Disability and medicare

The only way you would not have to pay for insurance is if you qualify for Medicaid. I usually get a letter automatically each year stating I don’t meet the criteria.

I have a two year wait until I will be 65. I went thru the Affordable Care Act at HealthCare.gov. You will fill out a few questions on line and they will provide a list of plans and costs available to you. Just be sure that the plan you select covers your physicians and facility you want to use. It can be cheaper than Cobra however, be sure you also check each plan for pharmacy benefits as well. You may want to get help from a licensed insurance agent. They do not charge for their services. I found this helpful. My plan was still very pricey since I wanted premium coverage due to the facility I wanted to go to. With that said, Cobra may still be the best deal until it ends, usually at 18 months after you leave your job.

If you have questions, you can also contact your local SS Admin office and speak to a SHIP coordinator.

Once I was eligible for Medicare under disability and still pre-65, I had to get a Plan G
And pharmacy policy… again, it still costs the same as cobra.
Wishing you all the best!

My husband has been on Medicare since he was in his 50’s due to disability from this cancer. Do you have any specific questions? I’ll try to answer them!

Yes, I am 61 and my Medicare actually starts on Dec 1st 2024. You need to be on Social Security Disability for two years and they automatically give you medicare. I actually applied in Aug of 2022 and recieved my first rather large check in Oct 2022. They approved it and back dated to the beginning of the year and paid me all those months back. Because I was diagnosed Pancreatic Cancer in my medical records and not specifically Neuroendocrine Cancer it was easily approved as certain diagnoses are on a short list with Social Security and this one is on that list. Compassionate Allowances also known as CAL.

I had to wait the 2 years on SS disability before I qualified for Medicare. Luckily my COBRA lasted just long enough. My son used the affordable care act and it had expensive premiums, high deductible and copays. It also has a more limited choice of doctors especially for oncology. I agree that COBRA is probably best for many reasons. Expensive premium but better coverage.

For those of you signing up for Medicare for the first time and have cancer or other serious illnesses, know that Medicare supplement plans (like plan G) will accept you when you first enroll but can deny people for pre-existing conditions if you try to switch to that plan later. I have plans A, B, D and G for the greatest selection of care although higher premiums. If you take plan C Medicare Advantage HMO or PPO it’s less expensive but has a more limited provider selection. You probably won’t qualify for plan G later if you change your mind. If you have A and B, you need G or some other supplement/gap plan to pick up the 20% coinsurance with a pricey illness. Seek advice from a broker or agency for your circumstance when first enrolling.

Also, when you qualify under 65, the premium is a little higher than when you’re 65 and over. My premium went down $100/mo. when I turned 65. It can be confusing when first enrolling, but I’m very happy with my coverage and it runs smoothly.

Lastly, C plans are the only ones that include dental, vision, chiropractic and other perks but I chose my plans for better oncology selection. It’s all about trade offs and what is most important to you.

Plan D drug coverage has a lower $2000 per year out of pocket limit per year starting in 2025. It was $8000 in 2024 so that’s a huge help.

Long, but I hope this is helpful info.

It was exactly what I needed. Thank you

Do you have to apply for Medicare separately ?

Once they approve your disability status you are automatically eligible for Medicare after 2 years. They will send you notices
I agree 100% with others that when you do choose a Medicare plan, do not go with Medicare Advantage. It will limit your choice of doctors to a narrow network. If you can afford the premiums, then go with original Medicare and a supplemental plan. That allows you to see any Medicare accepting doctor in the US

This has been a wonderful discussion. I have needed this site for a while. Hard headed and reluctant to ask for help. Sounds like my best bet for now is to find a way to pay for cobra for another year. Continuity of care is important. I just got everything set up. The nurse comes to my house every 3 weeks for my shot and I go to the hospital for everything else. Not sure if the Lanrentide (spelling) is working but the process is pretty smooth now.
Thank everyone for your responses. Hopefully I will have some wisdom to pass on soon