You don’t say if you are on dialysis. If you do not have ESRD, you won’t be eligible to get Medicare until you’re 65 or until you receive Social Security Disability Insurance (SSDI) checks for 24 months.
Assuming you’re on dialysis, are you sure you need to take disability? If you’re new to dialysis, you might want to wait to see how you feel before you take this step. Disability typically pays much less than what people can earn from working and there’s a 5 month waiting period before you get your first check, employers are required to make reasonable accommodations for workers with disabilities, including ESRD, and if you’re on home dialysis, you should be able to schedule your treatments around work.
If you must take disability, you may have COBRA rights to continue your company plan for 18 months or another 11 months if you are certified disabled within 60 days. Often a COBRA plan offers benefits that Medicare doesn’t offer. Even if you get a Medicare Part D (drug coverage) plan, you may pay less for drugs with your employer plan. If you are eligible for Medicare, you might want to sign up for it before you sign up for COBRA. If you get COBRA first, your employer can terminate your COBRA coverage if you get Medicare later.
In most states, Medigap plans follow a model designated by letters A-L to make comparisons easy. For example, all Plan Cs have the same coverage so the only difference is cost and ratings of customer satisfation. Your best bet for finding a Medigap (Medicare supplement) is your state insurance department. Some states have regulations that allow people under 65 to get Medigap coverage, but others don’t. Most states have printed booklets and some have information online about Medicare supplement plans coverage and premiums. You might want to call your state insurance department so you can talk with a health insurance counselor. You can find your state insurance department contact info and website by clicking on your state on the map at:
Rerun wrote:
Medicare is only secondary if you are over 65 years old OR you have been on dialysis for more than 30 months. Just wanted to clarify that in case you just assumed you were covered by Medicare as primary insurer.
Rerun, I think you were trying to say when Medicare might be primary instead of secondary. If you don’t have an employer group health plan (EGHP), when you get Medicare it will be primary. If you have a health plan through your own or your spouse’s work (current or former), that plan will pay first for 30 months from the earliest date an ESRD patient can have Medicare (whether he/she takes Medicare or not). If you have an EGHP and Medicare, once the EGHP plan pays, Medicare may pay deductibles, coinsurance, or copays that the EGHP doesn’t pay. Even if Medicare pays nothing, having Medicare protects the patient from being billed by the provider who accepts Medicare assignment (dialysis facilities accept Medicare assignment) for any charges for Medicare covered services that exceed Medicare’s allowable amount. The cost savings from having Medicare just due to this alone is typically worth more than the Medicare premium.
