Medicare is a social insurance program that provides Americans with health insurance once they reach age 65. It also provides health insurance to millions of younger people who are disabled. Medicare covers an average of nearly half of health care costs incurred by participant, paying approximately $182.7 billion for inpatient hospital expenses in 2011.
The Medicare program currently utilizes 30 private insurance companies and has four parts: hospital insurance, medical insurance, health plans, and prescription drug plans. To qualify, an individual must have paid into this system during working years or must be receiving Social Security Disability Insurance (SSDI) benefits. Individuals receiving ongoing dialysis due to end stage renal disease or the need for a kidney transplant and those with ALS who are eligible for SSDI also qualify.
Disabled individuals younger than 65 and those receiving SSDI benefits are automatically enrolled in Medicare Parts A and B. They will receive their Medicare cards via mail three months before either their 24th month of disability or turning 65. Individuals with ALS automatically are automatically enrolled in Medicare Parts A and B the month their disability benefits are effective.
Other disabled individuals including those with end state renal disease and those who are not receiving Social Security benefits must enroll in Medicare Parts A and B. The initial enrollment period is the seven months following the date of initial Medicare eligibility. Those who do not sign up during this time may do so between January 1 and March 31 of each year, which is the General Enrollment Period. Their Medicare coverage will begin July 1 of that year. Special enrollment periods are available based on circumstances, so consult a Social Security disability attorney for details.
Though the Centers for Medicare and Medicaid Services manage the Medicare program, the Social Security Administration (SSA) enrolls individuals in Medicare. To sign up for Medicare Parts A and B, an individual can apply on the SSA website, over the telephone, or in person at a local Social Security office. Annual signup is not required but each year enrolled individuals may make changes to their Medicare coverage.
All Americans should understand and exercise their Medicare and Social Security disability rights. Online enrollment in Medicare takes less than ten minutes and does not usually require supporting documentation. Disabled individuals with questions regarding eligibility or the different parts of the Medicare program should contact a Social Security disability expert such as an attorney who specializes in this area of the law.