Hi,
I’m currently working full-time from home, but don’t know how long I’ll be able to continue.
After short term term disability, I’ll need to apply for a long-term. I understand that having MBC will qualify me.
My question is what’ll happen with my medical insurance? How long until I’ll get Medicare?
I’m 60 and living in US.
Thank you for all your help.
hi Tolife_18.
you mentioned that you understand that in 'having MBC, you will automatically be approved for long term disability (SSDI)....so I won't speak to that issue.
once you have been approved for long term disability (SSDI....Social Security Disability Insurance), you will automatically be eligible for Medicare...at two years from your SSDI approval date! at that time, the monthly Medicare premiums will automatically be deducted from your monthly disability payouts.
you can also purchase a 'supplemental' insurance plan to go along with the regular Medicare insurance. I myself, purchased AARP United Health Care supplemental. both the regular Medicare and the supplemental costs me approx $400 per month and is very good insurance. I have almost zero co-pays and do not need referrals to see specialists....I especially like the ability to go anywhere and see any doc/specialist I prefer.
so if you are now 60 and apply for disability asap, you will be eligible for Medicare while you are 62. (without being on disability, Medicare does not begin until at least 65).
obviously, there is a two year wait period for Medicare to kick in. do you presently have insurance that you can keep paying for...COBRA. or maybe you will need to purchase insurance through the Obama care health insurance connector. (not sure that is what it is called?) for that two year period?
probably more info than you requested. but hoping this was helpful🤞.
best wishes.
carole💛
thank you so much. Your response is very helpful.
What makes me furious is 2 year lag until Medicare kicks in. I don’t think that I’d be qualified for Cobra which is along with Obama care cost a lot and cover a little.
I hear you. honestly, I do not understand the 2 year wait period either. that is a long time, especially if disabled. XO
I don't think you need to qualify for cobra. It is just your same insurance from work but you pay the entire premium, which can be costly. You can also purchase from the health insurance marketplace and possibly qualify for a subsidy. There are many pl!ns to choose from.
Nshadt is correct, in the US when you leave a job with health insurance benefits for any reason you can extend your policy and pay for it directly through COBRA (your employer is required by federal law to offer this if you were full-time and had employer-paid health insurance. Your HR dept will have info on this). The standard COBRA extension period is 18 months but this may vary. Alternately if you prefer, you can buy a new health care insurance policy through the Obamacare marketplace which may be less costly. Both are viable options to get you through the 2 years til Medicare kicks in.
There has been a bill introduced in Congress several times now by a group of legislators to end the waiting period for Medicare for cancer patients. This has been going on for several sessions now and it always gets tabled. Maybe we should all start bugging our representatives, always more power in numbers. It is terrible that people who are dealing with so much have that additional (major) worry. I have been working full time for the past two years to maintain my insurance but it hasn’t been easy.
Yes, I agree that something should be done about the delay in starting Medicare . Don’t quite understand what the reasons could be.
Dear Tolife- Was thinking about you and wondering how you are feeling. Are you still in all that pain that you were having a while ago? Good luck with the insurance. I hope that you are able to get a satisfactory resolution. XXX
Hello dear,
It’s so good to hear from you. Yes, quite a bit of pain. The worth part is that I still can’t walk which, obviously creates a lot of logistical and physiological problems.
Be well!
I am now 64 living in the US. I claimed disability at 55. It was the best thing I ever did. I also did it because of long term disability payments from my employer. I have been getting a monthly payment from them and will God willing get it until I’m 67 which is my retirement age. If you are eligible for the the LTD through your employer and can get by on that then great! Just understand if you apply for Medicare, you don’t get that on top of LTD. Medicare will only give you half of your LTD. I wish someone had told me that because I received 70% of my monthly paycheck and I could have survived on that. I would have been able to put Medicare off until 67 and would’ve received higher monthly payments. Good luck with your decision.
'Just understand if you apply for Medicare, you don’t get that on top of LTD. Medicare will only give you half of your LTD. '.......you mean Disability, not Medicare.....right? and same with 'I could have been able to put Medicare off until 67 and would’ve received higher monthly payments'.....once again, you meant Disability and not Medicare....correct?
just clarifying because I want to share this with you. when you apply for US govt Disability, no matter what age you are at approval, you will receive the same amount of payout that you would have received if you had waited for full retirement age at 67. I am an example. I was approved for Disability (SDDI) at age 61. but the monthly payment I receive is based upon as if I had not retired until full retirement age, which for me is 66yrs 8mos.
this was about Disability. Medicare has a 2 year wait period from time of Disability approval to start of Medicare.....unless you are already 65 or older.
hope this made sense....XO
yes you are right about the first part, but if I didn’t collect my disability through Sddi and waited to apply for Medicare which you are right about it taking 2 years, I believe my monthly social sercurity would be higher. Bottom line I should not have applied for disability through Social Security. 🙏🏻
hello dear- it is my understanding that actually those of us given disability at an earlier than full retirement age, are not disadvantaged by this and are paid out as if we had retired at full retirement age…I had my cancer at 60… received SSDI at 62 and the payment is what I would get at full retirement age which for me was 67(born 1960) so that is good for most of us I think. The hard part is working the 2 years… but do apply early as it took me nearly a year.
Thank you, I do hope you are correct
hi again. Betty explained it better than me. however, that is what I was trying to explain in my previous reply. you are not penalized for applying early. and you end up receiving the disability payments as though you are at full retirement age. I applied for Disability at age 61 but my monthly payments are in the amount of what I would get at full retirement age of 66yrs 8 mos (I was born in 1958). XOXO
I didn’t know that! Thank you for everyone’s knowledge.
❤️
thank you all for the very informative replies.
I’m paying into LTD through work and will need to go into the details to understand the complete picture.
Hope that everyone is comfortable with their financial arrangements (MBC is VERY expensive disease). And can focus on their health.
I have had MBC in bones since 2018. I managed to work 3 years full time until 2021. I was on Short Term Disability starting 2/1/21 for 6 months then LTD. While on STD & LTD, I paid my company monthly for my health insurance (I paid exactly what the amount that was deducted from my paycheck as if I was still working). I was automatically put on Social Security Disability a month after LTD started. So LTD deducted my SSD amount from my total LTD-you CANNOT double dip! When I turned 65 last year, Medicare kicked in BUT I only took Medicare A because I was still considered an employee and paying the company for the insurance. It wasn’t until I was let go from the company last year in April( they closed the facility) that I had to get Medicare B but I decided on going on COBRA. So Medicare B is my primary and COBRA is secondary (beforehand it was the other way around). After Cobra comes to an end or before, I we will be covered through my husbands insurance. His insurance was not nearly as good as mine at the time, so we stayed with mine. I am lucky my husband could afford the Cobra-though the cost was not bad for both of us for complete coverage, no referrals, low deductible, dental & eye. He has Medicare A & B too. His company has better insurance now and we will be on it when enrollment period starts. Supplemental insurance will be chosen when he retires. We will be 66 this year.
Ask a social worker about a pooled trust spenddown. I was so lucky to get into a cancer center that had palliative care doctors, CT scans and radiation were all in basement. They also had social workers. I live in NY and since I was not working I was under the illusion I had no job so I had no medical so I went to a hospital for women with no insurance ONLY to find out I was on medicaid (I had no clue).
I had tried to buy insurance on the Obama marketplace, but it was so confusing to me that I gave up. Then I started getting all these brochures in the mail, and just tossed them in the garbage after reading one or two. I thought great now that they have my address, I will be getting loads of these envelopes.
Apparently since I did not know that the marketplace seen I had no income coming in, no savings so immediately I qualified for medicaid so they chose the medicaid plan for me and sent me a card (that I tossed LOL). When that ended and it was like six months before Medicare the social worker told me calm down, I go through this all the time. I was then put on the special NY Medicaid and not only that, but they had volunteer lawyers that went to different cancer centers one day a week.
I would think at least for that period of time, you would qualify for the special NYC medicaid to tide you over until Medicare kicks in and if you can get the assistance and help with the paperwork, you MAY also be able to qualify to have Medicaid pay for your medicare. Google advocates or Google special NYC Medicaid and who it applies to.
If it were not for the lawyers and social worker, I never would have known all of this.
The volunteer lawyers and social worker set me up with a pooled trust. I had to apply to be on medicaid and, of course, got rejected bc I was making too much as a single person just with my SSDI. So when you get rejected, Medicaid would send you a letter telling me, that in my case, I was $1,700 over the limit. So that was my spenddown. And because financially I was basically broke, I qualified for the MSP (Medicare Savings plan) and then I had full Medicare PLUS full NYC medicaid. I joined, as the social worker suggested, Center for Disability Rights (CDR), and they would take out the $1,700 (the spend down) and put it into a trust in which they paid my bills with. They would automatically send out my rent two weeks earlier bc that amount was the same every month and I would scan them my Verizon and Discover credit card bills which they would pay for me and they only charged $20.00 a month.
Many people are not aware of this pooled trust. You can own a home, a car and still join a trust. OH, THE BEST PART, because I was on the QMB Plan, Medicaid also paid Medicare my monthly charge (I think it was like $160) and I never laid out a penny for anything.
Please look into it. Find an advocate and join a pooled trust. I had never heard of it before (but I was never that sick before) and it was a blessing. To date, I am still not paying for my Medicare, Medicaid pays them. Whatever Medicare does not cover (which is alot as I found out...I stupidly thought Medicare was just like Medicaid LOL) and did not realize one had to pay monthly. So for the past four years, I have not paid for my medicare nor any drug. Please look into it. It is a blessing in disguise.
Last year in 2022, I was only allowed to "keep for myself" $934 (and they let you keep an extra $20 if you are on SSDI). This year bc the increase was so big the qualifying factor for a single person (like myself with no kids) I am now allowed to keep $1,546.00. So I cut down what I was giving to CDR and besides the increase I now have an extra $600 that I can keep.
Now bc we got a big increase (8.7% which the last time it was that large was I think 1982) so Medicaid now raised the limit and I can keep $1,560.00 and still qualify as a single person.
So I let CDR take out $1,375.00. My rent is $1,350.00 and then $20 for them so I am left with a $5 balance each year. (Because when I pass, CDR or any pooled trust (some charge way too much) gets to keep whatever is in there so you put the smallest amount that you will use every month to pay your bills. (They do not allow alcohol or gift cards on your credit card statements bc people can sell them to get more money for themselves.)
I now get $2,850.00 every month with SSDI. Plus, unlike 2022, when all I could keep was $954,00, now I can keep $1,562.00 for myself. It is the unknown secret, the pooled trust. I was just lucky that my cancer center had full resources and the lawyers practically did all the paperwork for me although I had to go and apply knowing I would be denied, just to know what my spenddown is. Please look into it.
thank you dear. This is very helpful. I’m happy that you’re able to get help with insurance and some financial help.
Hi Tolfie. I am in a similar situation. Currently working full time from home, however the day will come when I need to transition to STD then LTD through my employer. From what I have learned approval under the LTD policy is more difficult and may require assistance from an Attorney who specializes in disability insurance. The first LTD claim submission is often denied. A friend with MBC had her LTD claim denied because a box on the Insurance Company form was not checked. Ask your HR department for a copy of your company’s benefit handbook outlining your STD and LTD benefits. SSDI is an automatic approval for MBC. Medicare is 2 years. Another friend who went the SSDI Route received a large first time check dated back to her MBC diagnosis. It is challenging to sift through all the Insurance information. It just wears you down. However it might be worthwhile to hire a lawyer if able or check with your cancer center to see if help is available from a social worker or pro bono from a lawyer.
One thing I forgot to add. Employers are not required to provide health insurance while out on STD or LTD. As an example my employer provides employer paid health insurance during STD but there is nothing written about health insurance under the LTD section and I fear they may not. Although the policy pays 60% of your salary tax free because the cost of the LTD benefit was employee paid and deducted from my pay check after taxes. When I go on SSDI, the SSDI will be subtracted from the amount my LTD pays. Fortunately my brain is still functioning to some degree to be able to keep up with all this.
employer’s policies are very different. And it’s also depends on the state you live in.
When I was on STD, I was paid 100% of my salary. I still paid the taxes and my portion of the cost of health insurance.
I have LTD through my employer, but paying for it after taxes. It’ll pay 65% of my salary and I’ll likely have health insurance without my contribution. Not sure how long it’ll be.
Will cross that bridge when I’ll get there.
Ibrance and/or long term port & Blood Clots? 
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IBRANCE (75 mg) Long Term (over 5 Years)
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