What Are The Differences Between Medicare and Social Security Benefits?
By Jim A Allsup
Contrary to the commonly mistaken belief, Medicare and Social Security benefits are not one in the same program.
Medicare and Social Security benefits are both funded by federal employment and payroll taxes, but that's where the similarities end. Many people may receive benefits from both programs as they retire or because they have a disability. For people with disabilities, Social Security disability provides financial benefits and Medicare provides medical insurance.
What is SSDI?
Social Security Disability Insurance (SSDI) is a program that provides monthly income to people with disabilities after they are determined to be eligible. It is funded by payroll taxes through the federal government.
What is Medicare?
Medicare is a federally funded health insurance program with four parts: A, B, C and D. These parts (in different combinations) cover physician visits, hospitalization, prescriptions and other necessary healthcare services.
What is the difference between Medicare parts A and B?
Medicare Part A provides coverage for hospitalization, paying a percentage of someone's inpatient care. Given specific medical scenarios, Medicare Part A also extends coverage for hospice, home healthcare and skilled nursing facilities.
Medicare Part B provides medical insurance that covers physician visits, specified outpatient procedures and certain preventative health services (for example, mammograms, blood glucose tests, flu shots and more).
Medicare Parts A and B also are known as "original Medicare."
Medicare recipients also can choose to enroll in Medicare Advantage or Medicare Part C, which combines the healthcare benefits from Parts: A and B, and sometimes prescription drug coverage, or Part D. (Medicare Part D is prescription drug coverage.)
If an SSDI applicant qualifies for Social Security Disability Insurance, is he or she automatically eligible for Medicare benefits?
Not necessarily. Generally, SSDI beneficiaries must wait 24 months after receiving cash SSDI benefits in order to receive Medicare coverage, with some exceptions.
There are a number of prerequisites for receiving Social Security disability benefits, including meeting certain medical criteria. The application, review and approval process for Social Security Disability Insurance can be lengthy. One of the steps for Social Security Disability Insurance (SSDI) applicants is to prove that they are unable to work at any capacity for at least one year.
With Medicare, people can qualify either by age (65 and older) or disability, in other words, by receiving SSDI benefits. As mentioned earlier, 24 months after the award of SSDI benefits, most recipients become eligible for Medicare. Certain exclusions apply. For instance, with end-stage renal disease (ESRD) or a kidney failure diagnosis, patients qualify three months after the first date of dialysis. Individuals with amyotrophic lateral sclerosis (ALS)-often referred to as Lou Gehrig's disease-do not have to wait the typical 24 months to start receiving Medicare benefits. Medicare enrollment guidelines differ for different medical scenarios.
Are there professionals who can help with both applying for SSDI and enrolling in Medicare plans?
Absolutely. Several national firms, such as Allsup, provide Social Security disability representation, as well as unbiased support in understanding Medicare benefits and obtaining a Medicare plan.
Allsup has provided Medicare plan related services to the business community since 1994. An experienced and trusted resource that specializes in helping people obtain their SSDI benefits, we have expanded our Medicare assistance services to individuals who are eligible for Medicare.
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