Disability: Pain Insurance: 12/24 months? Who goes first?

Tony I worked with insurance at my job, you are not being specific enough about which types of insurance you are asking about. Give me some more info and I will try to help.

Tony,
I think I know SOME of what you're asking, but am a little confused, too. Since Susie has worked with this, I'd take whatever info. she gives you as more accurate than mine.

I think what you're referring to as "retirement" insurance is Medicare, which you will receive now that you're officially disabled. However, from my reading that does not kick in until 2 years after the date your disability started (the date your doctor says you were first disabled, not necessarily the date you got your approval). So that, for example, if you were determined to have been disabled starting a year ago, you'd have to wait another year to receive Medicare, unless you were older and then you'd be eligible for Medicare because of age (I believe age 62).

What you seem to be asking is what is your primary insurance (who pays first) and what's considered secondary (who pays what's left, subject to the limits of your policies). I believe once you receive Medicare, it's considered primary for all your health care but I could be wrong. It could be that Medicare is only considered primary for disability related conditions. But what would happen is that bills would likely be submitted to Medicare first, and if they're denied and you set it all up properly with any second ary carriers, the bill should automatically be submitted to the secondary carrier for payment. But again, it's all subject to the limits of your policies.

If your wife has insurance through her employer, and you are on her policy that may be considered primary until you get Medicare. The private insurance can't charge anymore, as they have contracts with the health care providers for certain amounts. If you don't have another private insurer, you'll have to do what most people with Medicare do, and that's get a supplemental policy, of which there are many. You'll have to pay for this (yes, even in retirement, unless you have an employer that's offering this kind of coverage. Most are stopping those programs to cut costs).

Anyway, I don't know if this helps or confuses, but it's a little of what I know.

Oh - and with what's going on in Washington, anything can change!

PaLady

Tony,
From what I know - and I could be wrong here - if you were determined to be disabled starting on April 27, 2009, you wouldn't be eligible for Medicare until April 27, 2011 - a 2 year wait. Unless your age would make you eligible sooner. It makes no sense to me why the wait is so long.

I think I'll wait for Susie to respond and see what she has to say as she's worked with this so much.

I think you'd have to stay on your wife's insurance (unless you have a plan of your own) until you're eligible for Medicare.

I hope I haven't made more of a mess of this with my response! LOL

PaLady

Tony,
I guess I was confused. I thought you wrote that your disability started in 2009. Since it's 4/27/08, as far as I know - and Susie is the expert here - it would be 24 momths after that, so yes, 2010.

The www.ssa.gov site (I put the link to someone else in one of the other threads) answers a lot of questions.

PaLady

If I understand, then there is no confusion, really, until April 2010 (in my case) since Medicare doesn't kick in until then - is that right?

Or is there confusion because Medicare is about to kick in?