Parents’ Corner


Understanding Medicare Coverage for People with Disabilities

According to the Centers for Disease Control and Prevention, about 1 in 3 American adults with disabilities have healthcare needs they cannot address due to the cost barrier. There are 61 million adults in the US living with disabilities, and among them, approximately 20 million cannot access the resources they need to improve their health and quality of life.

It is therefore vital for individuals with disabilities to be made aware of all the healthcare programs they can realistically access. One such program that aims to reduce out-of-pocket medical spending is Medicare, a federal insurance program that subsidizes the healthcare costs for certain demographics in the United States.

Who is eligible for Medicare?

Medicare is usually only available to adults aged 65 and older. However, adults under the age of 65 can also qualify for Medicare if they have been approved for Social Security Disability Insurance (SSDI) benefits. Only individuals with at least 40 Social Security work credits within the past 10 years are eligible for an SSDI.

What does Medicare cover?

Medicare has three parts, with each of them covering different healthcare services. These include Medicare Parts A, B, and D. Medicare Part A is hospital insurance and covers care services in different healthcare institutions, including hospitals, nursing facilities, hospice cares, and certain home care services. Meanwhile, Medicare Part B acts as medical insurance and covers outpatient care, including doctor’s services, medical equipment, testing, and ambulance and emergency services. Lastly, Medicare Part D covers prescription drugs.

If you want all three plans under a single package, you can opt for Medicare Part C, which is a Medicare bundle offered by private insurance companies. It is also known as Medicare Advantage. Kelsey Care Advantage outlines what a Medicare Advantage plan covers — on top of Parts A, B, and D, Advantage plans also include value-added benefits, such as vision, dental, and hearing coverage. Medicare Advantage plans can also provide transportation to medical appointments and facilities, which can be convenient for individuals with limited mobility.

How much does Medicare cost?

Adults under the age of 65 are not required to pay monthly premiums for Medicare Part A if they have Social Security or Railroad Retirement benefits. On the off chance that an individual does not qualify for free premiums, Part A costs $259 or $471 per month. The amount depends on how long their spouse has been paying Medicare taxes. For hospital stays, a $1,484 deductible will be charged per benefit period. Meanwhile, Medicare Part B costs an annual deductible of $203. After which, individuals are required to share 20% of the cost for the following services: doctor’s services, medical equipment, and outpatient therapy.

For Medicare Part D, the cost of one’s monthly premium depends on their income and IRS tax returns. For instance, individuals with a yearly income under $88,000 pay nothing on top of their plan premium, while individuals with a yearly income above $500,000 are required to pay $77.10 monthly on top of their plan premium.

The Kaiser Family Foundation explains that the cost of Medicare Advantage plans can vary depending on your insurer as well. Their reports show that the average Medicare monthly premium costs $25, though many can go for as low as $0. Plans with more value-added benefits can cost as high as $100 per month.

How do I apply for Medicare?

Individuals will automatically be enrolled in Medicare Parts A and B 24-months after getting approved for SSDI. However, there are exceptions for certain disabilities. Individuals with amyotrophic lateral sclerosis get enrolled after the first month on SSDI. On the other hand, individuals with the end-stage renal disease get enrolled into Medicare after three months of dialysis.

Individuals who want the added coverage of Medicare Advantage will have to apply to a private insurer after being enrolled into Medicare Parts A and B. To join a Medicare Advantage Plan, simply research the plans available in your area. Then fill out the necessary application forms. On top of your basic information, most insurers will also ask for your Medicare number and the date your coverage took effect.

What are my other options?

If you lack the work credits necessary to qualify for SSDI approval, you can consider applying for Supplemental Security Income. As stated in our article, ‘Preparing to Live Independently with Disability‘, an SSI is a government-sponsored monthly stipend given to limited-income individuals with disabilities. Individuals who earn a certain amount of income will not qualify for SSIs.

The Social Security Administration also notes that certain states also sponsor Medicaid medical assistance programs for individuals on SSI Benefits. Like Medicare, Medicaid covers hospital bills, physician costs, prescription drugs, and other health expenses.

Living with a disability can be very demanding financially, especially when it comes to healthcare costs. Enrolling in Medicare can help reduce out-of-pocket costs and give you access to the resources that can address your healthcare needs.

Posted on

If You’re an Entrepreneur With Disabilities, Ask Yourself These Basic Questions

Photo Credit: Pexels You can build your very own business and define your own version of success. In order to do so without any major issues, you need to ask yourself a few questions, to start. Read on to learn more from Disability Awareness Why do you want to start a business? Figuring out your “why” is a first step…

Posted on

How to Make Your Bedroom More Disability Friendly

If you have a disability, making home modifications can do a lot to boost your independence and improve your quality of life. The bedroom is one room where accessibility upgrades can be especially beneficial. Your bedroom should be a place where you can relax after a long day and wake up feeling refreshed and energized in the morning, so it’s…

Posted on

Use Technology to Your Advantage: Guide to Career Advancement for People with Disabilities

Thanks to technology, the workplace is much more accommodating to people with disabilities than in years past. With so many jobs being technology-centered, the job market is way more open to those with disabilities. We want to fill you in on a few ways you can use technology to your advantage when you begin advancing your career. That way, you…

Posted on

Budget-Friendly Ideas for Individuals with Disabilities who Want to Start a New Hobby

Everyone needs some occasional newness in their life. Whether your kids have moved out and you have more time on your hands, or you simply need a new activity to pass the time, a new hobby can often do the trick. For individuals with disabilities who want to begin a new hobby but don’t know where to start, try out…

Posted on

Practical Tips for Soon-to-Be Parents Who Have a Disability

Bringing a new life into the world invokes many emotions and thoughts in parents. Children push you to grow, improve, and sacrifice. Expecting a child is equally thrilling and scary, and you want to prepare yourself and your home as much as possible. For parents who have a disability, the process of preparing for a child might include extra steps,…

Posted on

Blazing a Career Path in Business as a Young Adult with Disabilities

Living with a disability, you might be used to people telling you that you can’t do this or you can’t do that. Maybe you’ve heard all about the myths of how people with disabilities can be risky hires in the workplace, and that’s discouraged you from pursuing your dream job. Well, I’m here to tell you that there is no…

Posted on

Supported Living For Adults With Learning Disabilities

Last week we talked about guardianship and how it helps a person when it is written for a particular purpose, but if it is not written well, it might cause severe damage to the person. The person must have support around them. Someone might need help at home, at school, at therapy, and in the community as well. How do…

Webinar on Guardianships and Supported
Posted on

Webinar on Guardianships and Supported Living

Last week I attended a webinar on guardianships and supported living. I think these topics are crucial for people to understand. I thought I would write two blog posts on these topics, and today’s post will be on guardianships. The speaker, who gave the webinar, was Jonathan Martinis. He is a lawyer and speaker who talks from the heart. Jonathan…

Copyright 2021© Disability Awareness. All Rights Reserved. Design by HeadFord Technology