Janie Slaven: TONI SAYS: Medicare enrollment times when on Social Security Disability

Janie Slaven, The Times-Tribune, Corbin, Ky.
·3 min read

Jul. 14—Dear Toni,

My husband has met his 24th month of being on Social Security Disability, which qualifies him for Medicare. His disability is due to a severe case of Parkinson's. On August 1 his Medicare Parts A and B will begin, but he is only 64. I am not sure what he should do when he turns 65 in March.

With Paul's serious Parkinson's affecting his health, I am concerned with which Medicare option is best for him. Should he enroll in a Medicare Advantage plan or a Supplement?

Because his Parkinson's medications are expensive, I am concerned about whether he will enter the Medicare Prescription drug donut hole. Can you please advise us on how to find what Paul's best Medicare option will be?

— Sheila from El Paso, Texas

Sheila:

Learning how to enroll in the right Medicare and Part D prescription drug plan when someone has a serious health condition can be extremely complicated. Your current specialists and prescriptions are what the Toni Says Medicare team focuses on for a Medicare consultation.

Those on Social Security Disability and qualifying for Medicare Parts A and B need to be aware that there are two Medicare enrollment times:

1. Enrolling in Medicare under 65. When one's Social Security Disability 24th month passes, the individual is automatically enrolled in Medicare to begin on the first day of the 25th month, as is the case with Paul's Medicare, even though he has not yet turned 65. In Texas, when one is under 65 and eligible for Medicare, there is only one Medicare Supplement plan which you are eligible for with most Medicare Supplement Insurance companies, and that plan is Plan A. Medicare Supplement Plan A works directly with Original Medicare and has more out-of-pocket costs than Medicare Supplement G. Different states have different Medicare Supplement plans available to those under 65.

When one is under 65 and enrolling in Medicare for the first time, we advise the new Medicare client to discuss with their medical professionals and facilities which Medicare Advantage plan(s) they accept to help to pick up their Medicare costs.

Medicare Advantage plans help to cover the Medicare costs that Medicare does not pay for. The Medicare Advantage plan will have deductibles, copays, or other out-of-pocket costs that the Medicare enrollee will have to pay. When under 65, this may be an option to consider since Original Medicare is out-of-pocket. Always verify that your health care professionals and facilities accept and will bill the Medicare Advantage plan you've picked.

2. Turning 65 and on Social Security Disability. Sheila, I have good news for you because when Paul turns 65 next March, he will have a second Medicare Supplement enrollment period which is called the Medigap/Medicare Supplement Open Enrollment Period. He will not have to answer any health questions to enroll in a Supplement, because he has turned 65 — the same as anyone who is just turning 65 and has received both Medicare Parts A and B. Those on Social Security Disability will qualify for Medicare Supplement Plans A-N during the 6-month period that begins the month one turns 65.

The Medicare Part D prescription drug donut hole and Paul's prescription drug plan options are covered during a Toni Says Medicare consultation. We always check prescriptions listed on medicare.gov to determine which Medicare Part D plan best fits a client's needs.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.