Medicare and People with Disabilities

Medicare is another medical benefit for people with disabilities who qualify for Social Security Disability Insurance (SSDI). The Social Security Administration (SSA) and Centers for Medicare & Medicaid Services follow certain guidelines for people with disabilities and others eligible for Medicare. Here are 15 facts you should know about Medicare plans.

  1. Most Americans become eligible for Medicare, a federally funded healthcare program when they reach age 65.
  2. Medicare’s age eligibility requirement does not apply to people with certain disabilities who are unable to work and qualify for SSDI.
  3. After people with disabilities receive cash Social Security disability benefits, there is a 24-month waiting period before they can receive Medicare. However, certain medical conditions can reduce or eliminate the waiting period.
  4. Those who have Lou Gehrig’s disease, or Amyotrophic Lateral Sclerosis (ALS), qualify for Medicare as soon as they are approved for Social Security disability benefits.
  5. Someone who has an end-stage renal disease (ESRD) can become immediately eligible for Medicare, without an age limitation or waiting period.
  6. Medicare comprises four key components: Parts A, B, C, and D.
  7. Medicare Part A provides hospitalization benefits. Medicare Part B covers medically necessary treatments, durable medical equipment (DME) and several preventive services. Examples of preventive services include screenings for cardiovascular impairments, diabetes, colon cancer, glaucoma, and HIV. In addition, mammograms, and prostate and pelvic examinations are covered.
  8. Medical services provided under Part B include services such as flu shots, medical nutrition therapy, pneumonia vaccines and bone mass measurements.
  9. Medicare Part C plans are known as Medicare Advantage (MA) plans. Part C includes all of the benefits of Medicare Parts A and B, and usually Part D, which is prescription drug coverage. However, Medicare enrollees should always compare the inclusions, exclusions and prescription limits of these plans to ensure the plan meets their health and financial needs.
  10. Under Medicare Part B, benefits also include durable medical equipment (DME) and prosthetics. And Medicare Part D covers prescriptions. It’s critical to review the terms provided under someone’s chosen plan or plans every year, especially during annual open enrollment, since they are subject to change.
  11. Each year, the federal government, the Centers for Medicare & Medicaid Services and the Social Security Administration (SSA) announce policy and program changes for Medicare recipients and people with disabilities. So it’s important to stay informed about these updates, and consider turning to Medicare and Social Security experts for assistance.
  12. Medicare Parts A and B are sometimes referred to as “Original Medicare” or “Traditional Medicare.”
  13. Even though Medicare Parts A and B cover a large number of healthcare services, some people with disabilities and others opt to purchase a Medigap plan. Medigap plans provide Medicare Supplement Plans 2018 that covers expenditures not covered by Medicare Parts A and B and are available to people under the age of 65 only in certain states.
  14. Subsequent to the general enrollment period, Medicare benefits become effective on the first day of one’s birthday month, or the previous month when the birth date falls on the first day of the month.
  15. People with disabilities and seniors eligible for Medicare do not have to struggle through the complex program alone. Some national organizations provide professional, unbiased guidance for determining whether original Medicare with a Part D plan or a Medicare Advantage plan will better meet the person’s needs.







Unraveling Medicare and Medicare Supplement Plans

Congratulations, as you turn 65 and are eligible for Medicare Supplement Plans 2018. Your monthly benefits from the Federal Government include social security as well as deductions for Part A and B of Medicare.  Below we will give you a brief synopsis and guide you through the first steps of understanding the Medicare options available to you. Under no circumstances is this thorough review. In order to completely understand the benefits, you will receive under Medicare, read the comprehensive brochure for seniors “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare”.

Original Medicare parts A & B

As we know it, there are 3 parts to Medicare-Part A, B and D. Managed by the Federal Government, Part A (hospital insurance) covers inpatient hospital costs and helps cover skilled nursing facilities, hospice, and some home health care costs. Medicare Part B covers physicians and services, outpatient care and some preventative services to help maintain your health when you are ill. The premium for Part A is over $400.00 per month and unless you are disabled or have survivor benefits from a spouse who was covered by Social Security, these costs are the same for everyone and part of the benefit. Part B premium starts at $96.40 (may cost more depending on your annual income) and is withdrawn directly from your social security check. You can opt out of Part B coverage if you choose. Both A (hospital benefits) & B (Physician and medical benefits) have deductibles, co-insurance/co-payments, and maximum benefits with extra lifetime reserve days. There are gaps in the government plan and payments you will be directly responsible to pay. Selecting a supplemental plan from a private insurer can cover part of these gaps.

Medicare Prescription Drug Coverage (Part D)

Section D, added to law effective January 1, 2006, was enacted under the Bush administration and is funded with taxpayer dollars. If you are new to Medicare, you may select a separate plan for drugs. There are two ways to buy a Drug plan-as part of a Medicare Advantage Plan or a separate Medicare Prescription Drug Plan.  Since Part D provides basic coverage’s with large deductibles and co-payments, besides premium differences, these drug supplemental policies must offer Formulary or Generic Drugs in every category of treatment. Deciding which drug plan is best for you may be challenging. Knowing your drugs and dosages before selecting the plan is helpful. For approved drug plans check out the department of insurance site in your state.





Changes that Medigap has experienced

When Medicare was born, when it was proposed by the United States Congress and later approved by the President, it was simply a federal health program that aimed to help those who need it the most. This is how, little by little, it developed and became in what it is today.

Being one of the largest initiatives in America that seek to guarantee the right to health to the entire population, has always been improving little by little. At first, Medicare only offered a basic plan for retirees and did not even allow regular people to pay their own separate fees.

After a while, it was that different plans were added and with the practice, Medicare realized that he should always listen to all his audience to be able to improve. In this way, several plans have been implemented that include different benefits and give people the opportunity to obtain better care during their illness.

In addition to these plans, an initiative called Medigap was started, which was born from the need to cover much beyond what was customary with Original Medicare. You see, when someone used Medicare Insurance there was a possibility that all expenses were not covered completely. That’s where Medigap comes into play.

At the time when you can not cover all the expenses, you can activate your Medigap policy. At first, it only worked as a kind of extension and there were some things that it did not cover at all. However, some of the changes that I experience allowed him to be the best option when looking for another ally during a moment of emergency.

Medigap is a Medical Supplement Plan and is available to anyone who needs it. You can go to any authorized agent to obtain it and work for hand in hand with Medicare Insurance and Medicare Advantage. Since, as previously stated, it is activated when the other insurances have been completely exhausted.

One of the most important changes that Medigap has suffered is that it is not available for group-type policies, but is clearly individual. This means that both you and your spouse must acquire it separately since they can not do both at the same time. This is something that any insurance expert should know and tell you at the most appropriate time.

Finally, the last thing that was established for Medigap is that to acquire it you must have both Medicare Part A and Part B and also all the policies have the option of automatic renewal. Even if you are sick as long as you pay the premium, you will be entitled to all the benefits that Medigap can give you as a Aetna medicare supplement plans.

Even so, you should be aware that there are many plans that look like Medigap but are not the same. So you have to be aware of this part. Now, Medigap is the best option for you in case you need support in this situation. Hurry up and get this amazing plan.

Enrollment of Medicare Advantage Plans, know the correct time

Each year there are specific times that allow you to get enrolled in Medicare Advantage plans. However, to join in a plan, you should be enrolled in Parts A and B of Medicare. In fact, you can enroll typically in Medicare Advantage plans in these periods:


  • IEP: This refers to the Initial enrolment period. This offers duration of seven months time such that 3 months before and after your birthday month and inclusive of your birthday month, it becomes seven months. You become qualified for Medicare Advantage plans right from the 65th birth month.
  • SEP: This refers to Special enrolment period. This is the time beyond the normal period of enrolment in Part B. The SEP of Part B allows delay in enrolment without penalty and this is possible only if you were under the job based insurance cover while you were Medicare eligible. Even after losing the coverage of job-base, there is a time limit of eight months period for you to get Medicare enrolled without penalty. In fact, you may get enrolled in the Medicare Advantage plans, once you have signed for the coverage of Par A and B.
  • GEP: This refers to General enrolment period. Every year from January to March, you are allowed to sign if you failed to do when you were eligible. There is an option to sign even between April to June for Medicare Advantage plans on signing during the GEP for Parts A and B.
  • Fall Open period of enrolment: This is the time between October 15 to December 7 every year and this is also the right time you can switch over your Medicare coverage. There are all chances to consider a new MA plan or even switch between Medicare, Original and Advantage. This is also the time you can consider Part D coverage change.


Note: In case an individual has Renal disease at the end stage, joining an MA plan is possible if there are special needs accepting ESRD people. You may retain any enrolled plan that you bought before developing ESRD.


Choosing United Healthcare medicare supplement plans is best done with proper awareness of the plans. The cost options vary with Original Medicare and now each plan also comes with additional rules that planning carefully prior to enrolling really helps. The Part B Medicare premium in Medicare Advantage plans specifies to pay the premium and there may also be additional premiums charged and some times, your plan may be a part of the premium of Part B.

How does Medicare Supplement Plan Work?

Regular hospital visits can get really heavy on the pocket isn’t it? Even if you might have signed up for the Medicare Plans, they fail to cover the entire medical expenses after a certain frequency of treatments.

The Medicare Supplement Plan comes to the rescue. It is devised keeping in mind the gaps created by the main Medicare Plan, making it earn an alternative name called ‘Medigap’. The gaps include Deductibles, Co-insurance and Co-payments.

How does Medicare Supplement Plan Work?

If you have the original Medicare Plan, it shall initially pay all the medical expenses incurred during that treatment. Once that is done, the supplement plan pays its amount according to the policy described in it. It acts as a financial support to the main Medicare Plan.

What does Medicare Supplement Plan Cover?

There are a total of 10 Medicare Supplement Plans each represented by a letter of the alphabet beginning from A all the way up to N although E,H, I and J are no longer available.

  • Medicare Supplement covers co-insurance costs upto an year after the Original Medicare Plan has expired.
  • The Part A and Part B of the Medicare Plan covers hospice and copayment costs.
  • The Medical Supplement plan also includes the costs incurred for the first three pints of blood.
  • The Medicare Supplement Plan F is the most comprehensive scheme out there and it includes all the deductibles for the A and B Parts, coinsurance charges for the B Part and even a foreign travel medical coverage.

When and How to Enroll for the Supplement Plan?

The Medicare Supplement Plans 2018 is provided by private insurance agencies and to enroll into one, you have to be enrolled into a Medicare Part A and Part B. You can enroll for the Supplement Plan during open enrollment.

If you are 65 and older, your enrollment commences when you be a holder of the Part B Medicare Plan.

If you are turning 65, your best enrollment period would be the first 6 months after you have turned 65 and while enrolled in the Part B during that period.

Note that if you are under 65, you would not be eligible to buy any Medigap Plan according to Federal Law.

A variety of private insurance companies out there offer the Medigap insurance plan. Thus, it is recommended you go through the schemes each one has to offer, carefully and compare its premiums and benefits. It is essential to understand their pricing schemes and analyze how it would be beneficial down the line. Note that, premiums may subject to increase with respect to the behavior of general market also.

Think of living healthy and spending less on your health coverage, then Medigap insurance plan is going to help you make a difference. It has been designed to give you the right package that will cover your medical needs. However, it is not every health plan that will be perfect for you.

Different Types of Commonly Used Medicare Advantage Plans

Health is wealth and thus you cannot ignore your health. When you fall ill you must get treatment and the cost of treatment is normally high. Thus, people opt out for different Medicare plans that will pay off the cost of treatment.

Now, there are different plans that cover your medical expenses. The most common ones are the Original Medicare or the Medicare advantage plans. There is difference between the two. If you have original Medicare then when you get Medicare benefits the Government will pay for it. On the other hand in case of the Medicare Supplement Plans 2018 are offered by the private companies and it is approved by Medicare.

There are different kinds of MAP plans that can be opt by an individual. They are

Health maintenance Organization plans (HMO)

In HMO plans you have to visit any Doctor or other health care practitioner who are include in the plan’s network. However, in case of emergency or out of area urgent care or dialysis you can visit any specialist outside the network. In other situation you have to get referred by the primary care doctor for getting consultation or treatment from any other doctor or specialist.

Preferred Provider Organization plans (PPO)

PPO plan gives an option to you for getting treatment. They have their own network of doctors and clinics. If you visit these and get treated then you have to pay less as premium. On the other hand, if you wish to visit any Doctor or clinic outside the network you can do so by paying more. There is no need to choose nay primary care doctor in PPO plans.

Private Fee-for-Service plans (PFFS)

This plan is provide by private insurance and you can visit any doctor or health care provider provided that they agree with the terms and conditions of the plan. A PFFS plan has set rules and regulation about how much can you pay to the Doctors. It also has its own network of doctors but if you wish you can visit anyone else.

Special Needs Plans (SNPs)

The Special need plans are mainly focused on providing special healthcare. It may cover certain chronic medical condition or may be for those who visit certain hospitals. These plan is mostly for those who are both eligible for Medicare and Medicaid.

Apart from the above mentioned plans that are mostly in use there are some other plans too. They are HMO Point of Service plans and Medical savings Account Plan.


All Medicare Supplements Available for You

Medicare prosperity supplements had been manufactured by the federal government just like an assortment of insurance anticipates Seniors and the individuals who are crippled or experiencing an extremely problematic disease like kidney failure. All things considered, this is viewed just like a program which is regularly changing, rendering it amazingly risky to get it. Remember this despite the fact that purchasing on your insurance arrangement, and guarantee that you wish to do what’s necessary research to distinguish what each exact variety involves.

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At this level, its of extreme importance to look around and do a minor investigation before selecting an insurance design private company to carry the outcomes with.


It can be crucial that you simply know the twelve distinct forms of coverage and what they every offer individually. It can be critical to suit your necessities to recognize particularly what you wish with regards to assurance. In the occasion you truly are a sensibly healthful individual, you would conceivably wish to run with essential plan A, which does exclude any month to month rates. Your value range will probably likewise have an influence in helping you figure out what creation you are encouraged to run together with. Think of it as is conceivable to perpetually redesign later.


Since you are not familiar with the thoughts A due to L, you could visit Medicares sites for the broad summary of each. In the event that you don’t have internet connection or are not a learner, call your community Medicare office environment for this data.


Likewise make sense of that costs are making a beeline for shift from back up plan to an insurance design firm. Be that as it may, when you perceive your thoughts, as heretofore prompted, it’ll conceivable be easy to understand the enormous distinction in the middle of overrated insurance arrangements traders and some of those which may give reasonable rates. It’s clear why its extremely important that you stick around. Regardless of whether you are major about picking up an incredible arrangement for the assets, you may put a minor time in analysis.


Perhaps the best place to gain tips is by utilizing your condition insurance magistrates goal of work or website page. Here you ought to approach costs that every last safety net provider in your own state who gives Medicare has printed. You can see at a look which supply the ideal arrangements and which you ought to keep away from.


You likewise need to know that while applying for some solution scan they have waiting periods or maybe affliction exclusion that may both lift your pleasantly being care costs or prevent you from meeting all requirements for the certain assortment of plan. Talking which has a Medicare agent might be your best bet on the off chance that you are wondering how likely the reality you may fit the bill for certain coverage.


How can Medicare Advantage Plans help its members?

Those eligible to avail Medicare might be eager to check out Medicare Advantage Plans. It was previously called Medicare + Choice. It is regarded as Medicare’s private insurance option, providing participants with the choice to avail private insurance plan rather than Medicare itself. Traditional Medicare’s restrictions and for-fee services are known to be significant, specifically with regards to prescriptions, offering people with an option to get better insurance coverage. It comes with plenty of benefits combined with minimum out of pocket costs. Since the plan costs are determined by competition amongst providers, it is quite possible to come across an inexpensive plan which can cover individual needs. This plan can prove to be a wonderful alternative to Original Medicare.

Benefits of Medicare Advantage Plans

Advantage plans are also called Medicare Part C. it allows the individual to register for PPO or HMO plan, MSA (Medical Savings Account) or FFS (Fee For Service), anything that fits the person’s needs. If coverage provided by Medicare is found to be adequate to meet specific needs, then the individual is not forced to make use of any private insurer.

Previously, this plan also had included the opportunity to avail better prescription coverage. However, with passage of Part D, Medicare prescription plan launched in the year 2006, the Medicare recipients are now required to register for private prescription plans, although they may not have registered for anything, but for basic Medicare.

If Medicare Advantage in 2019 are opted for, then most organizations offering such plans are found to offer prescription based Part D plans. Availing both is likely to be found beneficial, since there is involved minimal cost. But Medicare Advantage policies may be standardized, while prescription Part D plans might not. Hence, one should not register automatically for joint plan. Care should be taken to ensure that the prescription plan is to meet specific needs. No restrictions are present associated with buying a plan with a company, as well as another plan with another provider.

Things to do

In case, the person does not suffer from medical issues, and do not require visiting the physician besides the annual checkup or use rarely the medical services, then they should not take up Medicare Advantage Plans. But those having pre-existing condition are sure to get huge savings by reducing their out of pocket expenses in the long run. It is only pre-existing conditions and end-stage kidney disease that will prevent the person from enrolling, even though there will be required a special plan.