Friday, June 15, 2012

What if I am under 65 and disabled?


If I am under 65 and receive Medicare due to disability, does the supplement company have to sell a policy to me? No. At this time, there is no "Open Enrollment" period for disabled Medicare beneficiaries until they are 65. However, new laws are being proposed that would give disabled Medicare beneficiaries an Open Enrollment period.

If I am still working and have Medicare due to disability, can my employer group health plan turn me down?

That depends on the size of your employer.

If your company employs 100 or more employees and:

You work full time and your employer group health plan offers coverage to other full-time employees, they cannot turn you down, or charge you premiums which are higher than other employee premiums.
You work part time and your employer group health plan offers coverage to other part-time employees, they cannot turn you down or charge you premiums which are higher than other employee premiums.
If your company employs fewer than 100 employees, Medicare would be your primary insurance.

Can my working spouse's employer group plan turn me down?

That depends on the size of the employer.

Your working spouse's employer group health plan can only turn you down if the company has fewer than 100 employees. They have to cover you the same as any other spouse. They cannot give you less coverage or charge you a higher premium.
If your working spouse's employer has less than 100 employees, Medicare would be your primary insurance.

What are my other options?

Medicare Managed Health Maintenance Organizations (HMOs) cannot turn you down if you are on Medicare due to a disability.
View Medicare Advantage plans available where I live?
Some companies accept applications for a Medicare supplement policy application from those under 65 and disabled. However, there is no guarantee that they will sell a policy to you.
View companies approved to sell Medicare Supplement insurance.
ICHIA, the Indiana Comprehensive Health Insurance Association, can provide major medical coverage. The premiums and deductibles are usually very high. Call SHIP at (800) 452-4800 for more information.

If you are under 65 and receiving Medicare due to a disability, you trigger an "Open Enrollment" period when you turn 65. At this time, your Medicare is due to age and no longer due to disability.

Under 65 dissable brocchure

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