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Extended Medicare for SSDI Recipients
This provision became effective October 1, 2000
Background:
A Social Security Disability Insurance (SSDI) recipient is entitled to Medicare coverage after 24 months of SSDI eligibility.
Part A, hospital insurance, is automatic and cost free.
- Part B, covering outpatient services, is optional and carries a $96.40 per month premium in 2008. A small number of beneficiaries — individuals with income exceeding $82,000 and married couples exceeding $164,000 — will pay a higher Part B premium based on their income.
Under the old law, an SSDI recipient was entitled to continue Medicare coverage during a nine-month trial work period and for an additional 39 consecutive months following the ninth trial work month.
During this entire period (48 months), Part A coverage was automatic and cost-free.
- During this entire period, Part B continued to be optional and subject to premium payment.
New Provision from the Work Incentives Improvement Act
The new law extends Medicare eligibility, under these same terms, for at least an additional four and ½ years (i.e., 54 months).
- Now when an SSDI recipient goes to work for the first time:
Medicare continues for a nine-month trial work period and at least 93 more additional months.
- This means that the SSDI recipient who goes to work can keep Medicare for at least 102 months (or, nearly eight and ½ years).
Under the new law, Medicare Part A continues to be automatic and cost-free. Part B continues to be optional and subject to premium payment. The new Medicare Part D prescription drug program would also continue to be available during this extended eligibility period.
Note:
Your local Medicaid office can, in many cases, pay for the Medicare Part B premium. This is usually done under the Qualified Medicare Beneficiaries (QMB) program, the Selected Low-Income Medicare Beneficiaries (SLMB) program, or the Qualified Individuals (QI-1) program for individuals with low income. For information about the QMB, SLMB, or QI-1 programs and eligibility criteria, call your local Medicaid office or our Work Incentives Hotline.
Prepared by Neighborhood Legal Services, Inc. - Updated
January 2008
(716) 847-0650 • Work Incentives Hotline: 1-888-224-3272 • www.nls.org
