare Part B is the MD coverage, > it has a $110 > > annual deductible, and covers 80% of it's charges. You'll need > supplemental or > > Medicaid to pay the 20%. > > When you get your SSDI approved, it should automatically make your > LTD kick > > in-- and I know you get a match to your SSDI payment. You may > also get your > > company health insurance as a secondary (supplement) to your > Medicare. It > > will depend on your union contract. They have to go by the > contract that you > > were hired under, not any new negotiations. It also goes back to > the date > > that you applied for SSDI. So you will have retro SSDI, and > retro LTD. And > > very possibly, they will have to reinstate your coverage for your > company > > insurance, so all the premiums your folks are paying right now-- > and the copays > > that you wouldn't have had-- will also have to be reimbursed to > you. > > > > It takes time, but it will happen. > > > > Tracie > > > > PS. Sue sounds like one hell of a spirit-- thank you for > sharing. > > > > Oh, thank you so much for this info, Tracie!...I feel better! > > > > and yes, Sue was/is a very strong spirit! ... and oh, how > she would > > love to know, as I'm sure she is watching, that I share her > stories ... she > > didn't want to die ... yet, she felt lucky compared to me ...I say > is still a > > very strong spirit because she is still so very much alive in my > mind...her > > laughter was very unique and still very loud in my head...I hope > it never goes > > away...I doubt it will ... I can still hear one of my dearest > friend's laughter > > as well ... he actually died out in CA on xmas day in 1982 ... I > didn't want > > him to go, but he did ... I just felt " something " ... he, and two > other of > > our very good friends were sailing from LA over to Catalina ... > Steve had a > > chocolate lab ... the winds picked up, the dog fell over board, > Steve jumped > > over to get him and and Dave watched them both drown > immediately; Dave > > was the only one with a life vest; hung on to the side of > the boat for 8 > > hours. A Greek Vessel went by, and the wake took under. > Steve's body > > washed ashore 3 days later; 's body was never found; we know > all that > > happened because Dave survived. Anyway, I know is still > with me ... he's > > sent many signs... We grew up in the ocean...it was so ironic to > have 2 of > > them die in it... > > > > " I believe that friends are quiet angels who lift us to our feet > when our > > wings have trouble remembering how to fly. " > > > > > > ~~~~ *** ~~~ *** ~~~ *** ~~~~ > The Neurosarcoidosis Community > > NS CHAT:- Has been cancelled for now. > > Message Archives:- > http://groups.yahoo.com/group/Neurosarcoidosis/messages > > Members Database:- > Listings of locations, phone numbers, and instant messengers. > http://groups.yahoo.com/group/Neurosarcoidosis/database > > Quote Link to comment Share on other sites More sharing options...
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