Social Security & Medicare Questions: November 2010

Social Security & Medicare Questions: November 2010

Q:  My husband recently passed away and I was granted disability benefits.  I had VA health care as his spouse which was provided at no cost to me and included all my medication.  After starting disability benefits, I was forced to relinquish my entitlement to VA care and take Medicare instead at $110.50 per month.  That extra cost has made it especially difficult to meet my monthly bills.  If my benefits are lowered any further, I will lose my home to foreclosure.  Have you heard anything about how the health care reform affects those already receiving SSDI?

A: Medicare provides health insurance to 8 million younger adults with permanent disabilities.  Under federal rules, most people with disabilities who are younger than 65 aren’t eligible for Medicare until at least 29 months after they qualify for SSDI.  In your case you were fortunate to have excellent VA health benefits during those 29 months — something many other disabled individuals don’t have.

But as you point out, Medicare’s benefits are not as generous as those you received through the VA and your out-of-pocket costs can be steep.  In addition to a monthly $110.50 Part B premium, you may also be spending more than $200 per month for a Medigap or another type of supplement, and your Part D premium may add more than $35 to that monthly expense.  And that doesn’t count all of your out-of-pocket costs for deductibles and co-pays.

Medicare premiums are rising in 2011, but Social Security beneficiairies won’t receive any annual cost-of-living adjustment to help offset rising costs.  Most seniors will receive some protection from rising Part B costs by a special “hold harmless” provision of law.  When the Part B premium rises more than an individual’s COLA, the individual’s premium is adjusted to prevent reduction in Social Security benefits from one year to the next.  But there’s no such protection for rising premiums for Part D plans or your Medicare supplement.  Increases in those plans will reduce the amount of Social Security you have to live on.

TSCL strongly recommends that people with disabilities, and seniors who are having trouble affording their Medicare costs, contact their area Agency on Aging or local seniors department to learn about Medicare Savings programs and “Extra Help.” These programs pay some or all of your Medicare Part B and Part D drug premiums, deductibles, and co-pays.  Changes under healthcare reform make it easier for lower income people with Medicare to qualify and the valuable coverage could save you and your home.