Dealing with a disability can be challenging, and finding the right health coverage under Medicare might seem overwhelming if you’re under 65. At Skyline Benefit, we’re here to make it easier. With Medicare and Disability for People Under 65, you can access essential health benefits tailored to your unique needs. While the options for Medicare beneficiaries under 65 are more limited, effective plans are available to suit your healthcare needs. Let’s explore how Medicare works for those under 65 and find the best plan for you.
What Conditions Qualify for Medicare for People Under 65?
If you’re under 65, you may qualify for Medicare if you meet one of the following conditions:
- You’ve been receiving Social Security Disability Insurance (SSDI) for at least 24 months.
- You have End-Stage Renal Disease (ESRD) requiring dialysis or a kidney transplant.
- You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
These conditions grant eligibility for Medicare, but coverage options can vary, requiring careful consideration of your choices.
What Are the Best Plan Options for Medicare and Disability for People Under 65?
If you’re under 65 and on Medicare, a Medicare Advantage PPO plan is often the best option. Here’s why:
- No Underwriting: These plans don’t require medical approval, making them accessible to individuals with disabilities.
- Network Flexibility: PPO plans allow you to visit in-network and out-of-network doctors, giving you more freedom to choose healthcare providers.
- Additional Benefits: Many MAPD-PPO plans include extra benefits like dental, vision, and hearing coverage, typically not covered by Original Medicare.
Special Needs Plans (SNPs):
- Specifically designed for individuals with chronic conditions such as ESRD.
- May provide transportation, meal services, and care coordination.
Why Medicare Supplement Plans May Not Be an Option
While Medicare Supplement (Medigap) plans are popular among Medicare beneficiaries, they are typically unavailable to individuals under 65 with disabilities. Most insurance carriers decline these applications due to underlying health conditions. This makes it essential to explore alternative options.
How Has Medicare Changed for Individuals with ESRD?
Before January 1, 2021, individuals under 65 with ESRD couldn’t enroll in Medicare Advantage plans. However, the 21st Century Cures Act expanded eligibility, allowing these beneficiaries to choose between Original Medicare and Medicare Advantage. This change offers more flexibility and comprehensive options.
When Can You Enroll in Medicare?
1. Initial Enrollment Period:
– Begins three months before your 25th month of SSDI benefits and ends three months after.
2. Medicare Open Enrollment Period (October 15 – December 7):
– Allows beneficiaries to join, switch, or drop Medicare Advantage or Part D plans.
What Additional Benefits Are Available for People Under 65 with Medicare?
Many Medicare beneficiaries Under 65 can access:
- Coordinated care through SNPs.
- Prescription drug coverage under Part D.
- Comprehensive services under MAPD plans, which often include dental and vision.
Let Skyline Benefit Guide You
Understanding Medicare and Disability for People Under 65 can be overwhelming, but you don’t have to face it alone. Skyline Benefit is committed to simplifying the process and helping you find the best plan for your needs at no extra cost.
Need Help Selecting the Best Medicare Options for for People Under 65?
Skyline Benefit is an independent Medicare insurance broker that offers affordable and flexible Medicare options.
Selecting the best Medicare insurance plans and navigating open enrollment can be overwhelming; our mission is to simplify the process and help our clients every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112