The Social Security Disability and Medicare Double-Whammy

If you have been injured or have suffered a medical condition that prevents you from working, you may be seeking help in the form of Social Security Disability benefits. You think you qualify for benefits, and you send in your paperwork, anxious to get medical care and help with your living expenses.

What you may not realize is that first of all you have to be approved to receive Social Security disability benefits – a process that can take up to 2 years. Once you are finally approved, you find out that you won’t get medical care from Medicare for two more years! What is going on here?

The SSD / Medicare trap

Right now there are about 1.8 million Americans stuck in this two year waiting period. These unfortunate people have been approved to receive SSD benefits, but are waiting to get help with their medical bills. Unable to work, many lack any other form of insurance or private income to pay for hospital visits or doctor’s care, so they are stuck waiting and praying for the best.

While waiting for Medicare benefits to kick in, many people try to save precious dollars by not taking their medications or by skipping doctor’s visits and medical treatments. Unfortunately, this course of action can make their illness or disability work, and tragically one in seven people waiting for Medicare coverage dies before receiving it.

So this begs the question: is a waiting period really necessary? If somebody is sick or disabled enough to qualify for Social Security Disability, shouldn’t they be able to quickly get Medicare coverage?

Saving money, at what cost?

The reason for the 2 year delay is cost savings. In 1972 when Congress originally decided to extend Medicare coverage to people with disabilities they established the waiting period. It was believed that a waiting period would prevent Medicare from overlapping with private insurance and ensure that it was only available to people with long-term disabilities.

Unfortunately for the people who really need health care coverage, this waiting period comes at a terrible time in their lives. Already disabled and unable to work, many cannot afford COBRA and some are simply not eligible for insurance because of pre-existing conditions. This means that 40 percent of people in the 2 year waiting period have no health insurance at all.

Under current law there are two exceptions to the 2 year waiting period. There is only a three-month waiting period for individuals with end-state renal disease and there is no wait at all for people suffering from Lou Gehrig’s disease.

Can the waiting period be eliminated?

It seems like the answer should be obvious: eliminate the waiting period, or at least drastically shorten it. However, like any debate about healthcare the problem is the cost. According to the Congressional Budget Office eliminating the wait for SSD recipients to get Medicare would cost $6.8 billion the first year and then $110 billion through 2019.

There is a chance that some lawmakers will use the current debate on healthcare reform to change how long it takes for SSD benefit recipients to qualify for Medicare. The bottom line is that something has to be done to protect the health and well-being of millions of disabled and sick Americans.

If you have questions or need help please don’t hesitate to contact the Social Security Disability attorneys at Markhoff & Mittman. We can help you with your initial claim or your appeal, ensuring that all the required paperwork is filled out completely and professionally.

Markhoff & Mittman, P.C.

14 Mamaroneck Avenue

Suite 400

White Plains, NY 10601

Toll Free: (866) 205-2415

Phone: (914) 946-1452

Fax: (914) 946-0810

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